*This originally appeared in the Feb. 22, 2005 issue of ISMA Reports

What do you do when a physician demonstrates a pattern of angry, intimidating behavior? How do you handle a doctor who sometimes uses abusive and demeaning language with staff and even patients? What action can you take when nurses and others report being fearful or physically intimidated by a medical staff member? 

The ISMA Physician Assistance Program (PAP) was created to help answer those questions with appropriate action. The scenarios fit the typical description of the behaviorally disruptive physician. If you’ve had problems or questions about a physician co-worker or physician employee, the ISMA service can be an important resource – whether you are in a medical group or a hospital.

Physicians seen in the ISMA PAP regularly exhibit a pattern similar to the following:

Inappropriate anger or resentment

• Intimidation
• Abusive or demeaning language
• Blaming or shaming others for mistakes or errors
• Unnecessary sarcasm or cynicism
• Threats of violence, retribution or litigation

Inappropriate response to patient needs or staff requests

• Late or unsuitable replies to pages or calls
• Unprofessional demeanor or conduct
• Uncooperative, defiant approach to problems

“Any one symptom is not singularly diagnostic of any one illness; however, a combination of signs likely signifies a problem physician,” said Fred Frick, MD, PAP medical counselor. If intervention does not occur at this level, the impairment usually progresses to the point of interfering with the physician’s profession.

“Please remember that we are talking about a pattern of behavior,” said Candace Backer, ISMA PAP counselor. “This behavior may or may not be related to a psychiatric diagnosis, chemical dependency, depression or personality disorder.”

Backer noted that generally it will take more than an “anger workshop” to improve the behavior.

The next ISMA Reports will detail key steps to take if you believe you have an angry, disruptive physician in your work setting. Meanwhile, for further details about the ISMA PAP, log onto the ISMA Web site.

Part II here