Reporter's Notebook

Doctors Admit To Unprofessional Behavior In Study At 3 Chicago Hospitals

By Jordan Rau

June 13th, 2012, 1:22 PM

Working in a real hospital isn’t usually as dramatic as is portrayed in TV shows like Grey’s Anatomy or House, MD, but a new study has identified unprofessional behaviors to which hospital-based doctors most frequently admit, including badmouthing fellow doctors and finding medical excuses to get out of having to care for patients.

Two-thirds of doctors surveyed at three Chicago hospitals copped to having personal conversations, such as discussing evening plans, in earshot of patients, and 62 percent said they had mischaracterized a routine test as “urgent” to get it done faster. Four out of 10 said they mocked another¬†physician to colleagues. The same number said they bad-mouthed emergency room doctors for missing part of a patient’s medical problems.

Three out of 10 said they made disparaging comments about a patient on rounds. Twenty-nine percent said they had attended a dinner or social event sponsored by a drug or medical device manufacturer or other business that stood to gain by a doctor’s decision.

The study, published in the Journal of Hospital Medicine, was based on the responses of 77 hospital-based doctors–known as hospitalists–from the University of Chicago Pritzker School of Medicine, Northwestern University Feinberg School of Medicine and NorthShore University HealthSystem.

Some of the unprofessional behaviors involved dumping work on someone else.¬† According to the study, 9¬† percent admitted that they had transferred a patient they could have taken care of to another in order to reduce their patient load.¬ This practice is known as turfing, and 12 percent of physicians admitted they had “celebrated” a successful turf. Eight percent of doctors said they had blocked a patient, which means they refused to accept the patient into their unit by claiming the patient should be cared for in another part of the hospital. Twenty-one percent acknowledged celebrating a blocked admission.

The study noted that “participation in egregious behaviors, such as falsifying patient records (6.49%) and performing medical or surgical procedures on a patient beyond self-perceived level of skill (2.60%), was very low.” But more hospitalists reported seeing another doctor act unprofessionally than admitted they did so themselves. For instance, 68 percent said they had witnessed another doctor “blocking” a patient–eight times as many who admitted doing the blocking. And almost 20 percent of doctors said they had observed a patient being discharged before they were ready to go home, while only 2.6 percent admitted to doing that.

Dr.Vineet Arora, one of the authors of the study, said observations of unprofessional behavior can be wrong because doctors don’t “know the full context of the story” or because more than one doctor can report seeing the same incident, inflating the number. She said the study focused on rates of unprofessional actions that doctors admitted participating in, because those are more persuasive to the officials who put together trainings on professionalism for doctors and residents.

“The goal is to figure out what types of behaviors people are not in touch with, that come across as unprofessional,” she said. She said that since doctors may not admit to bad actions even in an anonymous survey, the real rates of some of the unprofessional actions may be somewhere between the number doctors admitted to doing and the number they claim they observed.

jrau@kff.org

4 Responses to “Doctors Admit To Unprofessional Behavior In Study At 3 Chicago Hospitals”

  1. KDC says:

    I find it interesting that accepting a physician accepting a meal from a drug rep is considered unprofessional, while the president and congress are celebrated for their “fundraising”. Are not the two mirrors of each other? Doctors take monetarily valued gift from someone who stands to benefit from their decisions= president taking money (cold, hard cash) from those who stand to benefit from his decision.

    And come on, talking about personal things in earshot of patients?? Really? Are Doctors supposed to not be human? Make up your minds. Hey, Doc, you need to empathize more, connect more, be more human, more personal, more relatable. But keep your personal life far, far away from the patients. Hmm. Interesting dichotomy.

  2. Pete says:

    Unprofessional? Are we to think this is some sort of news flash? Who doesn’t know this? Well, at least someone is finally admitting it! Most doctors are nothing but a bunch of prima donnas that think they are above everyone else. Very few think they are human like the rest of us. I guest they learn this behavior in medical school. At least in primary care, it’s a perfect example of why we need less doctors and more nurse professionals. Everyone keeps saying we will need more PCPs in the future. I say we need less! Way less! We need more PAs and RNs and less PCPs!

  3. a doctor says:

    I just got back from a personal vacation in Napa. Took a hot air balloon ride. One of the other people on the balloon was an optometrist from North Dakota. Her trip and her husband’s was all expenses paid by the manufacturer of lenses for glasses. Airfare, hotel, wine country tour, all meals- all free to her. Politicians are constantly going on “fact finding” trips paid for by private industry looking for government contracts. And a doctor cannot accept a lousy pen without being called a criminal? Oh please.

  4. Kathy says:

    I disagree with Pete. I have worked in major medical centers for 27 years of my 37 years as a nurse. I have not found “most” physicians as prima donnas. The turfing behavior described in the article is old news but still disturbing nonetheless. It also happens in other healthcare professions and other fields. I am sure lawyers “celebrate” turfing an obnoxious client to someone else. Many of the physicians deal with life, quality of life, and death decsions daily—and many do it well, others still struggle with it just like “other humans”.
    I have been on the patient side of things of late and found very caring physicians. My course of care involved respiratory complications but my surgeon and his staff were still attentive–I never felt “turfed”. Perhaps the public’s expectation is that physicians should be at their beck and call and walk on water. If the perception changes then there would be room for a physician to relax with their patients and be “human”.
    Being a nurse I am an advocate for more nurse practitioners in primary care–it will make for a better healthcare team.

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