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Courtesy and respect

Disruptive behaviour

Senior male physician speaking sternly to male medical traineeIn recent years, it is recognized that a small subset of healthcare professionals exhibit what is now referred to as disruptive behaviour. Disruptive behaviour is rarely a single egregious act but is more often composed of a pattern of behaviour.

Disruptive behaviour can interfere with team and patient communication, team morale, and may adversely affect patient care and satisfaction.

Examples of disruptive behaviour from the CMPA's medical-legal files include:

  • making comments in dismissive or derogatory ways to patients and other team members
  • displaying insensitive, uncaring, or callous attitudes
  • using inappropriate language (including profanity)
  • bullying, threats, or angry outbursts
  • demeaning, condescending, or aggressive conduct
  • boundary issues
  • inappropriate comments and conduct with medical regulatory authority (College) investigators

Personal factors that may contribute to disruptive behaviour include:

  • overwork and stress
  • marital or other personal difficulties
  • underlying psychiatric and medical conditions, often undiagnosed
  • alcohol or drug use

While the individual displaying disruptive behaviour may require an assessment, confounding factors and triggers may exist in the workplace: for example, other providers or administrators displaying disruptive behaviour, turf battles, and resource and funding issues.

What is not disruptive behaviour?

Examples of behaviour that are not likely to be considered disruptive or unprofessional include:
  • patient advocacy made in good faith, including professionally written alerts aimed at improving patient care or facilities, and submitted to the appropriate individuals
  • making a complaint to an outside agency
  • testifying against a colleague

Medical-legal consequences

Physicians who display disruptive behaviour risk medical-legal consequences including hospital or institutional restrictions, regulatory authority (College) sanctions (e.g. licence suspension or revocation) and legal actions.