I've written quite a bit about rude, arrogant, and insensitive doctors. Dr. Gooser stars in in The No Asshole Rule (note the artist's rendition above, which Value Rich magazine provided to go along with the text on page on page 21) and my post on Dr. Gooser about digs into evidence showing that bullying is especially prevalent in medicine. On the brighter side of things, new guidelines by the Joint Commission (which regulates U.S. hospitals) mean that those hospitals that let bullies run rampant risk losing accreditation. Also, one of the most heartening notes I ever got from a doctor was about how — after suffering so much abuse from attending physicians during their medical training — he and his fellow residents vowed to treat residents and nurses with respect when they rose to more powerful positions. A vow, he reported, that all had kept (see this post). I've also written about the impressive efforts that some hospitals and doctors are beginning to take to reduce medical errors, especially in neonatal intensive care units.
As such, I was intrigued to see a story in the science section of today's New York Times that discussed how nasty and arrogant doctors not only drive nurses out of the profession, they also can create a climate that causes more medical errors. Here is one example from the story:
In one instance witnessed by Dr. Angood of the Joint Commission, a
nurse called a surgeon to come and verify his next surgical patient and
to mark the spot where the operation would be done. The harried surgeon
yelled at the nurse to get the patient ready herself. When he showed up
late to the operating room, he did not realize the surgery site was
mismarked and operated on the wrong part.
“The surgeon then
berated the entire team for their error and continued to denigrate them
to others, when the error was the surgeon’s because he failed to
cooperate in the process,” Dr. Angood said.
A hostile environment
erodes cooperation and a sense of commitment to high-quality care, Dr.
Angood said, and that increases the risk of medical errors.
Check out the rest of the article here plus the accompanying piece on "The Six Habits of Highly Respectful Physicians."
I have been keeping track of the problem of nastiness in hospitals — especially by doctors — for a few years and I have been disturbed by how more and more evidence keeps coming out about the damage done by such widespread nastiness. But I am heartened by the serious steps that are apparently being taken to tackle the problem — including by the Joint Commission.
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