Getting Rid of Jerks in Healthcare

A post on Becker’s Hospital Review asks the question: “Is there a case for jerks in healthcare?”

In recent years, there has been an emphasis on educating medical students, residents, and even seasoned healthcare providers about appropriate “bed side manner” and its importance to the patient. This has been done in a campaign to rid the profession of jerks or – phrased in a nicer way – “disruptive medicine.” Even The Joint Commission on Accreditation of Healthcare Organizations has weighed with a new policy that encourages hospitals to take a zero-tolerance approach towards such people and situations.

According to The Joint Commission policy, disruptive behavior is defined as “overt actions such as verbal outburst and physical threats, as well as passive activities such as refusing to perform assigned tasks or quietly exhibiting uncooperative attitudes during routine activities.” This is far from rare; in fact, a study by the American College of Physician Executives, found that 98% of healthcare workers reported observing such behavior – behavior that can be detrimental to patient safety. Consequently, hospitals have begun cracking down on the “jerks” and Medicare has started rewarding the “nice guys.”

Despite this trend in favor of the more cooperative physician, Wen Shen, M.D., an endocrine surgeon at the University of California – San Francisco makes an argument that the “kinder, gentler surgeon” is misguided, and that the push for patient safety may have gone too far – especially when it comes to surgeons.

In an article for Pacific Standard, Dr. Shen shared the following example:

In his 2012 book Unaccountable:  What Hospitals Won’t Tell You and How Transparency Can Revolutionize Health Care, John Hopkins surgeon Marty Makary describes two very different attending surgeons whom he encountered during his residency. One was nicknamed ‘Dr. Hodad’ and was universally loved by patients for his warm bedside manner.  The ‘Hodad’ nickname bestowed upon him by the residents, however, stood for ‘Hands of Death and Destruction,’ because the man was a terrible technical surgeon with poor results. Another surgeon on the same faculty was nicknamed ‘The Raptor’ for his cold, abrasive personality. This surgical bird of prey frequently infuriated patients, staff and co-workers, but, as Markary recounts, he had amazing technical abilities, and his patients did far better than those of the kindly Dr. Hodad.

Who would you choose as your surgeon?  Dr. Hodad for his nice personality and smile which he serves up to you while he feeds you poison, or The Raptor who may leave you in tears, but alive?

These questions directly relate to medical malpractice issues, as patients are less likely to sue physicians they like, but who have nevertheless committed professional negligence.