There's no place for disruptive behavior in healthcare

Has the healthcare industry gone too far in cracking down on disruptive behavior? Is it okay for doctors to be rude, dismissive and act like jerks if they have superior surgical skills?

Those are the questions raised this week in an article that explored whether the patient satisfaction movement has gone too far and perhaps, in some cases, disruptive physicians aren't so bad.

Surgical residency programs now place tremendous emphasis on the need for communication, teamwork and leadership, Wen Shen, M.D., a surgeon at the University of California-San Francisco writes in the Pacific Standard. While admirable, he says they are losing ground in teaching surgeons how to operate.

"The next generation of surgeons might be better behaved," he writes, "but worse at their job." 

In the quest to obtain high patient satisfaction scores, Shen wonders whether we reward physicians who have good personalities, but a track record of poor outcomes compared to their more egotistical counterparts. And, "In trying to shape our trainees to be all things to everyone ... we run the risk of creating a workforce caught somewhere in the middle, not doing anything well," he writes.

But isn't it possible for our medical professionals to have superior technical skills and a gentle bedside manner? Why can't we have it both ways?

Over the years, I have encountered rude, ill-tempered clinicians. Two experiences were so awful that I left the practice for good and found a physician who would listen to my concerns and provide exceptional care. I can only imagine what it was like for the nurses and staff to work with this bully every day.

Studies show that disruptive behavior in the workplace, especially healthcare, results in negative consequences. In many instances, the bad behavior distracts the healthcare team and results in a potential medical error, William Martin, a DePaul University professor and expert on disruptive workplace behavior, told earlier this year

It's also why the Joint Commission issued guidance in 2008 warning hospitals that intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and adverse outcomes, increase the cost of care and force medical personal to seek new positions.

But the bullying culture thrives in healthcare because of a perception that harshness whips employees into shape, according to Ilana Yurkiewicz, a third-year medical student at Harvard Medical School, in a column for Aeon Magazine.

"Arguments such as these run counter to all the data we have on patient outcomes," she writes. "Brutality doesn't make better doctors; it just makes crankier doctors. And shame doesn't foster improvement; it fosters more mistakes and more near-misses."

Do you agree? Share your thoughts below.-- Ilene (@FierceHealth)

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