Accrediting agency cracks down on physicians’ bullying behavior

Chicago - A national hospital-accrediting agency has issued new requirements aimed at minimizing the kind of physician behavior that can lead to medical errors, the Associated Press reports.

The Chicago-based Joint Commission, an independent organization that accredits most of the nation’s hospitals, recently released a safety alert stating that intimidating behavior on the part of physicians can make nurses reluctant to question a doctor’s performance, which in turn can result in medical errors. Thus, the Commission will require hospitals to have codes of conduct and processes for dealing with inappropriate behavior in place by 2009. Hospitals that fail to do so risk losing their accreditation.

The AP story notes a 2005 survey published in the American Journal of Nursing that included nurses’ comments, such as, “Most nurses are afraid to call Dr. X when they need to, and frequently won’t call. Their patient’s medical safety is always in jeopardy because of this,” and “I have caught myself in the middle of mislabeling specimens after confrontations that have been upsetting.”

Another survey, conducted in 2003 by the Institute for Safe Medication Practices, found that 40 percent of health providers said they kept quiet rather than question a doctor known to intimidate others.

The AP story quotes Grena Porto, a nurse involved in the Joint Commission’s efforts, as saying that nurses need to be “appropriately assertive” and feel safe enough to ask a doctor, “Are you sure we’re supposed to operate on the right leg rather than the left?”