Abstract

Unprofessional behaviour occurs when ‘the use of inappropriate words, actions or inactions by a physician interferes with teamwork and quality healthcare delivery safety’. Unprofessional behaviour impacts on patient experience and outcomes, contributes to poor teamwork and increases the risk of complaints and litigation. Most clinicians do not present problems, but recurrent incidents involving the same individuals are common.

Responsibility for recognising and managing unprofessional behaviour should be encouraged at all levels of the health care system however clinical leaders have a particular role in both modelling professional behaviours and leading individuals and departments. Clinical leaders benefit from having policies in place for dealing with unprofessional conduct which must have the endorsement of the executive leadership team. Policies are required to be transparent, consistent and fair. Screening for health and other issues is an essential early intervention in managing unprofessional behaviours. Leaders need to be aware of where to find support for doctors with health or related issues. The evidence suggests that graduated response is most useful for managing the majority of disruptive behaviours except in the case of single egregious acts such as a sexual or physical assault.Leaders need to be supported and have the necessary training to develop skills in managing unprofessional behaviours. Organisations have an obligation to provide access to human resources, legal and occupation health advice for those directly leading doctors who display unprofessional behaviours.Clinical leaders with roles in colleges, regulatory organisation and policy directorates also play an essential role in creating and promoting a culture in which professionalism can thrive.