Physicians can be hard driving, high performing individuals whose professional training usually doesn’t involve a lot of interpersonal skills development. In fact, the process of going through internship and residency may involve a fair amount of harsh treatment, thus modeling behaviors that contribute to an aggressive organizational culture. It’s not surprising that some doctors bully nurses, hospital workers, and their peers.
Vanderbilt University Medical Center program
From healthcare, here’s one interesting program created specifically to deal with doctors who engage in disruptive behaviors, including bullying. The Center for Professional Health at the Vanderbilt University Medical Center has instituted a program for identifying, treating, and remediating disruptive behaviors by physicians. Under the program, complaints lodged by patients and others are used to identify physicians who may be behaving in disruptive ways. When necessary, a full assessment will evaluate all the circumstances surrounding a physician’s counterproductive behavior. This will lead to an individually tailored plan of education and counseling.
The Vanderbilt program focuses largely on the circumstances and actions of the offending physician. This makes eminent sense where the conduct has been inappropriate, disruptive, and potentially harmful to co-workers and patients, and the physician appears to be a candidate for whom education and counseling may have a positive remedial effect. The Vanderbilt program appears well situated to deal with such cases in a fair and responsive manner. Too many times, discussions about bullying and emotionally abusive conduct dismiss the possibility of working with the offending employee, but here this rehabilitative goal is paramount.
However, the Vanderbilt program is not without its limitations. It implicitly downplays how a negative organizational culture or acts by other individuals may trigger or contribute to behaviors deemed “disruptive” in quite predictable ways. For example, expressions of anger, derogatory comments about the institution, and various withdrawal strategies may be defensible, or at least understandable, responses to a dysfunctional, hostile, and/or non-inclusive work environment. Ironically, targets of severe bullying at work may react in just such a manner.
To learn more
An article fully describing the Vanderbilt program, written by program founder William Swiggart and his colleagues, appears in the Summer 2009 issue of Frontiers of Health Services Management. Here is the citation: William H. Swiggart, et al., A Plan for Identification, Treatment, and Remediation of Disruptive Behaviors in Physicians, Frontiers of Health Services Management, Vol. 25, No. 4 (Summer 2009). The article is not freely available online, but a symposium issue of the journal on bullying in healthcare containing the Swiggart piece, another lead article, and two responses (including one that I wrote) may be purchased here.
Link to the first in this series of posts on bullying in health care, discussing the Joint Commission standards
Link to the third post in the series, discussing tort claims brought against physicians by healthcare workers
Link to the fourth and final post in the series, discussing bullying of nurses and how nurses’ unions can respond