840 physicians responded to a survey in a study by QuantiaMD, sponsored by the American College of Physician Executives. The results are eye-opening, not only because of what it says about some in the medical profession, but because it shows there is a long way to go before hospitals and physicians can partner in meaningful ways that will reduce costs while improving the quality of care. Every healthcare reform effort will require a heightened level of physician-hospital collaboration and multi-disciplinary collaboration. This study does not bode well for these expectations:
More than 2 in 3 U.S. doctors witness other physicians disrupting patient care or collegial relationships at least once a month. More than 1 in 10 see it every day.
An example in the ACPE’s white paper on the study: A doctor who was being monitored because of a long history of rudeness again yelled at a nurse, resulting in “significant medication error and harm to a child.”
Not uncommon behaviors also included discriminating against colleagues or patients, inappropriate jokes, profanity and spreading malicious rumors, retaliating against perceived slights, and throwing things.
These behaviors not only poison the environment for patients, staff and other physicians, they impact the quality of care and put the hospital at significant legal risk, particularly as more physicians are employed by hospitals.
It should be noted that there are many fine physicians who do behave badly, and stress, adapting to constant change and increasing workloads have been identified as contributing factors. This does not change the fact that these behaviors are far more prevalent than should be acceptable. Some survey respondents actually indicated that these behaviors are learned in medical school!
Physicians, themselves, see the problem and understand the ramifications. We recently had a discussion with a group of physician leaders from some respected healthcare systems and they were adamant that something must change - not only when it comes to managing these behaviors, but also in the hiring and recruiting process, to identify the risks of these behaviors. Certainly, physicians are invaluable resources, but often their value to the medical staff and the hospital is more than offset by the disruption they cause. Given what we need to accomplish, the cost-benefit analysis is shifting.
We need to chart a new course by educating young physicians about their roles as leaders. We also need to maintain a level of professional autonomy for physicians, but also communicate our expectations that they demonstrate the ability to adapt to change, to lead, to manage, and to collaborate, professionally, with colleagues and staff. Then we need to implement a process to identify and develop these positive competencies, while avoiding the type of behaviors revealed in this study. We are working on some innovative approaches and would love to hear your thoughts.