Research carried out by University of Florida management professor Amir Erez and doctoral student Trevor Foulk at the Neonatal Intensive Care Unit (NICU), in an Israeli hospital, has uncovered the extent to which disagreeable comments can affect the care a doctor is able to deliver.
Doctors not immune to the negative mental effects of criticismMedical teams which included two doctors and two nurses
The control groups were not disparaged and every team’s performance was measured using 11 parameters including, time to diagnose,
The results showed that those who were faced with the argumentative mother underperformed in all measures. The effects of criticism accounted for 40% of the variance of practitioner performance whereas lack of sleep only accounted for 20%.
“People may think that doctors should just ‘get over’ the insult and continue doing their job. [Rudeness] is actually affecting the cognitive system, which directly affects your ability to perform,” Erez said.
Next step: Helping doctors to cope with criticismThe results “could potentially save lives” and pave the way in finding new methods to help doctor’s cope with derision. Erez and his team also investigated two different methods of intervention for the non-control teams.
Certain teams were given a pre-test intervention, in which doctors were provided with a computer game that desensitised them to strong emotions; otherwise known as cognitive bias modification. Other teams were given a post-test intervention in which they were asked to write about the experience from the point of view of the harrowed mother.
Erez found no difference in the performance between the control groups and those teams who received pre-test intervention.
“It’s really shocking how well it worked,” Erez said. “They were basically immunised from the effects of rudeness.”
Another study conducted by researchers from Erasmus University,
By asking the doctors to diagnose and rate the likability of each patient, the researchers found that the more difficult a patient, the more likely the doctor was to make a mistake.
Re-adjusting bias and de-sensitising to hurtful words can helpIn a follow-up study, the scientists further examined this connection and concluded that dealing with aggressive patients drained doctors of the mental energy required to make accurate clinical rulings. Additionally, some patients triggered reactions in doctors that hampered with their judgement and reasoning skills. Disruptive behaviour is powerful because it can disturb an individual’s working memory, which in turn affects the ability to learn, recall and apply information in the moment.
This is troublesome especially as a study conducted in 2010 suggested that this behaviour is very common – in
Another trick is meta-cognitive de-biasing or the ability to reimage a difficult patient behaving in a more pleasant manner. Converging with colleagues and asking for advice can help doctors feel less alone and reminding patients that they can express concerns in a more amiable manner, can help reduce tensions on both sides.
In the meantime,
The influence of word choices in patient-doctor communications
The patient’s differential treatment of nurses and doctors
Dismissive behaviour: A threat to a doctor’s workplace and career