Amidst all the reports of physician stress and burnout in recent months comes an article from the Canadian Medical Association Journal (CMAJ) that reports more than 75 per cent of health-care workers say they have witnessed uncivil behaviour from physicians.
The article was authored by Heather Murray, Christopher Gillies and Armand Aalamian from the Canadian Medical Protective Association in Ottawa and the Kingston Health Sciences Centre Department of Emergency Medicine.
Behaviour categorized as “incivility” includes aggressive or dismissive language, and actions or inactions, that degrade working relationships, said the article.
The authors also wrote that the prevalence of bad behaviour varies and is "likely underreported" owing to nonstandard and diverse behaviours.
"More than 75 per cent of health care employees have witnessed uncivil behaviour from physicians, and 31 per cent of physicians report receiving weekly or daily rude, dismissive or aggressive communication from other doctors," said the article.
"Habitual incivility from specific individuals is commonly reported, but situational triggers can increase uncivil behaviour."
The authors wrote that high workload, resource limitations, communication challenges, poor team cohesion, unfamiliarity with team members and interdisciplinary interfaces were associated with increased incivility. They added that physicians with consistent disruptive behaviours may have concurrent mental health challenges.
The article said there were reports of higher rates of incivility toward trainees younger than 30 years, people shorter than 5-8, junior trainees, females or non–native language speakers, or those who belong to a nondominant ethnicity.
The report said incivility by physicians is associated with poor patient outcomes, adverse effects on health care professionals and high organizational costs.
"Disruptive behaviour diverts attention away from patient care, diminishes team collaboration and is associated with medication errors, patient neglect, surgical complications and death," said the report.
In addition, those on the receiving end of poor behaviour have reported decreased well-being, with higher rates of burnout, absenteeism and premature departures.
The report concluded that organizational leadership is essential in successfully preventing and addressing incivility. This would include formalized training, specific policies and fair means to address the behaviours.
The full text of the article can be found online here: