The Joint Commission’s "Disruptive Physician" Standards Spawn a Cottage Industry of Questionable Providers

Effective January 1, 2009, JCAHO issued new guidelines to respond to the negative behavior of physicians that often places patient care at risk while increasing medical errors. These new standards make it mandatory for Hospitals to establish written policies designed to address what is defined as "disruptive physician behavior".

Essentially, a "disruptive physician" is one whose behavior is described as demeaning, aggressive, uncivil, or hostile to colleagues, patients or ancillary staff. The American Medical Association (AMA) has defined disruptive behavior as a style of interaction with physicians, hospital personnel, patients, family members, or others that interferes with patient care.

The recommended intervention is unclear in the Sentinel Alert from the Joint Commission on this matter. However, since there were already standards for psychiatric impairment, sexual harassment/boundary issues and substance abuse, the lack of specific intervention models for "disruptive physician behavior" have made it possible for psychiatrists, psychologists, and mental health providers to claim that psychotherapy is the intervention of choice.

Recently, in-patient Substance Abuse Rehab Centers have joined the chorus of instant experts by declaring that "disruptive physicians" are really "rage-aholics" who are addicted to anger and, therefore, can best be treated in in-patient Substance Abuse Facilities using a 12 Step program. Their argument is that all forms of addiction are responsive to the same intervention.

Even though there is no evidence that anger is an addiction, unsuspecting Hospital and Healthcare organizations are being duped by substance abuse marketers and providers into supporting this radical intervention for "disruptive physicians".

Psychologists, psychiatrists and other mental health clinicians are ignoring the fact that anger is not listed in the Diagnostic & Statistical Manual of Nervous and Mental Disorders (DSM IV), and, in fact, anger is a normal human emotion, which is a problem when it is too intense, occurs too frequently, lasts too long, has health implications, impacts interpersonal relationships or leads to person-directed aggression or violence. They are offering traditional insight-oriented psychotherapy or cognitive behavior therapy to address what amounts to problems in recognizing and managing anger and stress.

Self proclaimed anger management providers are offering on-line anger management with overnight Certificates of Completion for a fee of $40 with no questions asked. Many of these providers are located in Orange County, California and Charlotte, North Carolina.

The three most reputable programs for "disruptive physicians" are:

• The PACE Program at the University of California School of Medicine at San Diego.
• The Distressed Physician Program at Vanderbilt University School of Medicine in Nashville, Tenessee.
• The Anderson & Anderson Emotional Intelligence/Anger Management Coaching Program for "disruptive physicians" in Los Angeles, California.

These three programs were designed specifically for physicians in need of skills in recognizing and managing stress, recognizing and managing anger, increasing emotional intelligence/empathy and mastering assertive communication.

George Anderson, BCD, LCSW
Anderson & Anderson, APC
Trusted Name in Anger Management
310-207-3591
http://www.andersonservices.com/

Emotional Intelligence, The Most Effective Intervention for Executives

High level executives rarely need help in leadership skill enhancement. Nor are they deficient in team development, decision making, commitment ethic or time management. The fact that these executives have achieved their current status is an indication of their proven leadership skills. All of the above skills are key elements in effective organizational leadership.

What is generally lacking in most Executive Coaching programs for attorneys, physicians, and corporative Vice Presidents, are accurate assessments needed to determine the level of executive clients’ functioning in a wide range of emotional intelligence skills that are essential for the maintenance of high morale and a spirit of goal achievement in the workplace.

Included below is a list of the main tools useful for executives in maximizing the performance of employees in any organization:

·Interpersonal Assertion
·Self-Awareness
·Empathy
·Stress Management
·Self-control/anger management
·Effective Communication/listening skills
·Social-Awareness
·Relationship Management·Leadership

A careful review of the emotional intelligence skills listed above demonstrates that there is nothing here to suggest mental illness, substance abuse or psychiatric impairment. Rather, all of the above behaviors are learned and responsive to change. Therefore, for motivated participants, skill enhancement can be improved in all emotional intelligence areas with specific strategies designed for skill enhancement.

Executive Coaching Programs based on Emotional Intelligence always begin with a series of comprehensive Emotional Intelligence assessments to determine the clients’ current level of functioning in these areas. Emotional Intelligence Assessments are followed by skill enhancement coaching to address categories in which the participant scored in the need to improve range. Post Assessments are conducted following the Coaching. This is essential both for the executive client, the coach and the client organization.

Emotional Intelligence Coaching for Executives is available on-site anywhere in the United States or at the Los Angeles office of Anderson & Anderson, APC. Anderson & Anderson is the industry standard in Executive Coaching/emotional intelligence for physicians and high profile clients nationwide.

George Anderson, BCD, LCSW
Anderson & Anderson, A.P.C.
Trusted Name in Anger Management
310-207-3591
http://www.andersonservices.com
http://www.aaamp.org
http://www.anger-management-resources.org

How to Use Anger Management to Create Additional Revenue Streams for Non-Profits

Anger management is one of the new secrets to survival for money strapped non-profit social service agencies nationwide. California leads the nation in its cutbacks on funding for non-profit social service agencies as well as public schools.

As an antidote to loss of funding sources for community services, many organizations have discovered the tremendous new funding available from a wide range of untapped sources interested in promoting anger management as a violence prevention/intervention for children, adolescents, adults and couples.

School districts throughout the nation are contracting local, non-profit social service agencies that are Certified to offer assessments and intervention to students who are seen as at risk for person-directed aggression or who are perpetrators of violence in the school setting. Many school districts use anger management as an alternative to suspension for aggressive behavior at school. This avoids the loss of average daily attendance funds that occurs when students are suspended.

Mental Health Organizations are overwhelmed with referrals for anger management. Since anger is not a pathological condition, anger management cannot be billed as treatment or psychotherapy. Therefore, it is far less expensive and more effective for County and State Mental Health Departments to contract with competent, Certified Anger Management Facilitators from non-profit organizations to provide these needed services.

Family Service Agencies have traditionally provided a wide range on mental health as well as social services to families including substance abuse, domestic violence, parenting and outpatient mental health counseling. Family Service organizations are now being required to demonstrate training and Certification in Anger Management in order to bid on contracts to provide anger management.

With the unprecedented violence in Chicago during the last few days, At Risk Youth are again in the news. While the Chicago School System has invested in metal detectors and increased security, anger management has not been considered a viable intervention. We now see the results of this oversight.

Probation Departments in Texas and California are routinely training Adult and Adolescent Probation Officers to use anger management with probationers on their caseloads who have a history of person-directed violence as a part of their criminal history.

The California State Department of Parole has implemented a new mandate that requires all parolees to complete a 52 -week program in anger management prior to being released from parole for any parolee whose original offense included aggression or violence. The Parole Department routinely contracts for anger management services with non-profit organizations throughout the state of California.

Organizational anger management training is relatively new and not yet well understood. This type of intervention consists of small group trainings that are limited to one or two hours. Each intervention begins with an assessment, a generic feedback and mini lectures on anger management, stress management, communication and emotional intelligence.

The City of Los Angeles has one of the oldest and most respected After School Programs in the nation. This program is the recipient of major grants from the Broad Foundation of Los Angles. In addition to tutoring, it has always included anger management assessment and classes for most students enrolled in after school programs. The city of Los Angeles only contracts with Non-Profit agencies to provide after school anger management classes.

How to secure anger management contracts for non-profit organizations:

• Arrange for at least two members of your staff to receive a 40-hour Anger Management Facilitator Certification.
• Purchase and use a curriculum that includes a Pre and Post Test or one that is evidenced based.
• Contact your local probation, parole, public schools, mental health departments and at risk programs for youth and ask if your organization may send a proposal to provide this service.
• Use your agency’s website to announce your interest and availability to provide anger management to after school programs.
• Go to google and type in “opportunities for contracting” to provide anger management for jails and prisons.
• Co-sponsor a 40 hour Anger Management Facilitator Certification training in your city.
  

Finally, there are funds available from the U.S. Department of Justice to provide anger management in Youth Programs.

George Anderson, BCD, LCSW, CAMF
Anderson & Anderson, A.P.C.
Trusted Name in Anger Management
http://www.andersonservices.com
http://www.aaamp.org
http://www.anger-management-resources.org