Beyond Substance Abuse: Stress, Burnout, and Depression as Causes of Physician Impairment and Disruptive Behavior

Disruptive Physicians: How Behavior Can Undermine Patient Safety

“…Disruptive physician behavior is defined as that which "interferes with patient care or could reasonably be expected to interfere with the process of delivering quality care" [3,5]. The FSMB outlines a number of behavioral sentinel events attributed to disruptive physicians ( Table 1).…”

“…Table 2 highlights a number of these effects [8]. Resident physicians are at increased risk of suffering from mood disorders partly because of high levels of workplace stress and exposure to abusive behaviors [3]. A prospective study of pediatric residents showed that depression was associated with six times the number of medication errors.…”

“…Disruptive behavior should be considered a manifestation of an underlying issue [5]. The most common include substance abuse, stress, burnout, and depression [3].…”

“…Mood disorders such as depression and bipolar disorder have the same incidence in physicians as the population at large [3]. Some reports cite even higher rates of depression [24] and suicide [25] in physicians.…”

“…When competence breaks down, a physician may become impaired if they have "any physical or mental condition that detrimentally affects or is likely to affect, [the] capacity to practice medicine" [2,3]. At least 30% of all physicians will be impaired at some point in their career, with about 1-2 per 100 physicians per year being affected.…”