The new Joint Commission (JCAHO) definition of “disruptive physicians” has been changed to “disruptive behavior” and refers to anyone working in a Hospital or Healthcare Organization. Physicians and Physician Well-Being Advocates protested the unnecessary demonizing of physicians who are most likely experiencing enormous stress and burnout by labeling them as “disruptive physicians”.
The wide range of inappropriate and appropriate resources for physicians include the following:
- Comprehensive mandated: “Evaluation of disruptive behavior may require a multiplicity of assessments, including a psychiatric assessment, medical and laboratory work-up, addictions and trauma evaluations, psychological and neuropsychological testing, and brain imaging studies such as an MRI or even functional scans such as PET or SPECT examinations. Note that even negative findings can assist in establishing that disruptive behavior is not neurologically, but rather personality based, for instance”, according to Dr Donna Yi, MD, Mennenger Clinic, Texas.
- Seven Day, Inpatient Assessment including many of the exams listed above including the physician’s level of addiction to rage (rageaholism).
- Counseling or psychotherapy by Marriage Counselors, Anger Management Counselors, Licensed Professional Counselors and Psychologists with or without experience or training to work with persons who exhibit skill deficits in emotional intelligence.
- According to a December, 2010 article in the New York Times, “An entire Cottage Industry has developed to provide services to “disruptive physicians”.
The 2012 Industry Standard for Legitimate Coaching and Courses for “disruptive physicians” are listed below:
The Program for Distressed Physicians
The CME program was designed as part of the ongoing mission of the Vanderbilt Center for Professional Health’s commitment to physician well being. We have titled the course “distressed” instead of disruptive since the basic behavior of these physicians results from internal factors that is obvious from the experiences we have seen in the physicians attending the course.
The central theme for the course is to provide physicians with disruptive behavior a safe, confidential environment where they can learn with their peers about the origins and consequences of their actions. This environment must be conducive to open discussion in small groups with no more than seven and no less than five physicians in each group. The therapeutic modality is guided small group interaction. Each physician is given the opportunity to tell their story and confide their fears and hopes with other physicians in the group.
The Program for Distressed Physicians provides services in groups of 7 physicians each quarter for total of 27 physicians per year.
Anger Management For Healthcare Professionals Program
This course is designed to help those physicians and healthcare providers who have contributed to a disruptive working environment by way of inappropriate expression of anger. Conflict, stress and disruption in the hospital and clinic setting create low morale, heightened rates of staff turnover, and patient safety concerns.
The Anger Management for Healthcare Professionals program is a small, (6-8) participants), intensive and highly interactive three -day course taught by UC San Diego faculty from the Department of Psychiatry. Participant coursework in the form of self-reported inventories of mood and interpersonal conflict as well as reading is required.
The objectives and goals of this course include:
0.Aiding participants to identify triggers in the workplace leading to disruptive behavior.
0.Didactic instruction providing constructive tools and strategies to aid in diffusing and managing anger and conflict in an appropriate and professional manner including:
◦ Increasing Emotional Intelligence
◦ Empathy Training
◦ Transforming conflict into cooperation
0.Practicing both behavioral and cognitive strategies, including coping mechanisms, leading to healthier communication and interactions in the healthcare environment.
0.Developing a personalized plan of action (Commitment to Change)
PACE provides a dynamic training program that offers professionals an opportunity to obtain educational information and personalized assessment in a highly sensitive, supportive and confidential environment away from the workplace.
The Anderson & Anderson Executive Coaching for “disruptive physicians”
This is the largest program currently in existence for the assessment and coaching of “disruptive physicians. Services are available nationwide seven days per week with no limit on the number of referrals.
Services are provided either at Anderson & Anderson in Los Angeles or On-site, at the convenience of the physician anywhere in the United States. The Anderson & Anderson coaching for “disruptive physicians” uses a coaching curriculum based on Emotional Intelligence skill enhancement. This curriculum was designed in conjunction with physicians.
Each participant completes the Bar On EQ-i-2.0 Emotional intelligence Assessment that is considered the industry standard in emotional intelligence assessments worldwide. All training material is mailed to the participant in advance of the first session.
The Coaching is offered in two phases. The Bar On EQ Assessment is administered on-line prior to Phase One. Phase One consists of two days of assessment debriefing and skill enhancement coaching. All services are provided individually and are strictly confidential.
Phase two consists of twice monthly coaching sessions via phone over a 6- month period. At the conclusion of this six-month period, the physician completes the Bar On EQ Assessment again to determine the success or lack of success of the coaching.
In summary, Physician Well-Being Committees, Local, Regional and National Medical Associations should caution their physician members against taking risks that may unintentionally damage their careers such as information provided to The National Practitioners Data Bank based on inappropriate assessments or intervention for “disruptive behavior”. Such assessments are far more damaging than the “disruptive physician” label that fortunately is being changed to disruptive behavior.
George Anderson
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