Most doctors who wind up at Vanderbilt or similar anger management programs have long histories of conflict with colleagues and administrators, sometimes dating back to residency training, said GWU’s Samenow. Those whose outbursts are the result of underlying substance abuse or psychiatric disorders are usually diverted to other kinds of treatment.
Many are technically excellent and some are beloved by patients — even if their colleagues can’t stand to work with them. “Sometimes the guys who are most disruptive are winning teaching awards or . . . top-doctor awards,” Samenow said. Frequently they are narcissistic, compulsive perfectionists who insist that they are the real victims when complaints are lodged and defend their behavior by saying they were doing what was best for their patients.
“Other people experience them as disruptive, but I like the term ‘distressed,’ “ said William Swiggart, who co-directs Vanderbilt’s Program for Distressed Physicians. Swiggart said he tells participants in the course, which costs $4,500 per person, “This is a course based on how you’re perceived. I’m happy to assume your heart’s good. But your behavior sucks.”
The Vanderbilt team gathers considerable information before a doctor arrives in Nashville, interviewing co-workers and administrators about his or her skills, behavior and other factors.
To one doctor who complained that he didn’t know why he had been sent, Swiggart said he responded, ‘They think you’re an arrogant ass is why they sent you.’ “
George Anderson, a social worker in Beverly Hills, Calif., has been offering anger management counseling for 25 years to people in a variety of professions. Doctors, whom he treats individually, not in groups, account for a growing share of his practice.
“You’re working with the smartest group of people on the planet,” said Anderson, whose clients include doctors from UCLA Medical Center. “These are people with high IQs . . . [but] their emotional intelligence scores are really pathetic.” Anderson said he worked with one surgeon who booted an anesthesiologist out of the OR, leaving the patient unmonitored during surgery, after the two physicians had gotten into an argument.