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. 2015 Dec;15(6):541-5.
doi: 10.7861/clinmedicine.15-6-541.

Sticks and stones: investigating rude, dismissive and aggressive communication between doctors

Victoria Bradley  1 , Samuel Liddle  1 , Robert Shaw  2 , Emily Savage  3 , Roberta Rabbitts  3 , Corinne Trim  1 , Tunji A Lasoye  1 , Benjamin C Whitelaw  4
Affiliations

Sticks and stones: investigating rude, dismissive and aggressive communication between doctors

Victoria Bradley et al. Clin Med (Lond). 2015 Dec.

Abstract

Destructive communication is a problem within the NHS; however previous research has focused on bullying. Rude, dismissive and aggressive (RDA) communication between doctors is a more widespread problem and underinvestigated. We conducted a mixed method study combining a survey and focus groups to describe the extent of RDA communication between doctors, its context and subsequent impact. In total, 606 doctors were surveyed across three teaching hospitals in England. Two structured focus groups were held with doctors at one teaching hospital. 31% of doctors described being subject to RDA communication multiple times per week or more often, with junior and registrar doctors affected twice as often as consultants. Rudeness was more commonly experienced from specific specialties: radiology, general surgery, neurosurgery and cardiology. 40% of respondents described that RDA moderately or severely affected their working day. The context for RDA communication was described in five themes: workload, lack of support, patient safety, hierarchy and culture. Impact of RDA communication was described as personal, including emotional distress and substance abuse, and professional, including demotivation. RDA communication between doctors is a widespread and damaging behaviour, occurring in contexts common in healthcare. Recognition of the impact on doctors and potentially patients is key to change.

Keywords: Medical education; communication; incivility; rudeness.

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Figures

Fig 1.
Fig 1.
Combined data from three hospitals in answer to the question: How often do you personally experience rude, aggressive or dismissive communication in interactions with other members of staff? Visually represented are (a) all respondents’, (b) junior doctors’ and (c) consultants’ answers expressed as a percentage. DNA = did not answer.
Fig 2.
Fig 2.
Combined data from three hospitals in answer to the question: In your experience have you noticed any particular departments and/or types of staff who are more likely to be rude or dismissive to you or colleagues? Visually represented are all respondents’ answers expressed as a percentage.
Fig 3.
Fig 3.
Combined data from three hospitals in answer to the question: How much does this behaviour affect your experience of the working day at the hospital? Visually represented are all respondents’ answers expressed as a percentage. DNA = did not answer.
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