One topic that attracts a deluge of passionate-and sometimes horrifying-stories, anecdotes, and pleas for help: disruptive clinician behavior. If no one reports disruptive behavior to you, do you assume it's not a problem? It's an issue that's difficult to confront. It's easier to ignore because it's uncomfortable. We need to learn to define disruptive behavior, how it interferes with safe patient care, and how offices can implement strategies to reduce or eliminate disruptive behavior.

Offices need to address what is becoming a crisis as the industry moves toward a "culture of patient safety." Any office would be remiss to assume that all disruptive behavior involves physicians. Although they are notorious for rank-or ego-driven outbursts, there are well-documented and anecdotal cases of disruptive clinicians at every level. Disruptive behavior is not limited to physicians, but frequently involves other members of the healthcare staff as well.

What is disruptive behavior? Disruptive behavior is behavior that interferes with the ability of everyone on a team to provide safe and effective patient care. It undermines confidence in staff, and it even undermines confidence that patients and their families have in the organization if they witness the behavior. It does not always have to be physical or involve drugs, alcohol, or stress.