Medical Staff Leadership Responsibilities and the Issue of 'Disruptive Physicians'

In the 2009 white paper titled “Leadership in Healthcare Organizations, A Guide to Joint Commission Leadership Standards,” published by the Governance Institute, the four primary goals of leadership in a health care institution were identified as follows:

1. Quality of care and patient safety; a significant number of sentinel events are linked to ineffective leadership.
2. The financial viability of the health care institution.
3. A decrease in the risks of litigation.
4. Compliance with ethical and legal standards and obligations.

A significant factor that bears upon the issue of leadership in a health care institution and that impacts these cited goals of leadership is that of disruptive physicians and inappropriate behavior. Empirical data shows that disruptive and/or intimidating conduct by physicians can impair the quality of the delivery of patient care services. See “Revisiting Disruptive and Inappropriate Behavior: Five Years After Standards Introduced,” by Ronald M. Wyatt, Medical Director, The Joint Commission (Oct. 2, 2013); “Disruptive Clinician Behavior: A Persistent Threat to Patient Safety,” by Grena Porto and Richard Lauve, psqh.com (July/August 2006). So there is an established nexus between disruptive conduct and negative patient outcomes and medical errors.