Evidence-based framework for the management of disruptive physician behavior

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.