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Complex Factors Associated with Disruptive Medical Professional Behavior: Retrospective Analysis of the Colorado
Background:
Disruptive behavior in medical settings, which includes bullying, intimidating, and other behaviors, is associated with medical errors, low patient and team satisfaction, high job turnover, and understaffing throughout the healthcare system. State-level Physician and Professional Health Programs (PHPs) provide valuable coordination of evaluation, treatment, and monitoring for disruptive behavior in medical settings. The aim of this study was to describe characteristics of 308 physicians, physician assistants, anesthesiology assistants, and trainees in these fields referred to the Colorado Physician Health Program (CPHP) for disruptive behavior between 2015 and 2022.
Methods:
Using agency records and case reviews, the authors describe participant characteristics, diagnoses, recommendations for treatment and third-party evaluations, bivariate relationships, and outcomes.
Results:
Nearly three quarters of participants were male and had mandatory referrals. With a comprehensive evaluation conducted by a psychiatrist, 33.1% received a psychiatric diagnosis and 26.3% were identified as having symptoms of a personality disorder. Situational stress was identified in 54.9%, with workplace stress being most common and more frequent in females (46.2%) than males (34.1%) (p < 0.05). The most recommended treatment was coaching (49.7%), followed by therapy (29.9%), psychiatric treatment (17.2%), and education (14.3%). Nearly all (95.1%) successfully completed participation, with 57.8% completing within one year. Those with psychiatric diagnoses took longer to complete participation (median 390 vs. 279 days; p < 0.001).
Conclusion:
Thorough assessment of disruptive behavior can uncover multiple underlying conditions in providers and the systems in which they work. Agencies tasked with addressing this behavior should identify underlying conditions and consider them when developing personalized treatment plans that may address more than disruptive behavior.
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