New JCAHO “disruptive physician behavior” Standards Create Conflict Among Hospital Administrators and Medical Staff

Hospital administrators and doctors nationwide are experiencing problems in establishing and implementing the new JCAHO standards regarding “disruptive behavior” for physicians. Physicians are appropriately concerned over any possible damage to their future careers as the result of having been referred by their credential committee, physician well-being committee or any other disciplinary unit or hospital administration for “disruptive behavior”. Therefore, they have argued forcefully for all types of written assurances to protect themselves from risk.

One of the consequences of this squabbling is the delay in the implementation of these new standards. Some of the new policies appear to stall actions against any physician accused of disruptive behavior for at least six months. The physician becomes the subject of a survey taken by other physicians and staff associates. Other staff members in the physician’s specialty area are asked to respond to a series of questions regarding his or her demeanor in relation to patient care and interpersonal interaction. The goal is to see if the physician is able to make changes in his or her behavior without intervention. If positive changes are reported, the survey is repeated in three months and a decision is made to dismiss the action or to order anger management.

What is clear so far is that psychological/psychiatric intervention is not seen as an acceptable remedy for disruptive behavior by any of the new policies that are being adopted. All physicians routinely reject any record of intervention, which implies treatment for mental or nervous disorders. This is a reasonable strategy since anger is not a pathological condition. Rather, according to the American Psychiatric Association, anger is a “lifestyle issue” that is generally stress related. It is not a diagnosable mental or nervous disorder.

Anger is a normal human emotion, which is a problem when it is too intense, occurs too frequently, lasts too long, is harmful to one’s health, leads to person-directed aggression or damages interpersonal relationships.

To date, it appears that physicians are more comfortable with individual coaching designed to teach skills in recognizing anger, stress, assertive communication, and enhancing emotional intelligence.

Anger management is or should be a class which begins with a series of objective assessments for anger, stress, communication and emotional intelligence and is followed by individual coaching or classes designed to teach enhancement skills in the same four areas mentioned above.

There is absolutely nothing which can be perceived as negative in learning to recognize and manage stress and anger as well as enhancing skills in assertive communication and emotional intelligence.

Those physicians who have participated in Executive Coaching/Anger Management for Physicians quickly recognize the value of this type of intervention and actually endorse the this type of non-psychiatric intervention.

Physicians from the following hospitals have successfully completed the above model of intervention:

St. John’s Hospital
Santa Monica, California

Cedar-Sinai Medical Center
Los Angeles, California

Santa Monica Hospital Center
Santa Monica, California

Midway Hospital
Los Angeles, California

McHenry Hospital
McHenry, Texas

Harlingen Baptist Hospital and Medical Center
Harlingen, Texas

Hospital Corporation of America
Richmond, Virginia

Kaiser Permanente
California

UCLA Medical Center
Los Angeles

Southeast Georgia Health System
Brunswick, GA

John C. Lincoln Hospital
Phoenix, AZ

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org/
http://www.linkedin.com/in/geoanderson
http://www.anger-management-resources.org/