The Disruptive Radiologist

Ulreich, Sidney; Harris, Robert D.; Sze, Gordon; Moriarity, Andrew K.; Bluth, Edward I.

doi:10.1016/j.jacr.2015.02.013

Cited by 11 publications

(21 citation statements)

References 11 publications

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“…Conflicting goals, interests, and incentives have led to a wide variety of misaligned behaviors (1). These behaviors can negatively affect or potentially negatively affect patient care (2). Therefore, preventing and managing disruptive behaviors are critical to optimizing performance.…”

Section: Sa-cme Learning Objectives Introductionmentioning

confidence: 99%

Optimizing Performance by Preventing Disruptive Behavior in Radiology

2018

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Disruptive behaviors impede delivery of high-value health care by negatively impacting patient outcomes and increasing costs. Health care is brimming with potential triggers of disruptive behavior. Given omnipresent environmental and cultural factors such as constrained resources, stressful environments, commercialization, fatigue, unrealistic expectation of perfectionism, and burdensome documentation, a burnout epidemic is raging, and medical providers are understandably at tremendous risk to succumb and manifest these unprofessional behaviors. Each medical specialty has its own unique challenges. Radiology is not exempt; these issues do not respect specialty or professional boundaries. Unfortunately, preventive measures are too frequently overlooked, provider support programs rarely exist, and often organizations either tolerate or ineffectively manage the downstream disruptive behaviors. This review summarizes the background, key definitions, contributing factors, impact, prevention, and management of disruptive behavior. Every member of the health care team can gain from an improved understanding and awareness of the contributing factors and preventive measures. Application of these principles can foster a just culture of understanding, trust, support, respect, and teamwork balanced with accountability. The authors discuss these general topics along with specific issues for radiologists in the current medical environment. Patients, providers, health care organizations, and society all stand to benefit from better prevention of these behaviors. There is a strong moral, ethical, and business case to address this issue head-on. ©

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Section: Sa-cme Learning Objectives Introductionmentioning

confidence: 99%

Optimizing Performance by Preventing Disruptive Behavior in Radiology

2018

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“…A private group in some cases may be able to punish the disruptive behavior of one of its providers with monetary penalties, additional call duty, decreased vacation time, or termination of employment. 2 However, in the event of an egregious act such as a sexual attack or other assault, the provider may need to be immediately suspended pending further review. In serious and/or persistent cases of disruptive behavior, especially if collegial discussions are not effective in changing the situation, the medical executive committee needs to get involved quickly.…”

Section: Remediationmentioning

confidence: 99%

“…It is therefore important that disruptive behavior by a provider be addressed as soon as possible, preferably immediately. 1,2 Typically for physicians, if disruptive behavior is not first addressed and changed by members of the team or peers in 1 or more conversations, then the individual should be spoken to by the departmental chairperson, chief medical officer, medical affairs vice president, and/or the chief of staff. If the departmental chairperson is the point person, it is often wise to have one of the other aforementioned officials present as well, especially if it is anticipated that the discussion will be heated and/or if the departmental chair and the disruptive individual have a history of negative interactions.…”

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confidence: 99%

Quality and Safety in Healthcare, Part LXXIV

Harolds¹

2020

Clin Nucl Med

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Disruptive behavior has major adverse consequences for patient care, morale of the staff, and institutional reputation. Disruptive actions must be confronted as soon as is feasible. Usually, such behavior will not recur following 1 more firm conversations by officials of the healthcare institution, but if necessary disciplinary measures and/or remediation may be necessary. Rarely, because of egregious or repeated offenses, it may be obligatory to suspend the privileges of the individual permanently or until there is further evaluation, such as by a subcommittee of the medical executive committee or perhaps by a fitness-for-duty assessment by an outside organization.

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“…Letters of reference have been shown to not be a reliable way to identify potential problem physicians [38], likely an effect of selection bias. There was significant interest in utilizing emotional intelligence scores during residency interviews as a predictor for future success; however, studies have shown mixed results [39][40][41].…”

Section: Vignettes In Patient Safety -Volumementioning

confidence: 99%

Disruptive Physicians: How Behavior Can Undermine Patient Safety

Tatebe¹,

Swaroop²

2018

Vignettes in Patient Safety - Volume 2

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Disruptive physician behavior is a pervasive threat to patient safety and a source of emotional and financial hardship on the health care system. It causes increases in medical errors, staff turnover, and risk of litigation. Behavioral problems can be symptoms of underlying issues that must be addressed, such as substance abuse, psychiatric conditions, or burnout. Reporting of disruptive behavior is low, especially by colleagues. Current methods in place in many health care systems do not adequately recognize warning signs or take appropriate corrective actions to limit the effects of disruptive physicians. Changes must be made at a system level to improve rehabilitation of problem physicians.

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The Disruptive Radiologist

Cited by 11 publications

References 11 publications

Optimizing Performance by Preventing Disruptive Behavior in Radiology

Optimizing Performance by Preventing Disruptive Behavior in Radiology

Quality and Safety in Healthcare, Part LXXIV

Disruptive Physicians: How Behavior Can Undermine Patient Safety

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