Doctors With Poor Bedside Manners Will Have to Change Their Ways

The healthcare industry can be characterized by some not-so-flattering statistics.  The industry has one of the highest rates of workplace violence, for example.  It is also known for fostering an environment that breeds distrust among co-workers and that acts as a petri dish of sorts for bullies and jerks.  That is, until now. 

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The problem with bullies and jerks in healthcare is contagious.  Doctors, nurses, and other clinicians, who work in an environment where hostility is tolerated and where bullying behaviors are common, aren’t the only ones paying a price.  For years, bad behavior among workers has been linked to medical errors. 

In his book, The No Asshole Rule, Bob Sutton discussed a study of hospital employees as evidence of this link.  The study looked at two groups of nurses and doctors.  One group was led by a jerk-doctor, the other by a non-jerk-doctor.  The researchers were surprised when they found that the first group (led by the jerk), reported a significantly lower rate of medical errors than did the happy, nice-guy group. 

So what was the deal?  Was the second group just too busy being nice to one another to pay attention to crucial medical procedures?  Or was the first group really more responsive to the reign-of-terror leadership style that the jerk doctor embodied?  Don’t kid yourself.  The researchers soon learned that the first group had a lower reported rate of errors because they reported fewer mistakes–not because they made fewer mistakes. The second group, on the other hand, reported their mistakes without fear.  And the patients of the nice guys finished first after all. 

A 2004 study of workplace intimidation by the Institute for Safe Medication Practices (ISMP) found that nearly 40 percent of clinicians have kept quiet or ignored concerns about improper medication rather than talk to an intimidating colleague.  More than 90 percent said they’d experienced condescending language; nearly 60 percent had experienced strong verbal abuse and nearly half had faced negative or threatening body language.

The Joint Commission, though, is trying to put an end to these bullying tactics.  The Joint Commission is a national hospital accrediting agency, making it one of the few agencies with the power to effect real change.  Beginning in January, it will require hospitals to have implemented codes of conduct that define inappropriate behaviors and have plans for dealing with them.  This requirement is a recognition of the correlation between intimidating tactics and an increasing number of costly medical mistakes.  The Joint Commission’s special Alert, Stop Bad Behavior Among Health Care Professionals, and corresponding report, Behaviors that Undermine a Culture of Safety, is packed with data and statistics that support the directive and is well worth the read for those who have an interest on the impact of Jerks at Work.

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