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Anger Management for Healthcare Professionals

The typical behaviors are often divided into aggressive and passive aggressive categories. Aggressive behaviors include yelling, abusive language, intimidation, and physically aggressive actions. Passive-aggressive behaviors include intentional miscommunication, impatience with questions, racial, general or religious jokes, and implied threats. Despite estimates that only 3 to 6% of physicians qualify as disruptive physicians,27 the negative impact on the health care system is significant. The behavior undermines morale and productivity as well as the quality of care and patient safety. For example, nurses are less likely to call physicians with a history of disruptive behavior even when they need to clarify an order or report a change in a patient’s condition. According to the Joint Commission, these behaviors “can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators, and managers to seek new positions in more professional environments.”28 In an academic environment, this behavior is associated with poor role modeling for students and trainees. Because of the impact, both the Joint Commission and the Federation of State Medical Boards addressed the issue in their standards and policies.28 29

If the pattern of behavior is recognized early, a conversation with a trusted colleague or physician leader using the techniques described above might be sufficient to change the pattern of behavior. One model of corrective feedback starts by preparing the physician for the meeting with advanced notice and provision of a private setting and respectful atmosphere. Often asking the physician to provide a self-assessment of their interactions with others is a good starting point that can be followed with the observations of specific disruptive behaviors. Strategies for change and improvement as well as set expectations and a monitoring program need to be discussed and articulated before concluding the meeting.