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Evidence-based framework for the management of disruptive physician behavior.

Allen M Chen1

  • 1Department of Radiation Oncology, University of California, Irvine, Chao Family Comprehensive Cancer Center, Orange, California, USA.

Journal of Healthcare Risk Management : the Journal of the American Society for Healthcare Risk Management
|September 10, 2025
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Summary

Developing a practical framework to manage disruptive physician behavior is feasible. This evidence-based approach focuses on expectation setting, organizational climate, peer involvement, and professional training for healthcare accountability.

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Area of Science:

  • Healthcare Management
  • Medical Professionalism
  • Organizational Psychology

Background:

  • Promoting a respectful and accountable workplace culture is crucial for healthcare organizations.
  • Literature on practical strategies for addressing physician misconduct is limited.
  • Disruptive physician behavior negatively impacts patient care and organizational function.

Purpose of the Study:

  • To devise an evidence-based, empirical framework for managing and remediating disruptive physician actions.
  • To identify core themes for constructing a framework based on existing literature.
  • To address the scarcity of practical guidance for healthcare leaders.

Main Methods:

  • Systematic literature search using PRISMA-P guidelines and MEDLINE database.
  • Inclusion of original peer-reviewed English-language articles published between January 2014 and March 2025.
  • Exclusion of articles focused on behavior characterization, trainees, ancillary staff, prevention, or consequences.

Main Results:

  • Eleven original publications met the inclusion criteria.
  • Core themes for framework development included expectation setting (4 studies), climate/organizational analysis (3 studies), peer involvement (2 studies), and professional training (2 studies).
  • The feasibility of an evidence-based framework for addressing disruptive physician behavior was demonstrated.

Conclusions:

  • An evidence-based framework for managing disruptive physician behavior can be developed.
  • Key components for the framework include clear expectations, organizational assessment, peer engagement, and targeted training.
  • This framework offers practical implications for healthcare risk management and fostering accountability.