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/