What's the best way to handle disruptive radiologists?

2021 04 21 23 42 8719 Doctor Personnel Distrust Suspicious 400

Disruptive colleagues are common in the workplace, and radiology isn't immune. However, practices can mitigate this problem through training and fostering a productive workplace culture, according to an article published April 11 in Clinical Imaging.

A team led by Dr. Karen Gerlach from the MD Anderson Cancer Center in Houston laid out some ways in which radiologists can be disruptive, as well as the consequences of their behavior, and how practices can help mitigate such disruptions.

"Disruptive behavior can present in multiple forms which can be overt or passive," Gerlach et al wrote. "The commonality of these behaviors is they negatively affect the workplace environment and the delivery of safe patient care."

Collaboration is a requirement for radiology practices, including interacting with patients, referring clinicians, administrators, staff, and other radiologists. A survey published in 2021 by the Society of Breast Imaging found that dealing with difficult radiologists was a major stressor for one-third of practicing breast radiologists.

Disruptive behaviors come in various forms and can be overt or passive, such as being uncooperative or using microaggressions. There are multiple causes of such workplace behavior, including use of electronic medical records, burnout, stress, skill deficiencies, and impairment.

In the current study, Gerlach and colleagues wanted to develop a diagnosis of physician behaviors, as well as strategies on how to help with these issues.

"Addressing non-ideal workplace behavior is integral to maintaining physician professionalism and the public's trust," they wrote. "When any component of a healthcare institution is compromised, the downstream effect impacts the delivery of safe, patient care."

  1. Training: Researchers wrote that recognition and successful intervention of skill and interaction deficiencies during residency training is important. They added that using an introspective approach could help trainees recognize future deficiencies and self-correct them before they become more problematic in the workplace.
  2. Revamping the interview process: This includes using a structured process that identifies behavioral discrepancies and sharing the code of behavior with physicians, as well as having a process in place for when inappropriate behavior is seen.
  3. Intervention and employee assistance: Employee assistance programs recommended by practices can help radiologists whose disruptive behaviors may stem from familial difficulties, addictions, and financial issues.
  4. Evaluate systemic challenges: Input from front-line staff should be considered when institutional changes are being planned, and assistance toward radiologists should be provided when changes are implemented, the researchers wrote.
  5. Coaching: The authors wrote that coaching could help transition employees to higher-stress roles, as well as usher in behavioral changes that help prevent or fix bad behaviors.
  6. Leadership and culture: Removing barriers between leaders and employees can help foster mutual respect among staff and a blame-free culture, as well as ensure patient safety, the team wrote.

"Radiology imaging practices and organizations have multiple opportunities to assist disruptive radiologists during time of hire, orientation, and training," they added. "Utilizing these toolsets can improve healthcare team dynamics and increase both staff and physician retention."

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