“Standards set by the Joint Commission for Accreditation of Healthcare Organizations can help medical staffs deal with disruptive physician behavior in a fair, organized fashion. Should a physician’s disruptive behavior reflect a health problem, the JCAHO standards go further to require the medical staff to implement a process to identify and manage the individual physician’s health-related matters. In some cases disruptive behavior may be reasonably interpreted to require anger and/or stress management or formal behavioral counseling and monitoring.”

-- Michael D. Youssi

Physicians accused of “disruptive behavior” are organizing to develop stalling tactics to delay being held accountable for alleged “disruptive behavior by hospital committees responsible for disciplining doctors. While the new standards were introduced in April, many hospitals have been unable to institute these new requirements because of the opposition of some physician groups.

The 360-Degree Feedback which is a respected technique in coaching is being used to delay for at least 6 months, any action against physicians whose behavior defined as “disruptive. The 360-Degree Feedback refers to a process in which data is collected from multiple sources or multiple raters surrounding the person being assessed. Respondents may include self, supervisor, reporting employees, peers, and, in some cases vendors/clients. Applications include performance appraisal, professional development, succession planning, assessing organizational climate, and targeted competency areas specific to the individual being assessed.

Physicians who are mandated to enroll in a coaching program for anger are given an opportunity to opt for the above assessment which will be conducted twice over a 6 month period. If the initial assessment does not indicated “bad behavior” on the part of the physician, any further action against him or her is dismissed. If the assessment indicates problem behavior, the physician is given another three months to change the behavior in question. If the 6 month assessments suggest the need for professional help, the physician is then mandated to enroll in an anger management coaching program.

It is likely that a careful, objective monitoring of this novel program will reveal that it is a stalling tactic rather than a reasonable response for “disruptive behavior”.

George Anderson, MSW, BCD, CAMF
Diplomate, American Association of Anger Management Providers