This Viewpoint discusses the problem of disruptive behavior among physicians and offers guidance for developing a medical culture of safety with clear expectations and standards.
Concerns regarding the “disruptive physician” have been reported in the medical literature for at least the past 30 years. Recently, there has been the perception that the problem is increasing, although it is unclear if this is because of increased awareness or greater surveillance or because more physicians are acting unprofessionally. A report from 2006 estimated that 3% to 5% of physicians had demonstrated behavior that interferes with patient care or could be expected to interfere with the process of delivering quality care.1 Disruptive behavior has been described as “disruptive behavior by a physician, sometimes called ‘abusive behavior,’ generally refers to a style of interaction by physicians with others, including hospital personnel, patients, and family members, that interferes with patient care or adversely affects the health care team’s ability to work effectively. It encompasses behavior that adversely affects morale, focus and concentration, collaboration, and communication and information transfer, all of which can lead to substandard patient care.”2