Culture of Disrespect in Medicine Affects Patient Safety

Lucian Leape’s words from the 2009 Telluride Patient Safety Educational Roundtable and Student/Resident Summer Camps tend to come back to me at random times. Not only was it amazing to sit in small group breakout sessions with him, discussing patient safety topics like a culture of disrespect in medicine, but to be in the classroom as he taught was something I’ll never forget.

Recently, his words on bullying in the healthcare workplace rang true and clear. In Danielle Ofri’s July 18 NYTimes Well blog piece, In a Culture of Disrespect Patients Lose Out, the topic was highlighted yet again. Unfortunately, this healthcare challenge remains alive and well. (See also ETY posts What Doctors Feel, and Bullying: Just Say No).

What struck me about Ofri’s NYTimes piece wasn’t that disrespect in the medical workplace was being linked directly to patient safety. That is just common sense. If your workforce is being bullied or treated poorly, how will those same individuals feel when going to do their job — which in this case, is care for patients? It was the following that was a reminder of the responsibility we all have to stop disrespectful behavior:

…This shift in perspective was a shock to the system. When we tolerate a culture of disrespect, we aren’t just being insensitive, or obtuse, or lazy, or enabling. We’re in fact violating the first commandment of medicine. How can we stand idly by when our casual acceptance of disrespect is causing the same harm to our patients as medication errors…

How can we continue to stand idly by? Bullies need to be called out. Period.

As we embark on yet another wonderful week of “Educating the Young” and move Telluride east to the Georgetown University campus for the first time, I hope that those of us able to stand up for students, residents and those we are charged with leading, continue to do just that — to stand up, to not stand idly by, and as Ofri says, view respect for one another…as common decency, something we should do because it’s simply the right thing to do.

For more information, see Leape et al in Academic Medicine July 2012.


3 Comments on “Culture of Disrespect in Medicine Affects Patient Safety”

  1. Disruptive physicians are serious risks, which I am sure you understand. I have seen some success in residential treatment programs, and then there are those who are convinced that others are the problem and will not acknowledge, despite Medical Staff action, that their own behaviors are, indeed, an issue. Early intervention can work (I’ve seen it), but there are those physicians who cannot or will not deign to believe a single negative thing about themselves when it concerns their practice of medicine.

    I have also seen a physician be very disruptive in one workplace and charmingly professional at the next. Only once, though. Usually the behaviors are ingrained.

    • Tracy Granzyk MS says:

      Thanks so much for taking the time to comment. Would love to better understand ways in which others have learned to manage this, as would I’m certain many of our readers as well as thought leaders looking at same.

      • I worked as in-house counsel for two academic medical centers for a total of 15 years. Never has a lawyer loved her jobs more than I did. Though I did have opposing counsel scream at me, demanding to know what a “disruptive physician” was. I thought it was rather self-explanatory.

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