Physician disruptive behaviors: Five year progress report

Table 1 Barriers

Organizational responsiveness (code of silence)

Reluctance to act (financial/hierarchy)

Structure and process (policy/reporting)

Process review (bias/conflicts of interest)

Intervention (skill sets)

Recommended action

Physician liabilities (personality)

Table 2 Risks of non-action

Organizational morale

Recruitment and retention

Staff/patient satisfaction (HCAHPS)

Community reputation

Patient complaints/malpractice

Care efficiency (process flow/delays/utilization/productivity)

Poor compliance (documentation/metric based performance)

Communication gaps/medical errors/adverse events

HCAHPS: Hospital Consumer Assessment of Healthcare Providers and Systems.

Table 3 Recommendations

Awareness and responsiveness

Address organizational culture

Solicit project champions

Develop policies and procedures

Implement a consistent reporting and review process

Follow established process

Document all interactions

Intervention with trained personnel

Prevention

Provide physician/staff education (recognition/accountability)

Provide physician training (diversity/conflict management/communication skills)

Offer physician assistance and support (coaching/counseling/behavioral intervention)

Enhance physician engagement (input/motivation/alignment/satisfaction)

Recognize efforts