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disruptive physician behavior

However, most disruptive physicians require more intensive intervention. Reynolds argues that “constructive change in disruptive physicians comes through requiring adherence to expected behaviors while providing educational and other supports to teach the physician new coping skills for achieving the desired behaviors.”25 A comprehensive evaluation including medical, chemical, and psychiatric evaluation is the first step. It is important to identify an underlying treatable condition. A program of remediation including educational and psychological training to foster new coping skills is outlined. A critical part of the program is long-term follow-through and monitoring. For most disruptive physicians, it is the threat of imposed consequences rather than internal motivation to improve that guides their compliance with the program.25 Several well-established programs offer resources for the training including the Physician Assessment and Clinical Education (PACE) program at the University of California School of Medicine, San Diego33 and the Distressed Physician Program at Vanderbilt University School of Medicine in Nashville.34 A composite case study of transformative learning to address disruptive physician behavior illustrates the process used.35

Conflict occurs frequently and often results in significant disruption and cost for individuals and organizations. Although often avoided or poorly managed, evidence suggests the skills for effective management of conflict can be learned. Multiple studies confirm when conflict is successfully addressed, and multiple benefits accrue to the organization and individuals.