The disruptive physician: A conceptual organization

Disruptive physician behavior is now generally recognized to pose a potential threat to patient safety. Recent policy positions and sentinel event designations have acknowledged this. Disruptive behavior is a widespread event with some 1-5 percent of physicians acting in a disruptive manner although significantly higher rates are cited for incidents of verbal abuse. Disruptive behavior can be classified along at least two dimensions. The first dimension is whether the behavior is goal-oriented in the sense that the physician achieves some goal or end. The second dimension focuses on the physician’s social/ behavioral competence. In addition, the disruptive physician should be assessed for psychological or psychiatric conditions (Axis I and II) as well as medical conditions that could be contributing.