RT Journal Article
SR Electronic
T1 Sticks and stones: investigating rude, dismissive and aggressive communication between doctors
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 541
OP 545
DO 10.7861/clinmedicine.15-6-541
VO 15
IS 6
A1 Victoria Bradley
A1 Samuel Liddle
A1 Robert Shaw
A1 Emily Savage
A1 Roberta Rabbitts
A1 Corinne Trim
A1 Tunji A Lasoye
A1 Benjamin C Whitelaw
YR 2015
UL http://www.rcpjournals.org/content/15/6/541.abstract
AB Destructive communication is a problem within the NHS; however previous research has focused on bullying. Rude, dismissive and aggressive (RDA) communication between doctors is a more widespread problem and underinvestigated. We conducted a mixed method study combining a survey and focus groups to describe the extent of RDA communication between doctors, its context and subsequent impact. In total, 606 doctors were surveyed across three teaching hospitals in England. Two structured focus groups were held with doctors at one teaching hospital. 31% of doctors described being subject to RDA communication multiple times per week or more often, with junior and registrar doctors affected twice as often as consultants. Rudeness was more commonly experienced from specific specialties: radiology, general surgery, neurosurgery and cardiology. 40% of respondents described that RDA moderately or severely affected their working day. The context for RDA communication was described in five themes: workload, lack of support, patient safety, hierarchy and culture. Impact of RDA communication was described as personal, including emotional distress and substance abuse, and professional, including demotivation. RDA communication between doctors is a widespread and damaging behaviour, occurring in contexts common in healthcare. Recognition of the impact on doctors and potentially patients is key to change.