Irritable Physician Syndrome

Do you have “IPS” (Irritable Physician Syndrome)?

“IPS” affects up to 20-30% of the active physician population, and is the direct result of “toxic” levels of episodic or chronic irritability, anger, or rage. “IPS” is an independent risk factor equal to cigarette smoking, high blood pressure and others as a predictor of premature death amongst physicians. It is also a direct contributor to “CWB” (Counterproductive Work Behavior) which costs industry up to $200 billion per year in direct costs.

In particular, “IPS” is related to disruptive physician behavior in the health care work environment. It has been shown to have direct linkage to the nursing shortage and negative outcomes of care (e.g. adverse events, errors, mortality, etc.) Thus, all physicians have a vested interested in understanding the epidemiology, causes, course, prognosis and management of “IPS”.

SYMPTOMS OF “IPS” CAN INCLUDE:

Emotional Constipation: Frequent feelings of suppressed annoyance or anger at subordinate staff
Emotional Diarrhea: Episodic or chronic verbal confrontations, comments, or acts directed at staff, colleagues or others
A strong cognitive conviction that, if but for the incompetence of others, your feelings of upset and acts of verbal aggression wouldn’t be necessary
The view that any pattern of complaints or criticisms is secondary to “personality conflicts” with one or more individuals who “have it in” for you
Low levels of awareness regarding your “social stimulus value” (i.e. how your behavior is perceived by others who work with you)
“LFT” (Low Frustration Tolerance for others who fail to live up to standard)

Note that the course of “IPS” is typically chronic, though can fluctuate depending on life circumstances and stress levels.

Relevant Background: The 2009 review for the Joint Commission of Accreditation of Health Care Organizations included a standard that hospitals develop and implement institutional Codes of Conduct. In addition, the Joint Commission has recommended that hospitals provide for education and other measures that address disruptive physician behaviors in the health care environment.

Further, the “zeitgeist” in health care is evolving rapidly. For many organizations, the liability/risk on several levels is so great that they are becoming much more involved in addressing physician conduct issues. This will undoubtedly increase significantly in years to come.

In addition, other health care workers are not immune from the effects of a sub-variant of “IPS”: Irritable Professional Syndrome. It has been known to affect comparable numbers of others in the health care field, including nurses, administrators, and technicians. The negative effects on them and the health care system can be equally as daunting.

Prognosis: The good news is that, in most cases, “IPS” is an entirely manageable condition. Particularly for those who recognize the warning signs, obtain early screening and take effective preventative measures to manage “IPS”. By completing the “Toxic Anger Quiz” below, you will be taking a first step in seeing how you compare with the general population on this underlying contributor to “IPS”. After doing so, you can judge for yourself whether this is an area that warrants your further attention and concern.

The bad news is that when “IPS” is ignored it often leads to a variety of negative outcomes which can include:

Loss of professional licensure
Loss of hospital privileges
Loss of income and status
A 4-5 time increase in the likelihood of premature death from all causes
Divorce and damage to other relationships

Download and take the quiz: Here

Have you taken the quiz? Here is the interpretation document.