The culture of silence: disruptive and impaired physicians

An experienced hospital CEO examines the emergence of disruptive and impaired physicians as an overwhelming problem for hospital medical staff nurses, and administrators. The poor behavior ranges from aggressive acts of yelling, swearing, or pushing to passive ones of being chronically late or providing inadequate chart notes. The Joint Commission on the Accreditation of Healthcare Organizations and the American Medical Association have standards and guidelines to minimize unprofessional behavior that negatively impacts hospital patient care. The hospital staff and employees fear retaliation and the stigma associated with "tattle telling," and demonstrate a reluctance to confront the physician or peer, resulting in a culture of silence. The healthcare industry has a "history of tolerance and indifference to intimidating and destructive behaviors." To combat this 'silent response," hospitals have created wellness committees composed of caregivers such as physicians, nurses, and therapists who are specifically trained by an outside entity skilled in hospital wellness committee response functioning. The culture of silence must be replaced with the culture of safety.