Physician behavior: not ready for 'Never'land

Area of Science:

• Medical practice and physician behavior analysis.

Background:

• Disruptive physician behavior is a recognized concern in healthcare.
• Limited data exist on the actual frequency and types of reported behavioral issues.

Purpose of the Study:

• To determine the prevalence and nature of reported physician behavioral issues.
• To analyze patterns in reporting based on physician demographics and specialties.

Main Methods:

• A retrospective review of two years of blinded physician behavior reports.
• Analysis included department, gender, event summary, and peer review conclusions.
• Chi-square analysis was used to assess statistical significance (P < 0.05).

Main Results:

• 191 behavior issues were reported involving 114 (18%) of 640 physicians.
• 44 physicians (7%) accounted for 63% of reports; multiple-report physicians had more communication issues.
• Higher incidence in anesthesia, cardiology, hospitalists, orthopedics, trauma, and obstetrics/gynecology; female physicians reported less.
• Fewer than 1% of reported incidents were deemed validly disruptive.

Conclusions:

• Disruptive physician behavior is variable and context-dependent.
• Robust definitions and thorough peer review are essential for accurate assessment.
• Current reporting suggests a low incidence of genuinely disruptive behavior requiring intervention.