JULY 8, 2013
Unprofessional behavior by medical hospitalists

By their own admission, medical hospitalists are guilty of many types of unprofessional behavior says a paper in the Journal of Hospital Medicine. A group of researchers from the University of Chicago surveyed medical hospitalists from three major Chicago area teaching institutions. The respondents themselves rated each listed behavior on a professionalism scale. There were 77 responses from pool of 101 hospitalists who were sent the questionnaires. The study asked respondents to state whether they had either engaged in and/or observed unprofessional conduct.

The key findings were as follows:

  • Most of the respondents had engaged in at least one unprofessional behavior.
  • The most common unprofessional behavior was [I hope you are sitting down.] having non-medical/personal conversations, such as discussing plans for the evening, in hospital corridors. [Gasp!]
  • Over 60% of these doctors admitted that they ordered a routine test as “urgent” as a way of obtaining results more quickly. [Can you believe it?]
  • My favorite is that 40% confessed that they had made fun of or disparaged the emergency department team for missing findings. [Unreported but very likely true is that 60% of those questioned committed another unprofessional act, which was lying by claiming they had never made fun of or disparaged any ED MDs. The only physicians I know who do not routinely make fun of the ED staff are pathologists because they never deal directly with the ED. Before all you ED docs get your panties in a knot, I am certain all of you disparage all of us too.]
  • Other alleged unprofessional behaviors were celebrating a blocked admission, going to working when ill and texting during conferences.

Another interesting finding was that for every one of the over 30 unprofessional behaviors listed in the questionnaire, hospitalists said they had observed many more such behaviors than they admitted to participating in.

Despite what many surgeons may have believed, this survey shows that medical hospitalists are really pretty normal. 

But I suspect there will be corrective actions for these doctors at the three hospitals. A curriculum will be developed and monitoring metrics will be established. Maybe listening devices will be placed in hallways. These scandalous behaviors must be stopped.

A final note—this study was supported by grants from two different sources.

Skeptical Scalpel is a recently retired surgeon and was a surgical department chairman and residency program director for many years. He is board-certified in general surgery and a surgical sub-specialty and has re-certified in both several times. For the last two years, he has been blogging at SkepticalScalpel.blogspot.com and tweeting as @SkepticScalpel. His blog averages over 900 page views per day, and he has over 6200 followers on Twitter.

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