The most common problems exhibited by disruptive physicians are:
 Depression
  • Anxiety
  • Burnout
  • Stress
  • Family discord    
Programs for “disruptive physicians”
  • Continuing Medical Education Programs
  • Anger Management Classes
  • Emotional Intelligence for Impulse Control
  • Psychiatric inpatient or out-patient treatment
Continuing Medical Education programs by definition are designed to educate rather than change behavior. Therefore, these programs are limited in terms of their ability to recognize or respond to individual issues that play a role in many physicians’ disruptive behavior. All of these interventions are offered in small group settings without the opportunity to address personal issues. Continuing Medical Education Courses for disruptive behavior are usually two or three day small group classes.
Anger Management Classes are unregulated and are frequently provided by scam artists. Many California based Anger management classes can be completed on-line. These classes have no content and are not regulated by any entity. Unfortunately, many health care organizations as well as Medical Licensing Boards are not aware of appropriate interventions for “disruptive physicians”.
Emotional Intelligence Coaching for Impulse Control is currently the most popular intervention for “disruptive physicians” in the U.S. This coaching is offered on an individual bases following a Pre EI assessment and includes a client workbook along with a Post assessment at the completion of the coaching. A clinical assessment is a routine part of the client intake. It is during this assessment that related problems like those mentioned above are identified and either addressed or appropriately referred.
Inpatient Psychiatric Treatment has traditionally been reserved for persons who are a danger to self or others. The Joint Commission does not include impaired physicians, substance abusers, or sexual abusers in the category of “disruptive physicians”. It is difficult to explain how any physician can be mandated for inpatient or out patient psychiatric treatment for “disruptive behavior”. It is equally unclear as to how any type of psychiatric treatment can be provided for a non-DSM diagnosable illness. It is necessary to justify inpatient treatment. Physicians who are labeled as suffering from serious psychopathology are at risk of career derailment.
Individual treatment is necessary for most of the common problems seen in physicians mandated to receive a program for “disruptive physicians”. Providers who lack training, experience and competence in psychotherapy are not capable of addressing problems that require treatment by licensed mental health clinicians.
Lectures and role-play on communication and life/work balance may be useful but unlikely to address a physician’s symptoms of anxiety, depression or marital conflicts. Evidenced based intervention including Pre and Post Assessments are clearly needed in all interventions for disruptive physicians. Emotional intelligence skill enhancement for self-awareness, self-control, social awareness, empathy and other EI competencies offer the best chance of improving interpersonal relationships in work and intimidate
 George Anderson, MSW, LCSW, BCD