September 9, 2022

Hospitals are frequently a highly emotive environment with patients, and their loved ones responding to the stressful situation by being rude to their medical practitioners when they are perceived to be receiving inadequate care. However, a new study reveals that rudeness could come at a fatal cost.


University of Florida management professor Amir Erez and doctoral student Trevor Foulk confirmed their previous research that rudeness has “devastating effects on medical performance,” according to Erez.


One estimate by Johns Hopkins estimated more than 250,000 deaths are attributed to medical errors in the U.S. annually. That would rank medical error as the third highest cause of death in the U.S. according to statistics provided by the Centers for Disease Control and Prevention.


In some instances, doctors simply made a poor judgment call possibly due to a chronic lack of sleep. According to prior research by Erez and Foulk, these events account for about 10 to 20 percent of the variance in practitioner performance. In contrast, the effects of rudeness, account for more than 40 percent according to Erez.


“[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.”


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 impact of rudeness from a patient’s family member.


The recent research was based on 39 neonatal intensive care unit teams (two doctors and two nurses) from Israel. These teams 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 the teams experiencing rudeness performed poorly when 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 illustrating negative effects last an 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 designed to raise the threshold of the participants’ sensitivity 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 between 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 impacted 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 produced a negative impact 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.”


Given the researchers’ findings and the significant number of deaths attributed to medical errors, Erez believes teaching medical professionals to handle rudeness more effectively should be a priority for the medical community.


“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.”

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