When Behaviour is a Barrier to Collaboration, Quality Care

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When physicians demonstrate unprofessional behaviour — whether through words, actions, or inactions — it not only has a negative effect on teamwork and morale but can interfere with the delivery of quality health care.

Take the example of the doctor with a quick temper who inhibits patients from raising concerns about their care. Or the doctor who makes demeaning and abusive remarks towards a colleague, making them feel unsafe at work.

“When one physician has their colleagues, learners and patients walking on eggshells just so they don’t trigger some outburst, that not only undermines medical professionalism and the communication and collaboration that underpin good medical practice, but it also impacts the delivery of quality health care and patient safety,” says Dr. Karen Saperson, a geriatric psychiatrist and Chair of the Policy Working Group.

At its meeting in December, the Board approved consultation on the Professional Behaviour policy, which requires physicians to act in a respectful and civil manner toward their patients, colleagues, and others involved in the provision of health care. The term used to describe the behaviour the policy prohibits has been reframed as “unprofessional” rather than “disruptive.”

Five elements of the draft policy:  

  • Focuses primarily on physician behaviour in the professional context, including any situation where a physician is publicly identified as a physician and/or is representing the profession (e.g., social media);   
  • Expects physicians to take appropriate action when staff they are responsible for behave unprofessionally; 
  • Expects physicians, especially those in leadership positions in workplaces, to create an environment that allows for reporting of unprofessional behaviour;   
  • Expects physicians will not punish or retaliate against those who report unprofessional behaviour; and  
  • Expects professional behaviour, including when physicians engage in advocacy — with its potential for disagreement or conflict with others. 

The College has also developed an Advice to the Profession document to accompany this policy. This document addresses the factors that can result in unprofessional behaviour, outlines the support available to physicians, makes suggestions on how to engage in advocacy professionally, and provides steps that can be taken to address unprofessional behaviour by non-physician staff members.