Disruptive physician behaviour is not something hard for the first time. The struggle to juggle with the mounting work pressure and personal life is real and very raw. The repercussions of which are felt by the colleagues, nurses, staff, patients, and other acquaintances at one time or another.
However, it is important that we address the precarious situation with utmost care and sensibility. Do not flounder in making the distinction between the assertive personality and behavior of the physician in certain situations.
For instance, a physician is being extra stern to a nurse in a jam packed hospital can be deemed as inappropriate and disruptive. But not if he or she has innate personality of a dominating individual or is neck deep in work.
As per the American Medical Association Code of Medical Ethics in 2009, disruptive actions include “any abusive conduct, including sexual or other forms of harassment, or other forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.”
If you have witnessed any such incident or in knowledge of such occurrence, please be known staying silent is not the right solution.
Herein, we will list out four mandatory steps that can help you contain the situation:
The first and foremost step is to focus on building a professional working environment that manifests clarity over what constitutes disruptive behavior and severity of its repercussions. The HR has an active role to play in establishing the right code of conduct for physicians, nurses, lab assistants and other staff members.
Most of the hospitals have clearly defined bylaws whose tenets are to be adhered to in order to maintain the sanctity of the respectable profession. It will include:
There shouldn’t be any discrepancy in determining the nature of the incident both by the physician as well as the person at the receiving end.
Having frequent incidents of disruptive behavior can rupture the core of the health care system of any hospital or clinic. From causing fear amongst the staff members to affecting the patient care, the direct impact of such incidents can be far reaching.
Report them to the authorized person to ensure that corrective action can be taken before it is too late. Most of the hospitals follow extremely formal and detailed procedure and protocols to report the unwarranted or unfavorable physician behavior.
It is then the duty of the designated authority to configure the actual nature of the incident to get a clear insight. All the important facets must be recorded with complete clarity so as to create a universal definition of the incident.
This would help in anticipating the future course of action towards the main culprit and the affected parties. Lack or inadequate formal procedure could cause distrust amongst the staff and they may deter reporting such serious incidents in future.
Accept and acknowledge the severity of the situation or incident to ensure a corrective course of action in the larger interest of the healthcare system. For instance, determine if it is the first ever incident or a case of repeated behavior. Do not shy away from accepting such shameful incidents to save your face.
Get a detailed record of any such similar incidents in the past so that a better decision can be made. Ideally, an informal or private conversation with the individual is preferred. However, if he or she is a repeat offender, then a more formal format must be adopted with the leadership coming into immediate action to set things straight.
Having said that give a chance to the concerned physician to explain his or her side of the story to be on a fairground. A thorough discussion is needed to avert such situation in future.
As part of the corrective plan agreed upon, keep a close eye on the physician to determine if he or she is abiding by the directions or not. The duration can vary from one month to at least 6 months or even more.
Though relapse can happen if the case is grave, improvement in the overall conduct must be appreciated. If an unfortunate case, if there is no change in the behavior, severe penalties including suspension must be considered.
In situations, wherein the internal medical team and the HR is struggling to get to the root cause of the problem, Dr. DeLaRosa and his highly qualified and trained team could provide suitable solutions to address the disruptive behavior disorder amongst physicians.