consequences13Physicians considered “disruptive” in their professional lives are now faced with a greater possibility of administrative interventions due to JCAHO standards.  Interventions could result in loss of facility privileges, limited or lost privileges to practice medicine and even legal proceedings.  Physicians should be aware that administrative agencies could require that a disruptive physician undergo psychological assessment in order to determine fitness for practice and that a disposition of impairment is possible.
Such proceedings are distinct from civil or criminal proceedings reactive to malpractice. These are not to examine a case of patient care per se, but are to evaluate a physician’s fitness to continue medical practice. Interventions to address professional disruptive behavior and professional impairment can result in revoked licensure.  While revocation has been appealed in state courts, typically courts defer to the discretion of medical boards.
The AMA stands firm that all physicians are responsible for maintaining health and wellness in order to be fit for medical practice.  The following is from the AMA Ethics Policy E-9.0305 Physician Health and Wellness:

“To preserve the quality of their performance, physicians have a responsibility to maintain health and wellness, construed broadly as preventing or treating acute of chronic diseases, including mental illness, disabilities, and occupational stress.  When health or wellness is compromised, so may the safety and effectiveness of the medical care provided.  When physical or mental health reaches the point of interfering with a physician’s ability to engage safely in professional activities, the physician is said to be impaired.

In addition to maintaining healthy lifestyle habits, every physician should have a personal physician whose objectivity is not compromised.  Physicians whose health or wellness is compromised should take measures to mitigate the problem, seek appropriate help and engage in an honest self-assessment of their ability to continue practicing.”

The AMA Code of Medical Ethics states that a “physician shall respect the rights of patients, colleagues, and other health professionals” and that a “physician shall…report physicians deficient in character or competence…to appropriate entities.”

Hospitals mandated by JCAHO to develop policies to address disruptive physicians may make decisions about their own organization’s relationship with a physician against whom allegations of disruption are made.  They may also, based upon the results of an investigation, involve the state medical society’s impaired physicians’ health service program. 

Confidentiality is guarded in treatment and supervision of impaired physicians; however, some states do have disclosure laws that mandate certain types of information be reported.  Discovery of past serious misconduct and patient harm, or potential patient harm, are reported to the state medical board.
Additionally, some state medical boards will post findings of misconduct in print and/or electronically.  The National Practitioner Data Bank will also post allegations and findings that come to medical boards for review.

Anger Management Institute of Texas’ Executive Coaching Program is utilized by management of accredited hospital/organizations for physicians displaying disruptive behaviors in the workplace.

For more information please visit

“Anger Management Institute of Texas is a certified Anderson & Anderson provider.”

Gregory A. Kyles, M.A., LPC, CEAP, CAMF
Director, Anger Management Institute of Texas
Diplomate, President of Texas Chapter
American Association of Anger Management Providers

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