Interventional strategies for the management of the disruptive physician: A systematic review

The aim of this study was to identify and evaluate published interventional strategies that address disruptive physician behaviour.

This study was designed based on the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) statement. A comprehensive literature search of publications from January 2013 to November 2023 was undertaken to identify original peer-reviewed studies pertaining to the development and implementation of targeted strategies for the management of disruptive physicians. An interpretive synthesis of the available publications was then presented in both tabular and descriptive format.

Among the 1,005 original articles that entered the final selection process, a total of 998 were then excluded because they were focused solely on the characterisation of disruptive behaviour (n=399); limited to trainees (n=258), limited to ancillary staff (n=135); concentrated on prevention (n=111); and described consequences (n=95). A total of seven original publications thus met criteria for inclusion and differed in their design, methods and endpoints. Two articles reported on longitudinal experiences involving prospective data. The most commonly identified themes related to accountability (five studies), organisational commitment (four studies) and professionalism training (three studies), with most studies covering more than one item.

Given the practical scope of this problem, a relative lack of publications exist focused on remediation strategies for disruptive physician behaviour. Investment in the development of evidence-based programmes are warranted.