Journal of General Internal Medicine

, Volume 28, Issue 11, pp 1405–1409

Physicians Criticizing Physicians to Patients

Authors

    • Department of PsychiatryUniversity of Rochester Medical Center
    • Department of Family MedicineUniversity of Rochester Medical Center
  • Diane S. Morse
    • Department of PsychiatryUniversity of Rochester Medical Center
    • Department of Internal MedicineUniversity of Rochester Medical Center
  • Shmuel Reis
    • Faculty of Medicine in the GalileeBar-Ilan University
  • Elizabeth A. Edwardsen
    • Department of Emergency MedicineUniversity of Rochester Medical Center
  • Mary Gale Gurnsey
    • Department of PsychiatryUniversity of Rochester Medical Center
  • Adam Taupin
    • Department of PsychiatryUniversity of Rochester Medical Center
  • Jennifer J. Griggs
    • Internal Medicine, Division of Hematology/Oncology and Health Management and PolicyUniversity of Michigan
  • Cleveland G. Shields
    • Human Development & Family StudiesPurdue University
Original Research

DOI: 10.1007/s11606-013-2499-9

Cite this article as:
McDaniel, S.H., Morse, D.S., Reis, S. et al. J GEN INTERN MED (2013) 28: 1405. doi:10.1007/s11606-013-2499-9

ABSTRACT

BACKGROUND

Teamwork is critical to providing excellent healthcare, and effective communication is essential for teamwork. Physicians often discuss patient referrals from other physicians, including referrals from outside their primary institution. Sharing conflicting information or negative judgments of other physicians to patients may be unprofessional. Poor teamwork within healthcare systems has been associated with patient mortality and lower staff well-being.

OBJECTIVE

This analysis explored how physicians talk to patients with advanced cancer about care rendered by other physicians.

DESIGN

Standardized patients (SPs) portraying advanced lung cancer attended covertly recorded visits with consenting oncologists and family physicians.

PARTICIPANTS

Twenty community-based oncologists and 19 family physicians had encounters with SPs.

APPROACH

Physician comments about care by other physicians were extracted from transcriptions and analyzed qualitatively. These comments were categorized as Supportive or Critical. We also examined whether there were differences between physicians who provide supportive comments and those who provided critical comments.

KEY RESULTS

Fourteen of the 34 encounters (41 %) included in this analysis contained a total of 42 comments about the patient’s previous care. Twelve of 42 comments (29 %) were coded as Supportive, twenty-eight (67 %) as Critical, and two (4 %) as Neutral. Supportive comments attributed positive qualities to another physician or their care. Critical comments included one specialty criticizing another and general lack of trust in physicians.

CONCLUSION

This study described comments by physicians criticizing other physicians to patients. This behavior may affect patient satisfaction and quality of care. Healthcare system policies and training should discourage this behavior.

KEY WORDS

physician communication teams criticism cancer

Copyright information

© Society of General Internal Medicine 2013