In a two-part series published in Academic Medicine, the journal of the Association of American Medical Colleges, Lucian Leape, MD, and co-authors describe six categories of disruptive behavior in health care and how such behavior can impact patient and worker safety.

“Perspective: A Culture of Respect, Part 1: The Nature and Causes of Disrespectful Behavior by Physicians”

Leape LL, Shore MF, Dienstag JL, et al. Acad Med. 2012(Jul); 87(7):845–852.

The authors examine the phenomenon of disrespectful behavior by physicians in academic medical settings, arguing that disrespect extends beyond overtly disruptive actions to encompass myriad other forms of incivility and aggression toward nurses, medical trainees, and patients. In this first of a 2-part series, the authors describe ways in which disrespectful behavior is manifested, discuss factors that give rise to and perpetuate a “culture of disrespect,” and examine the destructive and sometimes insidious effects of such behavior on workplace morale, quality of care, and patient safety.

“Perspective: A Culture of Respect, Part 2: Creating a Culture of Respect”

Leape LL, Shore MF, Dienstag JL, et al. Acad Med. 2012(Jul); 87(7):853–858.

In this second of two articles, the authors argue that establishing a workplace culture characterized by mutual respect is a prerequisite for achieving high reliability and safety in the delivery of health care. Noting that health care organizational leaders hold the primary responsibility for effecting this change, the authors outline steps that CEOs must take to promote the development of such a culture and to address disrespectful behavior effectively when it occurs.