Evidenced Based Intervention Is The Missing Link In programs for "disruptive angry physicians".

Two of the three current coaching, classes or continuing education programs for "disruptive physicians" do not offer evidence of the success of its interventions.

The Joint Commission On The Accreditation Of Healthcare Organizations in its Sentinel Alert regarding "disruptive physicians" announced its initiative to require all Healthcare Organizations to establish policy for addressing the issue of anger and abuse on the part of practicing physicians. It is this alert that lead to the development of these programs.

Below is a summary of the three largest programs for "disruptive physicians" in the nation.

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 US 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:

•                Aiding participants to identify triggers in the workplace leading disruptive behavior.

•                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

•                Practicing both behavioral and cognitive strategies, including coping mechanisms, leading to healthier communication and interactions in the healthcare environment.

•                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 University of California, San Diego School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of California, San Diego School of Medicine designates this educational activity for a maximum of 30.50 AMA PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

There is no mention of a Pre and Post Assessment in this important model of intervention for "disruptive physicians".

Center for Professional Health, Vanderbilt University School of Medicine.

§      Background


§      The disruptive physician is an emerging issue for all who are concerned about physician wellness, positive outcomes in patient care, and a healthy working environment for the healthcare team. Disruptive behavior of these physicians in group practice or on hospital staffs is well documented. The American Association of Physician Executives polled their membership and found that a small percentage of physicians in the practice groups were responsible for most of the disruptive physician behavior. Nurses were often the targets of these physicians’ rage or uncontrolled frustration. 

The continuing medical education (CME) course for distressed physicians was developed at the Center for Professional Health (CPH) because of the belief that these physicians could be helped in an educational environment. The need to address this problem was confirmed by the experience of Dr. Roland Gray, Director of the Tennessee Physician Health Program, with disruptive physicians that were being referred to him on a daily basis from hospitals and practice groups in Tennessee. Cases of disruptive behavior by physicians who are acting out their frustrations with variety of inappropriate behaviors are very complicated and time-consuming. These behaviors become so routine that nurses are afraid to work with them either on the wards or in the operating room.
The CPH at Vanderbilt organized the Program for Distressed Physicians in 2005 patterned on the format of the other CME courses that had proven successful for physicians in the CPH. They are described on the CPH web site: www.mc.vanderbilt.edu/cph. 


This intervention model includes a formal psychiatric association prior to admission. Both of the above interventions are offered in a group format based on "role play". There is no mention of a Pre or Post Test or Aftercare.

General Description:

The Anderson & Anderson Disruptive Physicians / Executive Coaching / Anger Management Program™ is designed to meet the needs of high-level executives, physicians, and those clients who prefer to be seen on an individual basis for specialized coaching and privacy.  The program includes, The Practice of Control, the Anderson & Anderson “disruptive physician” client workbook, along with Gaining Control of Ourselves DVD, and Contrasting Wheels of Behavior – the does and don’ts of self-control.

EQ-i 2.0 Pre & Post Assessment:    SAMPLE REPORT PDF

Each of our coaching clients will receive an E-mail containing access to the internationally recognized Bar On EQ-i 2.0 Model of Emotional Intelligence.  This is conveniently online 24/7 available to fit your schedule. Our Clients report back that it takes about 13 – 20 minutes to complete. We actually encourage you to “not think” while taking it for most accurate helpful results. So the fast routine is read and answer. Next. Read and answer and so on. You will find it easy.

This comprehensive assessment examines the following Emotional Intelligence competencies:

Emotional Self-Awareness, Self-Regard, Self-Actualization, Emotional Expression, Independence, Assertiveness, Interpersonal Relationships, Empathy, Social Responsibility, Impulse Control, Reality Testing, Problem Solving, Stress Management, Flexibility, Stress Tolerance, Optimism.

Following the Pre Test plus six months of individual coaching a Post Test is administered to determine the level of success or lack of success. This means that each client and each referral source can determine the results of the intervention for his physician.

In contrast to the two University based programs, the Anderson & Anderson model consists of 12 hours of live individual coaching  along with six months of skill enhancement coaching via phone.

This is the only program that offers on-site coaching anywhere in the U.S.

George Anderson, MSW, BCD, CEAP, LCSW