Publication:

Disruptive clinician behaviours in healthcare: prevalence, impact and strategies for cultural reform

Disruptive clinician behavior (DCB)—ranging from incivility to overt aggression—undermines team dynamics, clinician well-being, and patient safety, particularly in community healthcare systems where resources and oversight may be limited. This narrative review synthesizes evidence from peer-reviewed and gray literature published between January 2013 and June 2024, focusing on the prevalence, typologies, drivers, and institutional responses to DCB, with special attention to its impact in community-based settings and broader public health implications. Using sources from PubMed, Scopus, and Google Scholar, and search terms such as “disruptive behavior,” “workplace incivility,” “medical bullying,” and “patient safety,” eligible studies included hospital and community healthcare workers, trainees, and medical students. Findings reveal DCB is highly prevalent and disproportionately affects junior staff and women, driven by factors such as hierarchical power imbalances, inadequate institutional oversight, cultural permissiveness, and reporting barriers. The consequences are far-reaching, ranging from increased burnout and reduced clinical performance to weakened team cohesion. Effective interventions include peer-support programs, simulation-based professionalism training, and leadership-led cultural reform. Addressing DCB demands systemic change grounded in psychological safety, policy clarity, and leadership accountability, with these principles integrated into medical education and community health governance to foster safer, more equitable healthcare environments.