Table 1.

Fundamental principles
1.Principle of primacy of patient welfare
2.Principle of patient autonomy
3.Principle of social justice
Professional Responsibilities
1.Commitment to professional competence
2.Commitment to honesty with patients
3.Commitment to patient confidentiality
4.Commitment to maintaining appropriate relations with patients
5.Commitment to improving quality of care
6.Commitment to improving access to care
7.Commitment to a just distribution of finite resources
8.Commitment to scientific knowledge
9.Commitment to maintaining trust by managing conflicts of interests
10.Commitment to professional responsibilities

Charter on Professionalism^[19]

Mayo WJ. The necessity of cooperation in the practice of medicine. Commencement address, Rush Medical College (June 15, 1910).
Snyder L, Leffler C for the Ethics and Human Rights Committee, American College of Physicians. Ethics Manual, 5th ed. Ann Intern Med. 2005;142:560-582.
Bendapudi NM, Berry LL, Frey KA, Parish JT, Rayburn WL. Patients' perspectives on ideal physician behaviors. Mayo Clin Proc. 2006;81:338-344.
Fabri PJ. Beyond competence: the case for emotional intelligence. Available at: http://www.ama-assn.org/ama1/pub/upload/mm/44/a-06pdfpresnt1.pdf Accessed March 3, 2009.
American Medical Association. E.9.045 Code of Medical Ethics: Current Opinions with Annotations: 2006-2007. Chicago: American Medical Association; 2006.
American Medical Association. Physicians with disruptive behavior. CEJA Report 106.
Pfifferling JH. Managing the unmanageable: The disruptive physician. Fam Pract Management. 1997; Nov/Dec:77-78,83,87-88,90,92.
Weber DO. Poll results: doctors' disruptive behavior disturbs physician leaders. Physician Executive. 2004;Sept-Oct:6-14.
Rosenstein AH, O'Daniel M. Disruptive behavior & clinical outcomes: perceptions of nurses and physicians. Am J Nurs. 2005;105:54-64.
Manderino MA, Berkey N. Verbal abuse of staff nurses by physicians. J Prof Nurs. 1997;13:48-55.
Cook JK, Green M, Topp RV. Exploring the impact of physician verbal abuse on perioperative nurses. AORN J. 2001;74:317-331.
Weber DO. For safety's sake disruptive behavior must be tamed. Physician Executive. 2004;Sept-Oct:17.
Nagata-Kobayashi S, Sekimoto M, Koyama H, et al. Medical student abuse during clinical clerkships in Japan. J Gen Intern Med. 2006;21:212-218.
Daniel AE, Burn RJ, Horarik S. Patients' complaints about medical practice. Med J Aust. 1999;170:576-577.
Rosenstein AH, O'Daniel M. Disruptive behavior & clinical outcomes: perceptions of nurses and physicians. Am J Nurs. 2005;105:54-64.
Rosenstein AH. Nurse-physician relationships: impact on nurse satisfaction and retention. Am J Nurse. 2002;102:26-34.
Youssi MD. JCAHO standards help address disruptive physician behavior. Phys Executive. 2002;(Nov/Dec):12-13.
Mareiniss DP. Decreasing GME training stress to foster residents' professionalism. Acad Med. 2004;79:825-831.
ABIM Foundation, ACP-ASIM Foundation, European Federation of Internal Medicine. Medical professionalism in the new millennium: A physician charter. Ann Intern Med. 2002;136:243-246.
Accreditation Council for Graduate Medical Education. Outcome project: General competencies. 1999.
ACGME Outcome Project. Advancing education in medical professionalism. 2004.
Joint Commission on Accreditation of Healthcare Organizations Medical Staff Standard, Physician Health, MS 4.8
Benzer DG, Miller MM. The disruptive-abusive physician: a new look at an old problem. Wisconsin Med J. 1995;94:455-460.
Hewson MG, Little ML. Giving feedback in medical education: verification of recommended techniques. J Gen Intern Med. 1998;13:111-116.
General M, MacDonald N, Hayes V. The tale of Dr. Wells. Virtual Mentor: Ethics Journal of the American Medical Association. 2003;5:1-7.

CME

Dealing with the "Disruptive" Physician Colleague

Authors: Paul S Mueller, MD, MPH ; Lois Snyder, JD
THIS ACTIVITY HAS EXPIRED FOR CREDIT

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Target Audience and Goal Statement

This activity is intended for physicians and administrators who are colleagues of physicians with disruptive behavior.

The goal of this activity is to define and identify physician disruptive behavior and understand the need to report it.

Upon completion of this activity, participants will be able to:

Define "disruptive physician behavior"
Recognize the most common conflicts that involve disruptive physician behavior
Examine the reasons why disruptive physician behavior is underreported
Discuss the ethical obligations of the physician as described in the ACP Ethics Manual
Identify a strategy for dealing with disruptive behaviors

Author(s)

Paul S Mueller, MD, MPH

Associate Professor of Medicine, Mayo Clinic, Rochester, Minnesota; Consultant Physician, Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota

Disclosures

Disclosure: Paul S. Mueller, MD, MPH, has disclosed that he has received grants for educational activities from Boston Scientific and Wiley-Blackwell. Dr. Mueller has also disclosed that he has served as an advisor for Boston Scientific and has served on the editorial board for the Massachusetts Medical Society.

Lois Snyder, JD

Director, Center for Ethics and Professionalism, American College of Physicians, Philadelphia, Pennsylvania

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For Physicians

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Medscape, LLC designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credit(s)™ . Physicians should only claim credit commensurate with the extent of their participation in the activity.

The cases and commentary were developed by the American College of Physicians.

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This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page.

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Pre-Assessment

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To measure the effectiveness of this continuing education activity, please complete the following 2-question pre-assessment. The activity addresses these questions in the content that follows.

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Pre-Assessment
Introduction
Commentary

References

Table 1.

References

Faculty and Disclosures

Author(s)

Paul S Mueller, MD, MPH

Lois Snyder, JD

CME

Dealing with the "Disruptive" Physician Colleague

Target Audience and Goal Statement

Author(s)

Paul S Mueller, MD, MPH

Lois Snyder, JD

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Dealing with the "Disruptive" Physician Colleague

Pre-Assessment

Table of Contents