Physician behavior: not ready for 'Never'land

Disruptive physician behavior, particularly by surgeons, is a common perception. Increasing awareness and regulatory oversight is being felt in medical practice; however, little data exist regarding the frequency of these behaviors. This study was undertaken to determine the prevalence and type of reported behavioral issues. Blinded data for 2 years of physician behavior reports were reviewed for department, gender, event summary, and peer review conclusions. Chi-square analysis was used with statistical significance at P < 0.05. One hundred ninety-one behavior issues were reported in our 751-bed hospital, which employs 640 active physicians. One hundred fourteen (18%) physicians were reported. Forty-four (7%) physicians had multiple reports, accounting for 121 (63%) reports. Twenty-seven physicians were reported twice, eight 3 times, four 4 times, three 5 times, and one 6 times. Multiple-report physicians compared with single-report physicians showed no difference in distribution of outcomes, but more communication issues and fewer unacceptable behaviors. Specialty groups with a higher incidence of reported behaviors included anesthesia, cardiology, hospitalists, orthopedics, trauma, and obstetrics/gynecology. Female physicians were less likely to be reported. Staff reports were mainly against physicians within their hospital practice area (75 of 94 [80%]), whereas physician reports were mainly against physicians outside their practice area (18 of 25 [72%]). Disruptive physician behavior is variable and culturally defined. Although all reports should be taken seriously, fewer than 1 per cent of reported incidents were found to be definably disruptive and valid. As quality and oversight groups consider making disruptive physician behavior a "never" event, firm definitions and full peer review are mandatory.