“Disruptive behaviour can have a significant impact on care delivery, which can adversely affect patient safety and quality outcomes of care.”

Disruptive behaviour may cause stress and anxiety to others and may undermine the effectiveness of patient care within the healthcare team. “The equivalent of road rage”, said Dr Peter Angood in the NY Times, that can so intimidate others that they are scared of voicing concerns about a potentially dangerous medical error.

Confronting such behaviour makes most people very uncomfortable, so often the behaviours continue to be tolerated. But this can lead to resentment and morale can suffer. Tackling the behaviour needs to be supported by the facts and at a senior level, documented and not swayed by threats of legal action or other retribution. It is also important that in reporting such conduct, those in “lesser’ positions of power are not given a hard time or have to resort to more informal and potentially more destructive, forms of letting it be known that Dr So-and-So is a so-and-so.

For further reading, refer to Dr Gerald Hickson of the Vanderbilt University Medical Center for Patient and Professional Accountability. When doctors are bullies, patient safety may suffer vanderbilthealth.com


  1. Rosenstein, A and O’Daniel, M. Invited Article: Managing disruptive physician behaviour: Impact on staff relationships and patient care, in Neurology Vol 70 (17), 22 April 2008, 1564-1570
  2. Doctors in Society: Medical professionalism in a changing world. Royal College of Physicians, UK, 2005