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Multidisciplinary committee cuts back on disruptive physician behavior

Nurse Leader Weekly, May 2, 2003

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Disruptive physicians make other care providers less likely to question the physician's judgment or to offer information that the physician needs to make an informed treatment decision. They also cost hospitals about $150,000 annually in unnecessary staff turnover costs. This can create a dangerous situation for your hospital and its patients.

That figure could easily double if the physician's behavior inspires a lawsuit from a patient or harassed employee, estimates John Henry Pfifferling, PhD, a Durham, NC-based anthropologist who specializes in changing disruptive physician behavior. Pfifferling also directs the Center for Professional Well-Being in Durham, NC, which he describes as "a glorified charm school" that helps disruptive and impaired physicians change their behavior, often using anger management techniques.

Consider this: Most liability lawsuits filed against hospitals involve a communication breakdown between providers.

One large Houston hospital wards off disruptive behavior through a multidisciplinary oversight committee that includes representatives from nursing, laboratory, and medical staff. The committee operates as part of the peer review function and is responsible for investigating all complaints and concerns about a practitioner's behavior, explains one TX risk manager.

Anyone who works at the hospital can approach the committee with a concern. All concerns must be submitted in writing. If the committee can substantiate the complaint, it confronts the physician and discusses ways to change his or her behavior. In most cases, the physician's disruptive behavior stops.Support from the medical staff is fundamental to the committee's effectiveness, says the risk manager.

Here are other road-tested tips to help you divert disruption:

1. Have a heart-to-heart. Ask someone who has a good relationship with the offending physician to confront the physician about his or her disruptive behavior. Disruptive physicians often are not aware of how negatively their behavior affects colleagues.

2. Research available resources. Most state medical associations and insurance carriers provide inservices and information about the causes and cures for disruptive behavior.

3. Formulate feedback. Solicit staff feedback on a regular basis. It can come from anonymous questionnaires or from routine conversations with medical staff and other employees.

Adapted from: Briefings on Liability Risk Reduction, www.hcmarketplace.com/Prod.cfm?id=1264&S=ENMW.

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