Physicians Criticizing Physicians to Patients
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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.
This analysis explored how physicians talk to patients with advanced cancer about care rendered by other physicians.
Standardized patients (SPs) portraying advanced lung cancer attended covertly recorded visits with consenting oncologists and family physicians.
Twenty community-based oncologists and 19 family physicians had encounters with SPs.
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.
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.
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.
- Grumbach K, Bodenheimer T. Can health care teams improve primary care practice? JAMA. 2004;291(10):1246–51. CrossRef
- Rutherford JS, Flin R, Mitchell L. Teamwork, communication, and anaesthetic assistance in Scotland. Br J Anaesth. 2012;109(1):21–6. PubMed PMID: 22696557. CrossRef
- Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiologica Scandinavica. 2009;53:143–151. Retrieved from http://onlinelibrary.wiley.com/doi/10.1111/j.1399-6576.2008.01717.x/full accessed April 6, 2013.
- Armour FR, Bramble JD, McQuillan R. Team training can improve operating room performance. Surgery. 2011;150:771–8. CrossRef
- Epstein RM, Fiscella K, Lesser CS, Stange KC. Why the nation needs a policy push on patient-centered health care. Health Affairs. 2010;29:1489–1495. Retrieved from http://content.healthaffairs.org/content/29/8/1489.short. accessed April 6, 2013.
- Rosenstein A. Managing disruptive behaviors in the health care setting: process, policy, prevention and intervention. Adv Psychol Res. 2009;72:1–14.
- Rosenstein AH, O’Daniel M. Original Research: Disruptive Behavior and Clinical Outcomes: Perceptions of Nurses and Physicians: Nurses, physicians, and administrators say that clinicians’ disruptive behavior has negative effects on clinical outcomes. American Journal of Nursing. 2005;105:54. Retrieved from http://journals.lww.com/ajnonline/Abstract/2005/01000/Original_Research__Disruptive_Behavior_and.25.aspx. Accessed April 6, 2013.
- Samenow CP, Spickard Jr A, Swiggart W, Regan J, Barrett D. Consequences of Physician Disruptive Behavior. Tenn. Med. 2007;38–40.
- Weber DO. Poll results: doctors’ disruptive behavior disturbs physician leaders. Phys Exec. 2004;30:6–14.
- AMA Code of Ethics E-9.045. Physicians with disruptive behavior. March 2009. Available at www.ama-assn.org/ama1/pub/upload/mm/code-medical-ethics/ceja-3i09 Accessed April 6, 2013.
- Beckerman J. Personal Communication. Office of Patient- and Family-Centered Care. University of Rochester Medical Center. Rochester NY. March 7. 2013
- Peabody JW, Luck J, Glassman P, Dresselhaus TR, Lee M. Comparison of vignettes, standardized patients, and chart abstraction: a prospective validation study of 3 methods for measuring quality. JAMA. 2000;283:1715–22. CrossRef
- National Comprehensive Cancer Network Guidelines for Treatment of Lung Cancer, https://nccn.org. Accessed April 6, 2013).
- Franz CE, Epstein R, Miller KN, Brown A, Song J, Feldman M, Franks P, et al. Caught in the act? Prevalence, predictors, and consequences of physician detection of unannounced standardized patients. Heal Serv Res. 2006;41(6):2290. CrossRef
- Shields CG, Coker CJ, Poulsen SS, Doyle JM, Fiscella K, Epstein RM, Griggs JJ. Patient-centered communication and prognosis discussions with cancer patients. Patient EducCouns. 2009;77:437–42. CrossRef
- Hodges BD, Kuper A, Reeves S. Discourse analysis. BMJ. 2008;337:570–2. CrossRef
- Miller W, Crabtree B. Primary care research: a multi-method typology and qualitative road map. In: Crabtree BF, Miller WL eds. Doing Qualitative Research. Sage Publications; 1999:17–18.
- Creswell JW. Qualitative Inquiry and Research Design: Choosing Among the Five Traditions. Thousand Parks Oaks: Sage Publications Inc; 1998:208–9.
- Creswell JW, Maietta RC (2001) Systematic procedures of inquiry and computer data analysis software for qualitative research. In: Salkind NJ, Delbert MC, eds. Handbook of Research Design and Social Measurement (6th ed.,) Thousand Oaks, CA: Sage Publications, Inc; pp. 142–143–184.
- Leape LL, Shore MF, Dienstag JL, Mayer RJ, Edgman-Levitan S, Meyer GS, Healy GB. A culture of respect, Part 1: the nature and causes of disrespectful behavior by physicians. Academic Med. 2012;87:845–52. CrossRef
- American College of Physicians. American College of Physicians Ethics Manual. Ann Intern Med. 2012;156:76–104.
- Beckman HB, Markakis KM, Suchman AL, Frankel RM. The doctor-patient relationship and malpractice. Arch Intern Med. 1994;154:1365–70. CrossRef
- Berry W. Minimizing vulnerability to malpractice claims. Elements of Contemporary Practice. Decker Intellectual Properties. 2011;1–11.
- Hickson GB, Clayton EW, Githens PB, et al. Factors that prompted families to file medical malpractice claims following perinatal injuries. JAMA. 1992;267:1359–63. CrossRef
- Griffen FD. ACS closed claims study reveals critical failures to communicate. Bull. Am. Coll. Surg. 2007;92:11–6.
- Bowen M. Family Therapy in Clinical Practice. New York: Aronson, Jason Inc; 1985.
- Zwarenstein M, Goldman J, Reeves S (2009) Interprofessional collaboration: effects of practice-based interventions on professional practice and healthcare outcomes. Cochrane Database Syst Rev, 3. Retrieved from http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000072.pub2/pdf/standard
- Roberts KH. New challenges to organizational research: high reliability organizations. Organ Environ. 1989;3:111–25. CrossRef
- Roberts KH, Stout S, Halpern J. Decision dynamics in two high-reliability military organizations. Manag Sci. 1994;40:614–24. CrossRef
- Mishra AA. In union lies strength: Collaborative competence in new product development and its performance effects. J Oper Manag. 2009;27:324–38. CrossRef
- Mickan SM, Rodger SA. Effective health care teams: A model of six characteristics developed from shared perceptions. J Interprofessional Care. 2005;19:358–70. CrossRef
- Wu AM, McPhee SJ, Christensen JF. Mistakes in medical practice. In: Feldman MD, Christensen JF, eds. Behavioral Medicine. New York: Lange; 2008:375.
- Hunt DD, Scott C, Zhong S, Goldstein E. Frequency and effect of negative comments (“badmouthing”) on medical students’ career choices. Acad Med. 1996;71(6):665–9. PubMed PMID: 9125925. CrossRef
- Kamien BA, Bassiri M, Kamien M. Doctors badmouthing each other. Does it Affect medical students’ career choices? Aust Fam Physician. 1999 Jun;28(6):576–9.
- Stephens MB, Lennon C, Durning SJ, Maurer D, DeZee K. Professional badmouthing: who does it and how common is it? Fam Med. 2010;42(6):388–90. PubMed PMID: 20526900.
- Leape LL, Shore MF, Dienstag JL, Mayer RJ, Edgman-Levitan S, Meyer GS, Healy GB. A culture of respect, Part 2: Creating a culture of respect. Academic Med. 2012;87:853–8. CrossRef
- Physicians Criticizing Physicians to Patients
Journal of General Internal Medicine
Volume 28, Issue 11 , pp 1405-1409
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- Author Affiliations
- 1. Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- 2. Department of Family Medicine, University of Rochester Medical Center, 777 S Clinton Ave, Rochester, NY, 14620, USA
- 3. Department of Internal Medicine, University of Rochester Medical Center, Rochester, NY, USA
- 4. Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
- 5. Department of Emergency Medicine, University of Rochester Medical Center, Rochester, NY, USA
- 6. Internal Medicine, Division of Hematology/Oncology and Health Management and Policy, University of Michigan, Ann Arbor, MI, USA
- 7. Human Development & Family Studies, Purdue University, West Lafayette, IN, USA