Most transgressions considered “low-level” unprofessional behavior
by Richard Quinn
New research published in the Journal of Hospital Medicine found two-thirds of hospitalists at three Chicago academic health centers engaged in some level of unprofessional behavior.
The report, "Participation in Unprofessional Behaviors Among Hospitalists: A Multicenter Study," found 67.1% of the 77 respondents had medical or personal conversations in patient corridors, 62.3% had ordered a routine test as "urgent" to speed up results, and 40.3% poked fun at other physicians to colleagues. More troubling, the report showed that 6.5% of respondents had engaged in falsifying patient records and that 2.6% had performed medical or surgical procedures on a patient beyond their self-perceived level of skill. Both behaviors were defined as egregious.
Some media reports have played up the findings of unprofessionalism, but study authors note that the findings are more nuanced than that. "I would emphasize that participation in egregious behaviors was low especially related to trainees, which is a plus," says co-author Vineet Arora, MD, FHM, MAPP, associate professor of medicine and associate director of internal-medicine residency at the University of Chicago's Pritzker School of Medicine. "However, certain job characteristics change the likelihood of unprofessional behavior—that is probably the most interesting finding."
Dr. Arora says that the report's findings helped craft a video intervention that has been used at all three academic centers. The video, funded by the American Board of Internal Medicine (ABIM), is just a first step in stressing to hospitalists behaviors that are considered professional, she adds.
One of the surprises of the data, she says, is that hospitalists with lower amounts of clinical work on their plate were more likely to report making fun of other physicians or patients.
"We often think that too much clinical work leads to burnout and depersonalization, but this shows the opposite," she says. "It may be that those hospitalists who do a lot of clinical work value their relationships and understand the importance of setting a professional tone for their work."
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