And how to deal with them.
Related posts:
- The Angry Pharmacist calls out physicians
- Why are pharmacists angry?
- Why is everybody so angry?
- ER doc to angry patient
- Why is everybody so angry at doctors?
- How to make patients angry
- The Angry Pharmacist responds to his critics
KevinMD.com on Facebook
{ 21 comments }
Just reading this advertisement for anger management by an anger management consulting firm makes me angry.
All such regulations violate the First Amendment. These are more pretexts to oppress the doctor and prevent adequate patient advocacy.
I love hearing about how angry physicians are by the social workers, nurses, and retired docs who are now administrators. None of them have the nuts to go to work and actually be responsible for sick people each day.
Lets make a change. Instead of all you paramedical types imposing rules and recommendations on the people doing the work, why don’t you make it your calling to help the real medical staff help the patients.
In my mind I think of these people as speed bumps. They are usually about as smart too.
b
It’s very hard to tell from a web page if the doc was indeed out of control or is the social worker is simply too sensitive.
I can’t tell you how many people (especially generation Y kids) cry and complain about “being yelled at” when us Gen Xers just told them to actually do their job and not complain.
“Crying wolf” about these kinds of things only makes it harder for doctors to actually police their own who are indeed out of control.
Sometimes I just want to say “will you grow a backbone, you work in health care!”
Funny how patients and family members can behave like idiots inan ICU and that’s OK but me saying “where is that damn blood gas already” gets me sent to anger management…
In the incident cited, it appears at first glance that the social worker was at fault. What happens in a department SHOULD go through the head of the department. The Head of the Dept, while going “John McCain” on her, may have been boorish, but he did her a favor. Another, softer spoken Chief might have filed a formal complaint on her outrageous conduct which would possibly have led to her dismissal.
Docs have more than enough reason to be angry these days. With the government, trial lawyers, MCO’s, and consumer groups lined up against them, physicians are no longer “feelin’ the love.”
Wow. The comments made me wonder if anyone has ever interacted with an angry physician as defined here or read carefully the story presented.
Even if we grant that the social worker did not follow chain of command exactly, the chief called her to a meeting at which she was forbidden to speak. How many of us could tolerate that. Her response was perfectly appropriate. Walk out.
I have had one physician, angry at me because of a difference in opinion, throw a metal chart at my head, missing me by inches. As Chief of Staff at a hospital I forced Corrective Action on another Physician. It didn’t make him less angry but he learned the limits of what he was allowed to do. E.G. It is NOT okay to swear at nurses and other personnel either in private or over the phone, That is clearly abusive. It is NOT okay to throw scalpels in the operating theater. It IS okay and even appropriate to get angry but part of being adult, educated, and in charge, means constructively controlling it.
I think as more physicians are stressed to the breaking point trying to see more patients and do more work, they may lash out more. I don’t think it’s right. In fact I think we should be better at this, but after being at the hospital for 80 days in a row, I can understand people getting like this. Especially if it’s in their personality.
Throwing things is definately not OK. Ever. No question.
Patients who do that are assumed to be not in control of their actions and can be medicated against their will.
Family members of patients who do that are escorted out by security (or worse, arrested).
Any staff memeber who throws something at another person that has no right to be in the hospital. They be physically removed and not allowed to come back until they have been taught how to act like a civilized human being.
Yelling is a way fo expressing frustation. Perhaps not an advanced way but that is it’s function.
Getting physical (hitting, throwing, banging things) shows that you’ve already lost control of yourself. Like a child, you need to be removed before you hurt someone.
The angry physician is the salaried physician. The fee for service doc has to pay $6 a minute for that pleasure.
How to deal with the “angry physician”, as if that was someow different from dealing with anyone else who is angry . . .
Interesting.
Well, one suggestion might be to avoid doing things either by thoughtlessness or malice that might provoke an angry response. Deliberately going over the head of your department chief would be, for all but the dimmest-witted, something that one might expect to provoke ire once discovered. Offering the lame story about how wonderful the implemented idea was is hardly an excuse; she owed the chief the courtesy of his approval; had the idea been a bust, do you think he might have been held accountable? In many organizations, he would have been.
The writer seems like a wimpy selfish whiner who trucks out the admin/personnel-speak and self-serving psychobabble when she should have been thinking about why she got the dressing-down in the first place. She got a chewing out, so what. From a more objective examination of her actions, she acted out of turn and ignored her chain of command whenever she felt it suited her. That just doesn’t cut it, no matter what the outcome.
I sure wouldn’t want her working under me.
How to deal with the “angry physician”, as if that was someow different from dealing with anyone else who is angry . . .
Interesting.
Well, one suggestion might be to avoid doing things either by thoughtlessness or malice that might provoke an angry response. Deliberately going over the head of your department chief would be, for all but the dimmest-witted, something that one might expect to provoke ire once discovered. Offering the lame story about how wonderful the implemented idea was is hardly an excuse; she owed the chief the courtesy of his approval; had the idea been a bust, do you think he might have been held accountable? In many organizations, he would have been.
The writer seems like a wimpy selfish whiner who trucks out the admin/personnel-speak and self-serving psychobabble when she should have been thinking about why she got the dressing-down in the first place. She got a chewing out, so what. From a more objective examination of her actions, she acted out of turn and ignored her chain of command whenever she felt it suited her. That just doesn’t cut it, no matter what the outcome.
I sure wouldn’t want her working under me.
My word, but these post certainly do a good job of validating the complaints against angry physicians.
“Such regulations violate the first amendmentt”? Really! Doctor, please quote to me the clause in the first amendment that authorizes you to demean me in the presence of my patients, threaten me, or assault me? I missed that part.
As for nurses like myself not having “the nuts to go to work and actually be responsible for sick people every day,” do tell! All those years I worked in surgical ICU I was not responsible for sick people! Well, I never would have guessed! Ah, bu then, I am only as smart a a speed bump, according to you, anyway.
Here is some news for you: you are the angry docs that we complain about, and anyone who reads your posts will hear and feel the anger in your posts. You are brilliant and capable. We have tremendous respect for the responsibilities you accept each day, and for the good you do for our patients. (Yes, OURS, we carre for them too!) However, a few of you have not grown up. And, judging by these posts, it seems unlikely that you will.
I will now duck the inevitable thrown objects.
County: Your friendly, loving remark is much appreciated. I am very offended by how unfair and misleading it is. However, I am not reporting you. These speech codes apply to you as well, Hon. As you can report to the speech police, so can you get reported to the speech police.
Here are the exceptions to the Free Speech Clause. Find one that applies.
http://en.wikipedia.org/wiki/Freedom_of_speech#Restrictions_on_free_speech
This is settled law. The Federal judge had to straighten out the New Hampshire licensing board PC clinician haters by an injunction reminding them this is America, not Venezuela. The AMA Ethics policy on civility that inspired the NH licensing investigation is lawless. I encourage the doctor to sue the licensing board. I ask that he request his lawyer explore a claim against the clinician bashing AMA.
Take these Commie left wingers out with exemplary damages.
Discussed here:
http://volokh.com/posts/1152903721.shtml
The horrid feminists and the rent seeking lawyers allow zero tolerance for any speech that does not promote their sick agendas, mostly plunder and oppression. They report, they sue. They bully employers to fire people for making a joke.
I suggest the full accountability of the speech police, the lawyers, the weasel informers, the employers, the clinician hater government oppressors. No government bully should attack a clinician without the certainty of facing personal destruction. These government thugs are little more than a front organization for the criminal syndicate that is the lawyer profession. To deter.
Supremacy Clause, I did not intend for my post to be friendly or loving. I intended it to be frank. You can handle that, can’t you, big guy? As for reporting me, go ahead. Need the number?
As for the rest of your post, what are yu talking about? I neveer mentioned “speech codes.” Neither did I suggest that doctors be kept from speaking. I oppose doctors who throw contaminated objects at me, who demean me in the presence of my patients (an act that would never be tolerated if I did it nor should it), and humiliating me and my colleagues in public. I would not be allowed to do those things to you, doctor, and you shopuld not do them to me. That is all I have said. Maybe you would like to write a post about how those things are actually good things that you should be allowed to do. I would read it with interest.
I have never advocated “speach codes.” I do not give a hoot how you speak to me. Just don’t threaten me or slander me to my patients or their families. That, doctor, is a reasonable request.
As for the feminist thing, where on earth are you coming from? What does feminism have to do with whether doctors should be exempt from the rules of civil society? My wife isn’t a feminist, and neither am I. Did you think that I had no right to protest the insulting and dangerous behavior of some unstable physicians because you assumed that I was a woman? I’ll let the readers form their own conclusions about what that suggests about you.
Feel free to say anything you want about me. Do not attack me, or my colleagues, or my patients. That is my only point.
Supremacy Clause, my post was not intended to be friendly and loving; it was intended to be frank. Frank talk is a way that adults who disagree with each other, but still respect each other, communicate. I note that you write that you are “offended by how misleading it [my post] is.” Unfortunately, you do not provide any specifics about what I said that was misleading. Please, write again, identify what I said that you found misleading, and provide factual information to correct my errors. That will benefit me, and all who read your post.
Please too tell me what your reference to “speech codes” has to do with my post? In my post, I argue that the first amendment does not give physicians a special privilege to “demean me in the presence of my patients, threaten me, or assault me” (quoting the relevant part of my post). In arguing that my post is offensive and misleading, are you asserting that doctors do in fact have rights to do those things? If so, please write that plainly, and we who read your post can decide whether we agree.
My concern is not with doctors being angry with nurses, nor have I or any nurse I have ever worked with ever reported a doctor for being angry or speaking in an angry way. My objection is to the repeated practice of SOME doctors of publicly humiliating, and in some cases physically assaulting nurses. Which of those behaviors do you support, Supremecy Clause?
This is not about “speech codes.” And it certainly isn’t about “horrid feminists and the rent seeking lawyers.” Those are your issues, not mine. My wife isn’t a feminist, and I wouldn’t pass the physical to become one, so what did that have to do with my post?
You see, Supremacy Clause, this is not really about speech at all. It is about how adults treat each other in a civilized society. In a civilized society, it is considered wrong to verbally attack another person in public. Adults are supposed to control their anger and express it in ways that do not threaten injury to others. SOME physicians behave in ways that could make a reasonable observer think that those particular physicians think that their M.D. degree absolves them from these common rules of civil behavior. I object to that. Please write again, and tell me specifically what is “ofensive and misleading” about my objection. I will read your response with interest. And, if it makes me angry, I will respond in a civil way in spite of being angry, because that is how adults talk with each other when they disagree.
By the way, even my wife does not call me Hon, and since I did not make any such demeaning references to you or to any other doctor, I will ask you to restrain yourself from doing so to me.
I look forward to your response.
County: You are an adult. Assert yourself with dignity, and deal with rudeness one to one. I do not support rudeness. I have already said, it is wasteful in my prior post. The rude doc is a doc with a lot of time on his hands because he is on salary, and not paid for work completed.
Do not be a stalking horse for the employment bar. They seek lawyer gotchas and violations of speech codes to generate a tribunal, giving jobs to three lawyers. These land pirates want to plunder clinical care. When they take money out, it threatens your job as well. So having a bad day means going to Federal court on a harassment charge.
I suggest an alternative. All lawyers and their collaborators pay to the fullest extent of the law. That includes the AMA with its lawyer welfare Civility Code. Always sue the plaintiff, the plaintiff lawyer, the authors of these unAmerican guidelines, and their employers, always sue the left wing ideologues now fully in charge of the AMA. To deter. If nurses want some, then go along with these lawyer pretexts to plunder clinical care, and include nurse associations.
I am defending your freedom as well as that of doctors. At some point, you will want to set limits with your own staff, with your own out of control patients, with visitors. If firm speech serves a clinical purpose, you should not fear ruinous litigation. Why? Because these PC Commie Chavez lovers, including the Commie, lawyer lover AMA will have already been deterred by the assertive physician. The enemies of clinical care must come to fear the clinician instead of the other way around. No one attacks clinical care without a getting a bloody nose, or preferably, a legal beheading.
Supremacy, I am pleassed that, in spight of the passion with which we address this issue, there is so much on which we agree. Of course rudeness should be bealt with in an adult mannor. But what does that have to do with my post? I never complained about rudeness (which is a lamentable, but inevitable human frailty.) As I said in my prior post, I have never “reported” a doctor for anything, and if I were so petty as to report someone for mere rudeness, I would be ashamed of myself.
My posts are clear. I am protesting behavior in clinical areas that is demeaning or violent. I am not a “stalking hourse” for lawyers. I have no idea what I wrote that lead you to believe that I have a dog in that race at all. I am objecting to THREATENING BEHAVIOUR that nurses endure frequently. I cannot believe that a person of your intellect would really disagree with that possition.
The AMA seeks to impose a KGB style speech code. The licensing boards mandate compliance with AMA Code of Ethics. They act as a quasi-governmental organization. If they continue their relentless attack on clinical care, they need to be taken out for their intentional torts, subject to exemplary damages.
As to a physician bully, I may join you, waiting for the offender after work to help him learn some manners. I oppose legal proceedings that plunder clinical care.
Supremacy: I will not join you “waiting for the offender after work to help him learn some manners,” as I get the impression that this is a threat of violence. I continue to assert that it is morally (and sometimes legally) wrong to use threats of violence to compel others to behave as we want them to, so count me out. If I have misunderstood the intention of your statement, I apologize.
If the AMA is indeed trying “to impose a KGB style speech code,” then they are being foolish and wrongheaded, and you are courageous and just in resisting their efforts. I wish that you had included some examples or evidence to support your characterization, so that I and other readers could assess your position for ourselves, but that is your prerogative.
I also wish that you had responded to any of the questions that I have posed to you in previous posts, or responded to my requests that you support your opposition to my comments by addressing them directly, rather than to referring to things that I never wrote. However, that is also your prerogative.
The great thing about blogs of the quality of Dr. Kevin’s is that it allows anyone who is interested to follow the comments and form their own conclusions about the merits of what has been written. He or she can read our comments, and decide for him or herself who (if either of us) has offered meritorious arguments, and who (if either of us) has offered only straw man rhetoric and unsupported characterizations. I defer to the judgment of the reader.
Moreover, I defer to you, Supremacy. I thank you for a very stimulating exchange. I also thank Dr. Kevin for graciously allowing non-physicians like myself the privilege of commenting on his excellent site. I fear that I may have imposed too much on Dr. Kevin’s hospitality by the number and length of my comments, so I will test his patients no further. I hope that I have not been too disagreeable a visitor.
Supremacy, you have the last word.
Best wishes,
David Deitsch
(AKA CountyRat)
County: I doubt beatin’ on an angry person is productive. He might enjoy the excitement.
The best approach is to have a small, unified group meet with the person. It should include someone the angry person likes and respects. Then one puts the problem in language that addresses the self-interest of the person.
“You are a leader. When you have to humiliate staff in front of patients, it makes you look weak, frustrated, and helpless. Use your leadership to get things done. Leadership is power. Power is quiet. Desperation is loud.”
Many “disruptive physicians” may seek help if they know where credible interventions programs can be found. Currently, the two major resources are Vanderbilt Universities’ Distressed Physician” program and the University of California School of Medicine at San Dioego which is the PACE program.
Some type of on-line directory of programs is needed.
Comments on this entry are closed.