title: Effects of disruptive surgeon behavior in the operating room.
abstract: BACKGROUND
  Surgeons are the physician group most commonly identified as "disruptive physicians." The aim of this study was to develop a conceptual model of the results of disruptive surgeon behavior and to identify the coping strategies used by perioperative staff.
  
  
  METHODS
  Perspectives of 19 individuals of diverse occupations in the perioperative setting were drawn together using a grounded theory methodology.
  
  
  RESULTS
  Effects of disruptive behavior described by participants included shift in attention from the patient to the surgeon, increased mistakes during procedures, deterrence from careers in surgery, and diminished respect for surgeons. Individual coping strategies employed in the face of intimidation include talking to colleagues, externalizing the behavior, avoidance of perpetrators, and warning others.
  
  
  CONCLUSIONS
  Using grounded theory analysis, we were able to elucidate the impact of disruptive surgeon behavior in the perioperative environment. This conceptual model may be used to understand and counter the negative effects of manipulation and intimidation of hospital staff and trainees and to build on current programmatic strengths to improve surgical environments and training.
authors.affiliation: Department of Surgery, University of Utah, 30 North 1900 East, SOM 3B312, Salt Lake City, UT 84132, USA. Electronic address: amalia.cochran@hsc.utah.edu.
authors.forename: Amalia
authors.initials: A
authors.lastname: Cochran
authors.affiliation: Department of Surgery, University of Utah, 30 North 1900 East, SOM 3B312, Salt Lake City, UT 84132, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: Elder
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000374:Aggression; D001291:Attitude of Health Personnel; D004291:Dominance-Subordination; D005260:Female; D066296:Grounded Theory; D006801:Humans; D007400:Interprofessional Relations; D007407:Interviews as Topic; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology*; D008875:Middle Aged; D009873:Operating Rooms; D036301:Qualitative Research; D066231:Surgeons / Q000523:psychology*
keywords: Disruptive behavior; Professionalism; Qualitative methods; Surgeons