Unhealthy behavior in hospitals and health care systems

Screaming matches in front of bewildered patients. Angry surgeons hurling instruments across the operating room. Treachery and backstabbing as physicians and nurses try to undermine one another.

It may sound like a script from a television medical drama, but these kinds of scenarios are occurring frequently in hospitals and health care systems across the country, according to a new survey conducted by the American College of Physician Executives. The survey of more than 2,100 physicians and nurses found examples of bad behavior are common in the health care field.

Many also wrote in with personal stories of behavior they witnessed:

• A physician groping a radiology tech as she attempted to take an X-ray.
• A nurse who spread false rumors about a new doctor in hopes of getting him fired or disciplined.
• A surgeon growing so enraged with a nurse that he stuffed her head-first into a trash can.
• Another physician telling a nurse, "You don't look dumber than my dog. Why can't you at least fetch what I need?"

According to the participants, the fundamental lack of respect between doctors and nurses is a problem that affects staff morale, patient safety and public perception of the industry.

Nearly 98 percent of survey participants reported behavior problems between doctors and nurses at their organizations. The most common complaint was degrading comments and insults, which nearly 85 percent of participants said they had experienced at their organization. Other typical complaints included yelling, cursing, inappropriate joking and refusing to work with one another.

The problem is not new. In fact, it is so widespread that The Joint Commission issued a statement requiring health care facilities to adopt zero tolerance policies for disruptive physician behavior by January 1, 2009. But the ACPE survey illustrates just how pervasive the behavior is.

Survey participants and experts in behavior also offered suggestions about the best ways to address the issue, from improved training for medical and nursing students to strict policy guidelines that carry real consequences.

The survey and related articles are being published in the November\December issue of ACPE's journal of medical management, "The Physician Executive."

For complete results, please contact Carrie Johnson, ACPE Director of Public Relations, at [email protected] or (800) 562-8088.

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