More than 250,000 deaths are
attributed to medical errors in the United States annually - which would rank as
the third-leading cause of death in the U.S., suggest statistics
from the Centers for Disease Control and Prevention.
Emotions tend to run high in hospitals, and patients or patients'
loved ones can be rude to medical professionals when they perceive
‘Even if doctors have the best intentions in mind, as they usually do, they cannot get over rudeness because it interferes with their cognitive functioning without an ability to control it.’
But berating your child's doctor could have harmful - even deadly - consequences, according to new research.
The findings by University of Florida management professor Amir Erez
and doctoral student Trevor Foulk reinforce their prior research that
rudeness has "devastating effects on medical performance," Erez said.
Some errors could be explained by a doctor's poor judgment due to a
chronic lack of sleep. Those types of circumstances, according to prior
research from Erez and Foulk, account for about 10 to 20% of the
variance in practitioner performance.
The effects of rudeness, Erez said, account for more than 40%.
"[Rudeness] is actually affecting the cognitive system, which
directly affects your ability to perform," Erez said. "That tells us
something very interesting. People may think that doctors should just
'get over' the insult and continue doing their job. However, the study
shows that even if doctors have the best intentions in mind, as they
usually do, they cannot get over rudeness because it interferes with
their cognitive functioning without an ability to control it."
In a previous study, Erez and Foulk examined the effects of rudeness
from a colleague or authority figure on individual medical
professionals. This study analyzed team performance and the effects
rudeness has when it comes from a patient's family member.
In the new study, 39 neonatal intensive care unit teams (two
doctors and two nurses) from Israel simulated five scenarios where they
treated infant medical mannequins for emergency situations such as
severe respiratory distress or hypovolemic shock. An actress playing the
baby's mother scolded certain teams while the control groups
experienced no rudeness.
Erez and Foulk found that the teams that experienced rudeness
performed poorly compared to the control groups. The teams that
encountered rudeness were deficient in all 11 of the study's measures,
including diagnostic accuracy, information sharing, therapy plan, and
communication, over the course of all five scenarios showing that the
negative effects last the entire day.
To combat the effect of rudeness, the researchers included
"interventions" for selected teams. Some teams participated in a
pre-test intervention which consisted of a computer game based on a
cognitive-behavioral attention modification method intended to raise the
threshold of the participants' sensitivities to anger and aggression.
Other teams participated in the post-test intervention, which consisted
of team members writing about the day's experience from the perspective
of the baby's mother.
Erez and Foulk found no difference in the performances of the
control groups and the teams that played the computer game. The teams
recognized the mother's rudeness - both midway and after the simulation
- but were not affected by it.
"It's really shocking how well it worked," Erez said. "They were basically immunized from the effects of rudeness."
Conversely, the post-test intervention, which research has shown to
be extremely successful for victims of trauma, actually had a negative
effect on teams.
"What is really concerning is that, at midday, these teams
recognized the mother was rude to them," Erez said. "But at the end of
the day, they did not. So not only did it not work, but it caused them
to not recognize rudeness later."
Considering the researchers' findings and the large number of deaths
attributed to medical errors, teaching medical professionals to handle
rudeness more effectively should be a priority for the medical
"In the medical field, I don't think they take into account how
social interactions affect them," said Erez, "but it's something they're
starting to pay attention to. The purpose of this research was to
identify what's going on here. Now that we've found serious effects, we
need to find more realistic interventions."