Disruptive Physician Behavior: The Importance of Recognition and Intervention and Its Impact on Patient Safety.

Professional misconduct by physicians is a significant problem with negative implications in the healthcare environment and has been termed "disruptive physician behavior" (DPB) in the United States. In recent years, hospitals and healthcare organizations have begun to better understand and formally address DPB, including its management and repercussions. Policy statements by the Joint Commission and the American Medical Association (AMA) have acknowledged that DPB may pose a threat to patient and provider safety. The purpose of this article is to raise awareness about the etiology of disruptive behavior in physicians, describe the consequences and the need for early recognition, and discuss potential interventions.

The development and evaluation of an internal workplace violence risk assessment protocol: one organization's experience.

The creation and development of a Risk Assessment Team at a large urban university is presented as a case study, with particular focus on the role the Employee Assistance Program (EAP) plays in the multidisciplinary team. The structure of the team and differing roles and responsibilities of members will be discussed. A specific protocol for addressing incidents will be introduced, along with changes in the team ' response over time. Major lessons learned will be presented, as well as the challenges the team faces today, and discussion of areas for future research and evaluation.

Psychiatry and terrorism: the profession's role in disaster response planning.

While America wages the "war" on terrorism and endeavors to protect the physical safety of its citizens, it is imperative to plan for the population's mental health needs in future terrorist/disaster scenarios. The importance of psychiatry's potential role in preparing the community for the psychological impact of terrorism is underscored against the historical backdrop of the field being "carved out" from the organization, delivery, and financing of health services in our society. A practical framework is offered for designing an organization's mental health disaster plan, including recommendations for strategic infrastructure and tactical response capabilities. Finally, the unique features of clinical practice with disaster victims are noted, including intra-clinician conflicts between professional/community interests and personal/family obligations during acute disaster events.