“Disruptive physician behavior” Will Dramatically Increase Under The New Health Care Law

Currently, inappropriate displays of anger among physicians at work is exhibited by 4% of physicians in the U.S. Anger is a normal human emotion that is considered “disruptive” in healthcare organizations when it is too intense, occurs too frequently, lasts too long, damages work relationships or compromises patient safety.

The Joint Commission requires that all healthcare organizations address this issue by establishing guidelines regarding “disruptive behavior”. This includes written policy to define unacceptable behavior as well as resources to address anger that risk patient safety.

According to healthcare experts, the Affordable Care Act will strip away physician autonomy, drown doctors in bureaucracy, and drain job satisfaction. As the profession deteriorates, older doctors will retire while younger doctors will look to switch careers. Many students considering a career in medicine will pursue other opportunities. The supply of providers will dwindle as demand for services reaches an all-time high.

Medical school training does not prepare doctors to develop skills in emotional intelligence designed to increase self-awareness, self-control, social awareness and relationship management. These and other Emotional Intelligence skills are the keys to success in interpersonal relationships including empathy, leadership, stress management, effective communication, and positive bedside manner.

Coaching for “disruptive physicians” is rapidly becoming the most popular niche in Executive Coaching. Many physicians are seeking assistance for impulse control/anger management. Some physicians are becoming Coaches for “disruptive physicians”.

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Anger Management Is Not An Alternative For Psychotherapy

Although anger is not an illness nor a DSM-5 Diagnosable Disorder, it is often the subject of counselors and psychotherapists who view all behaviors as subject to counseling or psychotherapy (“treatment”). The rationale often used is that anger is often a symptom of other disorders such as anxiety or depression or personality disorders and therefore should be explored in treatment.

The American Psychological Association fought tirelessly to get anger listed as an illness in the DSM-5 without success. After years of research, the Group For The Advancement Of Psychiatry that is responsible for the Diagnostic And Statistical Manual decided against adding anger as an illness. Consequently, the insurance industry as well as the criminal justice system are seeking non-psychiatric evidenced based interventions based on skill enhancement in self-awareness, self-control, social awareness and relationship management. These programs must include a Pre and Post Test along with a published curriculum designed to teach skills in impulse control.

Currently, Emotional Intelligence skill enhancement in impulse control is the favored choice of intervention for anger management programs in the U.S., Canada, England as well as Argentina, Puerto Rico and Mexico.

Problem anger has long been associated with substance abuse and Post Traumatic Stress Disorder. However, in both of these disorders, anger is a prominent symptom but not the primary diagnoses. Therefore, anger management must always be seen as an adjunct of the mental health intervention rather than the intervention of choice for the DSM-5 diagnosed disorder.

All Certified Anger Management Facilitators (CAMF) must be trained to provide Pre and Post Tests in Emotional Intelligence/Impulse Control and coaching for the defined deficits that are identified in the initial assessmment. Client workbooks must contain the exercises needed to master these skills.

Criminal Defense Attorneys Are Using Anger Management For Leniency

California Judges are ruling in favor of criminal defendants who enroll in anger management coaching prior to arraignment in domestic violence cases. This strategy is designed to convince the courts to show leniency in favor or defendants who are able to demonstrate that they acknowledge the need of anger management coaching and are moving proactively to seek assistance.

Current overcrowding in California Jails are also a factor in avoiding jail sentences in favor of rehabilitation. In Los Angeles County, the Superior Courts, District Attorney, Probation Department, Department of Children and Family Services and the Public Defender’s office have been successful in contracting with a Vendor to train and certify anger management facilitators to provide anger management classes and coaching in Los Angeles County.

All Certified Anger Management Facilitators in Los Angeles County must receive 40 hours of training and complete 16 hours of continuing education yearly. In addition, all approved programs must use a Pre and Post Test and client workbooks.

It appears that California will set a trend for other judicial districts nationwide.

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