Bad physicians do spoil the bunch, eroding trust in healthcare professionals

Trust is a big component of the relationship between patients and healthcare professionals and can be eroded by misconduct on the part of those professionals, new research confirms.

A study conducted in the United Kingdom examined the most prevalent forms of wrongdoing and how that misconduct undermines trust in healthcare professionals and confidence in the system. Researchers at Coventry University’s Centre for Trust, Peace and Social Relations took a closer look at cases of misconduct from the Professional Standards Authority database, the group that oversees nine statutory regulators in the country.

The researchers examined 6,714 "fitness to practice" cases from three groups of healthcare professionals: doctors, nurses and midwives, and allied professionals working in the U.K. The researchers looked at the most serious cases, which are referred to a formal panel hearing, and examined the documents that record decisions taken.

From the analysis, the researchers identified three forms of misconduct that undermine patient trust:

1. "The self-serving bad apple." These are individuals who undertake premeditated and strategic wrongdoing often involving either multiple offenses against the same targets or across multiple targets.

2. "The individual who is corrupted by the falling standards of their workplace." The researchers said misconduct arises in workplaces with poor climates.

3. "The depleted perpetrator struggling to cope with the pressures of life." The research suggests the influence of stress and strain in misconduct.

The researchers applied cluster analysis to identify how different kinds of misconduct group together. They also looked in more detail at cases involving dishonesty and theft, the most prevalent misconduct common to all three types of healthcare professionals, and sexual misconduct, the most severe form of wrongdoing.

“In shining the spotlight on professional practice in the health sector, we're examining relationships that are often intimate in nature and based on trust and confidence between health workers and service users,” said lead study author Rosalind Searle, a professor of organizational behavior and psychology, in a statement from the university. “It's crucial, therefore, for us to analyze where and how these taken-for-granted notions are being undermined through misconduct, and to take steps towards reducing instances of such behavior.”

Doctors in the U.K. are not alone in experiencing stress. New research shows that burnout has led 1 in 5 doctors in the United States to plan to reduce their clinical hours. And roughly 1 in 50 plans to leave medicine altogether within the next two years.