The Missing Link in the JCAHO “Disruptive Physician” Standards

Healthcare organizations nationwide, through their Physician Well-Being Committees and Credentialing Committees, are searching for appropriate resources to refer physicians who are considered to exhibit “disruptive behavior” at work. Unfortunately, the needed missing link is a directory or list of “approved programs” designed exclusively to address this issue.

Doctors are a highly trusted and valued group of professionals in all cultures. They enjoy social respect, but also have significant social responsibilities. Doctors who fail to maintain professional standards and conduct cause social concern, because they may do harm to patients if their performance is poor. The loss of a doctor has effects on service provision, and may be expensive to health care providers.

Doctors may fail to perform well for a number of reasons. Stress related problems, depression and substance misuse are known to be commoner among doctors than other similar professional groups. One particular manifestation of poor performance has been described as “disruptive” behavior or unprofessional conduct. These are situations where physicians are unhelpful, rude, or even abusive.

Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments. Safety and quality of patient care is dependent on teamwork and communication. To assure quality and to promote a culture of safety, health care organizations must address the problem of behaviors that threaten the performance of the health care team.

Below is a list of established organizations which provide assessment, intervention and monitoring of “disruptive physicians”:

Program for Distressed Physicians (Vanderbilt University)

The Center for Professional Health offers a three-day continuing medical education course (CME) to address the specific needs of physicians whose workplace behavior has become problematic. This course combines didactic presentations, role-play with focused feedback, group feedback from peers and colleagues, plus review of workplace/family complaints. Participants will receive training in alternative behaviors and explore cognitive distortions that relate to their problems. The course will focus on the problems identified by specific complaints. The solutions are reinforced by role-play, feedback, testing and group accountability.

An appropriate referral to this course would follow an assessment and evaluation to rule out medical and psychiatric problems. Contact William Swiggart for details.

The three-day Continuing Medical Education course follows an assessment. The course fee is $4000, which includes three follow-up group sessions with course participants facilitated by course faculty. There is no discount for missed follow-up group sessions. Vanderbilt University School of Medicine is accredited by the Accreditation Council for CME to sponsor continuing medical education for physicians. The Vanderbilt School of Medicine Division of Continuing Medical Education will award up to 48 AMA PRA Category 1 Credit TM for the completion of the course, homework and all follow-up sessions.

For more details and explanations of course material and assessments contact:

William Swiggart, M.S., L.P.C.
Training Director
The Center for Professional Health
1107 Oxford House Nashville, TN 37232 - 4300
Tel: 615-936-0678
E-mail: CPH@Vanderbilt.edu or william.swiggart@vanderbilt.edu
Web Site: www.mc.Vanderbilt.edu/cph

Anger Management for Healthcare Professionals Program (UCSD)

This course is designed to help those physicians and healthcare providers who have contributed to a disruptive working environment by way of inappropriate expression of anger. Conflict, stress and disruption in the hospital and clinic setting create low morale, heightened rates of staff turnover, and patient safety concerns.

The Anger Management for Healthcare Professionals program is a small, (6-8 participants), intensive and highly interactive three day course taught by UCSD faculty from the Department of Psychiatry. Participant coursework in the form of self-reported inventories of mood and interpersonal conflict as well as reading is required.

The objectives and goals of this course include: Aiding participants to identify triggers in the workplace leading to disruptive behavior.

Didactic instruction providing constructive tools and strategies to aid in diffusing and managing anger and conflict in an appropriate and professional manner including:

• Increasing Emotional Intelligence Empathy Training

• Transforming conflict into cooperation.

• Practicing both behavioral and cognitive strategies, including coping mechanisms, leading to healthier communication and interactions in the healthcare environment.

• Developing a personalized plan of action (Commitment to Change)

PACE provides a dynamic training program that offers professionals an opportunity to obtain educational information and personalized assessment in a highly sensitive, supportive and confidential environment away from the workplace. Participants who successfully complete the course receive 30.5 CME Category One credits.

UCSD PACE Program
1899 McKee Street, Ste 126
San Diego, CA 92110
Email: ucpace@ucsd.edu

Executive Coaching/Anger Management for Disruptive Physicians™

In response to the need for a one on one individual and sensitive intervention coaching model for physicians, Anderson & Anderson is now offering a twelve-hour coaching program with 6 months of aftercare for “disruptive physicians”.

This course is available at our Brentwood, California office or on-site seven days a week anywhere in the United States. The Anderson & Anderson Executive Coaching/Anger Management Program™ is listed in the Directory of Physician Assessment and Remedial Education Programs, Federation of State Medical Boards. No other anger management provider is authorized to use this model.

Components of the course include:

• One day, on-site observation (optional)

• Comprehensive Emotional Intelligence Assessments are given at intake, focusing on the participant's level of functioning in managing stress, anger, communication and emotional intelligence.

• We do not provide psychological testing, nor is our intervention considered counseling or psychotherapy. Therefore, there are no stigmas attached.

• "The Practice of Control", the new Anderson & Anderson Physician client workbook, includes didactic information and exercises focusing on enhancing emotional intelligence, improving assertive communication, as well as behavioral strategies for recognizing and managing anger and stress.

• Complimentary "Gaining Control of Ourselves" DVD along with follow-up kit.

• "Styles of Communication" and "A Day Without Stress" are two power DVDs that are also complimentary.

• Post-test at completion designed to determine the level of change during the course.

• Bi-monthly follow-up sessions are provided for a six-month period when needed.

Our services are provided with the utmost in confidentiality for all participants.

Anderson & Anderson is the Preferred Provider for Kaiser Permanente Health Maintenance Organization of Southern California. For more information, call our office at 310-207-3591 now.

Anderson & Anderson® Executive Coaching/Anger Management Program
12301 Wilshire Blvd. Suite 418
Los Ángeles, CA. 90025
Phone: 310-207-3591
www.andersonservices.com
greynotions@aol.com

Pinegrove Professional Enhancement Program
2255 Broadway Drive
Hattiesburg , MS 39402
Contact: Greg Phillips
(800) 301-6693
www.pinegrovetreatment.com

Elmhurst Memorial Healthcare
Professionals at Risk Treatment Services
360 W. Butterfield Road Suite 340
Elmhurst, IL 60126
Contact: Mary Pittman
(630) 758-5110 www.emhc.org

The Professional Renewal Center® is an international provider of behavioral health services and consultation for professionals striving to resolve work related challenges and personal dilemmas.

Our central purpose is to objectively assess and treat disruptive behavior, professional sexual misconduct, boundary problems, career burnout, psychiatric illness, compulsive behavior, and substance related disorders.

Our aim is to enable our clients to develop life plans that foster authenticity, personal growth, and professional integrity.

More than 900 clients from 48 states in the United States, four Canadian provinces, and Hong Kong have come to the Professional Renewal Center® for assessment and treatment.

Professional Renewal Center
1201 Wakarusa, Suite A-4
Lawrence, KS 66049
Contact: Kirsten Judd
(877) 978-4772 www.prckansas.org

Physicians Development Program
2000 South Dixie Highway., Suite 103
Miami, FL 33133
Contact: Larry Harmon, PhD
(305) 285-8900www.physiciansdevelopmentprogram.com