Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Push back on toxic behaviors from other doctors

Todd Rice, MD, MBA
Physician
April 13, 2018
Share
Tweet
Share

“Don’t get tired! Don’t f*cking move! Don’t you f*cking move, or I’ll f*cking die!”

That’s an excerpt from an OR in St. Louis on March 12th. This is just one of the outbursts that was reported from a single, multi-hour surgery — an attending’s toxic mandate to her resident, who was poised in a precarious situation under the drapes. The rest of the OR staff caught plenty of its own abusive flak throughout the case as she denied the circulating nurse relief: “No one’s f*cking leaving! Nobody is signing out!” And to the scrub tech who didn’t have available an item that she requested: “That’s bullshit!!” she exclaimed as she stormed out of the room … providing the team with what must have been a welcome, if brief, reprieve.

There’s more in the complaint that was submitted to the hospital medical staff office (and copied to The Joint Commission, the ACGME, and the state medical board), but you get the gist. Does the military even permit this type of hazing and harassment of its basic training recruits and subordinates anymore? Medicine apparently does, despite the high talk, the “sentinel event” designations, residency program requirements and official statements on the topic issued by a host of organizations.

To the OR team members’ credit, they submitted complaints against the physician, despite their concerns for identification and retaliation. What will happen as a result is yet to be seen. Given that this physician has been reprimanded in the past for dysfunctional behavior and continues to practice without restriction today after these most recent tirades, does not necessarily exude optimism that TJC’s “zero tolerance” policy for such behavior will prevail. With almost 20 years of focus on dysfunctional physician behavior (the AMA began to study this in 1999), and statements from such organizations and associations as TJC, the ACGME, and the Federation of State Medical Boards, eradication of toxic physician behavior has not been highly effective. One wonders if the persistence of such dysfunction shows the enforcement mechanisms to be toothless and ineffectual.

I’m reminded of the Seinfeld car reservation episode wherein the desk clerk tells Jerry that no car is available for him despite his reservation.

Jerry: I don’t understand. Do you have my reservation?

Clerk: We have your reservation, we just ran out of cars.

Jerry: But the reservation keeps the car here. That’s why you have the reservation.

Clerk: I think I know why we have reservations.

Jerry: I don’t think you do. You see, you know how to take the reservation, you just don’t know how to hold the reservation. And that’s really the most important part of the reservation: the holding. Anybody can just take them.

Likewise, anybody can just make up rules, regulations, and policies. These organizations know how to make the policies, they just don’t know how to enforce the policies. And that’s really the most important part of the policy: the enforcement.

But to be fair, over the decades the culture of medicine has been slowly improving. The older physicians are dying off, and fewer of the newer ones are adopting those archaic, destructive personality traits and behaviors. Certainly, the type of behavior taking place in St. Louis isn’t a norm of daily interaction in most of our health care settings. The metaphoric ship of medical culture is slow to turn, as a colleague recently told me, but does seem to be making an almost imperceptible corrective arc toward a better destination. Might we not turn the ship a bit more quickly if we all dug in with an oar from time to time, reporting bad behaviors, making dysfunctions more transparent, shaming those that are resistant to let go of the hostile and toxic work and learning environments that they perpetuate? We all have an ability to push back on these behaviors that negatively impact workplace morale, staff turnover, our own misery index and patient care and safety.

For the moment, St. Louis holds the uncontested and dubious distinction of Dysfunctional Physician Capital of America. Surely there are other contenders out there that could use some exposure. Pick up an oar, and make a difference.

ADVERTISEMENT

Todd Rice is an anesthesiologist and creator, Graduate Medical Education Compliance Project.

Image credit: Shutterstock.com

Prev

Physicians and medical students: Unlearn helplessness

April 13, 2018 Kevin 0
…
Next

When the doctor becomes the victim

April 13, 2018 Kevin 1
…

Tagged as: Hospital-Based Medicine, Surgery

Post navigation

< Previous Post
Physicians and medical students: Unlearn helplessness
Next Post >
When the doctor becomes the victim

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by Todd Rice, MD, MBA

  • Understand your resident contract: What you don’t know may hurt you

    Todd Rice, MD, MBA
  • Why direct primary care is the future

    Todd Rice, MD, MBA
  • Health coverage really isn’t covering much

    Todd Rice, MD, MBA

Related Posts

  • The public charge rule crosses the line, and doctors need to push back

    Susannah Hills, MD
  • Doctors die. But the good ones leave a legacy.

    Jaime B. Gerber, MD
  • Why do doctors who hate being doctors still practice?

    Kristin Puhl, MD
  • Doctors: It’s time to unionize

    Thomas D. Guastavino, MD
  • A physician’s addiction to social media

    Amanda Xi, MD
  • When doctors are right

    Sophia Zilber

More in Physician

  • Why we fear being forgotten more than death itself

    Patrick Hudson, MD
  • From basketball to bedside: Finding connection through March Madness

    Caitlin J. McCarthy, MD
  • The invisible weight carried by Black female physicians

    Trisza Leann Ray, DO
  • A female doctor’s day: exhaustion, sacrifice, and a single moment of joy

    Dr. Damane Zehra
  • The hidden cost of malpractice: Why doctors are losing control

    Howard Smith, MD
  • How scales of justice saved a doctor-patient relationship

    Neil Baum, MD
  • Most Popular

  • Past Week

    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • Do Jewish students face rising bias in holistic admissions?

      Anonymous | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • Surviving kidney disease and reforming patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Antimicrobial resistance: a public health crisis that needs your voice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why a fourth year will not fix emergency medicine’s real problems

      Anna Heffron, MD, PhD & Polly Wiltz, DO | Education
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 63 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • “Think twice, heal once”: Why medical decision-making needs a second opinion from your slower brain (and AI)

      Harvey Castro, MD, MBA | Tech
    • Do Jewish students face rising bias in holistic admissions?

      Anonymous | Education
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Residency as rehearsal: the new pediatric hospitalist fellowship requirement scam

      Anonymous | Physician
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
    • The hidden bias in how we treat chronic pain

      Richard A. Lawhern, PhD | Meds
  • Recent Posts

    • Surviving kidney disease and reforming patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Antimicrobial resistance: a public health crisis that needs your voice [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why a fourth year will not fix emergency medicine’s real problems

      Anna Heffron, MD, PhD & Polly Wiltz, DO | Education
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Push back on toxic behaviors from other doctors
63 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...