Engagements with healthcare professionals can often be fraught affairs.  From the patients side, people often come equipped with a degree of knowledge from Dr Google, with waiting times and generally slow service compared to other service providers raising tensions.  From the professionals perspective, the constant conveyor belt of demanding patients can leave one stressed and exhausted.

It’s a recipe for disagreements and conflict if ever there was one.  A recent study reminds us of the perils inherent should we allow these frustrations to boil over.  It suggests that when we’re rude to doctors, it sufficiently distracts them that their performance drops significantly.

Errors from doctors are already a major cause of deaths in hospitals, so the finding that our abuse of them contributes should be cause for considerable concern.  Indeed, the study found that rudeness can contribute to a 40% drop in performance, which is almost double that attributed to a lack of sleep.

“[Rudeness] is actually affecting the cognitive system, which directly affects your ability to perform,” the authors say. “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.”

Cognitive burden

The study saw a number of neonatal intensive care teams analyzed across a number of scenarios that covered a range of situations, from intense conflict from the mother of the child they were working on, to a control group that received no such scolding.

When the performance of the teams was analyzed, it emerged that those who had been scolded by the mother performed significantly worse than the control group team.  Indeed, across 11 measures used to analyze performance, they were down across each and every one of them, including the accuracy of diagnosis, the sharing of information and creation of a therapy plan.

What’s more, the impact of this situation was found to last beyond that immediate situation, with staff performing worse throughout the entire day, suggesting a lasting impact of conflict on their performance levels.

Combating rudeness

So how might such situations be handled better?  The authors tested a number of interventions to explore the best way to mitigate the influence rudeness has on performance.

For instance, some of the participants played a game prior to the study that was designed to raise the threshold of their sensitivities to anger and aggression.  Another group of participants undertook an exercise after the patient interaction that consisted of writing about the experience from the perspective of the mother.

Interestingly, it was the computer game that had the biggest influence, with playing it prior to the examination resulting in the same level of performance as those in the control group who had not experienced any aggression from the parents.

“It’s really shocking how well it worked,” the authors say. “They were basically immunized from the effects of rudeness.”

Whereas post-incident interventions have been proven to be effective after trauma events, they appeared to make performance worse in this instance.

“What is really concerning is that, at midday, these teams recognized the mother was rude to them,” the researchers say. “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 findings, it is perhaps prudent for hospital administrators to provide staff with training on how to handle rudeness as a matter of priority, especially given the huge impact it can have on performance, and therefore safety.