Long gone are the days when you needed to schedule an appointment weeks away and wait to complete your court ordered assessment.  Now, whether you have a DUI, Drug / Alcohol, anger management or domestic violence assessment, it can be completed quickly and easily with a licensed or certified provider.  Visit CourtAssessments for more information.

Program Types Vary Widely

Slamming a portable X-ray machine into a wall in front of a patient. Screaming at a nurse. Throwing instruments. Death threats.

All of these infractions are reasons physicians have been referred by hospitals, medical boards, and even their own attorneys to programs that assess their behavior and work with them to correct it.

However, even less-dramatic behavior seen by a coworker as passive-aggressive, manipulative, or threatening can result in a referral as well, leaders of the programs say.

“Perfect Storm” of Developments

Betsy Williams, PhD, MPH, clinical director of the Professional Renewal Center in Lawrence, Kansas, describes a “perfect storm” of changes that are sending physicians to programs such as hers.

Laws have gotten more strict, a Joint Commission alert has warned hospitals of the dangers of disruptive behaviors, more physicians have gone from being self-employed to being hospital employees, and team-based core competencies and Internet-savvy patients demand more collaboration from physicians.

Experts say only a small number of physicians (between 3% and 5%) exhibit disruptive behaviors, but more than 70% of physicians polled in a 2011 survey said disruptive physician behavior — from profanity to outright assault — occurs at least once a month at their organizations. More than 10% said such incidents occur daily.

Ultimately, these actions can have serious consequences for patient care and hospital finances, and the pressure is on to stop it from poisoning care environments.

“There may be more referrals [for treatment] because there’s simply more risk in not making the referral,” said Ari Novick, PhD, a psychotherapist with AJ Novick Group in Laguna Beach, California, which offers a program specifically for physicians.

“Twenty years ago, physicians could sort of behave the way they wanted to, and there really wasn’t a protocol to stop that. We’re seeing the trend move toward more equality in the workplace, regardless of whether you’re a physician or a scrub tech,” Dr. Novick said.

 

 

Some of the best known programs are those for distressed physicians at Vanderbilt and the University of Virginia, as well as the Physician Assessment and Clinical Education (PACE) program at the University of California, San Diego. But programs are available all over the country and range from one-on-one sessions once a week to group coaching to communal living in apartments so that interactions with others can be observed.

The referred physicians are more often men than women, but they come from all disciplines, program directors say. Giovanna Zerbi, PsyD, who teaches University of California, San Diego, anger management courses for physicians, said the more stressful their practice area — obstetrics-gynecology, surgery, emergency medicine, for example — the more likely physicians are to wind up in her program.

Dr. Zerbi said a large part of her workshop is teaching leadership skills. Many of the physicians she sees describe a loss of power from being the captain of the ship to having to work collaboratively as healthcare models evolve.

“They don’t really know how to make things happen, and so yelling is a way to get people to do what they want in the moment,” she said.

The first step is often getting physicians to take responsibility for their actions, program leaders note.

“I usually have a room full of innocent lambs who say the system is completely messed up,” she said. “That’s where we start, and then in the course of 3 days people start taking some responsibility.”

 

Other Reasons for Actions

 

Dr. Williams, from the Kansas program, said it is important to find the right program for a particular physician, because the reasons for referral vary widely. For instance, sometimes a change in an underlying medical condition is fueling unacceptable behavior, so the treatment options are different.

She approaches treatment as a way to fill in the collaborative and communication skills that may not have been stressed when physicians were in medical school.

That has changed, she said: Medical schools now are being more attentive to these issues early on and have even sent students whom they see as having potential for disruptive behavior to her program and others. Early intervention is important to stop what has become a culture of acceptance at hospitals, said Glenn Siegel, MD, who, with Mary Pittman, MS, RN, developed a model for treating disruptive physicians that is used in hospitals and state physician assistance programs nationwide.

“Often we see a long history of a physician being verbally abusive in the workplace and the hospital doing nothing about it because they don’t want to tamper with the revenue production of that physician,” Dr. Siegel said. That reinforces behavior and ultimately affects the patient. It also can undermine teamwork when colleagues feel they cannot approach the physician or know that he or she will not return pages or telephone calls.

When physicians come to Dr. Siegel and Pittman for treatment at Professionals at Risk Treatment Services in Elmhurst, Illinois, they have sessions between 9 am and 5 pm Mondays through Fridays. Physicians stay in apartments or “therapeutic residences” with other physicians so that professionals can observe during day sessions and after hours how they interact with people outside their clinical environments. Programs start with the recognition that a physician’s anger is quite often paired with a belief that they are championing quality healthcare and a fierce sense of responsibility to patients.

“It’s all these other contaminating parts of themselves that they’ve never really looked at or understood. They need some awareness of themselves and have a better relationship with themselves to function without so much anger,” Dr. Siegel said. At the extreme end of the training for disruptive physicians are long-term engagements during which experts are called to a hospital to interview staff, set limits, and restore order. William Norcross, MD, executive director of the University of California, San Diego, program, said PACE experts were once retained by a hospital for a year and a half to work with a staff dealing with disruptive physician behavior.

“For hospitals, this can be a multimillion-dollar problem…if 1 or 2 of their high-earning physicians are disruptive. There are patient safety issues, there are lawsuit issues, there are nurse retention issues,” Dr. Norcross said. “It is often in a hospital’s best interest to fix the problem, rather than just get rid of it.”

 

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Reprinted with permission from Medscape (http://www.medscape.com/), 2013, available at http://www/,medscape.com/view article/ 782504

Online Alcohol and Drug Awareness Classes

AlcoholDrugClass.com has long been a provider of online drug, alcohol, MIP and DUI programs.  We have recently teamed up with EasyDUIClass.com and will be the official provider of their NV licensed DUI school, license number DUI000043419.

If you have been required to complete a licensed DUI program for a DUI in the state of Nevada, then look no further.  This 8 hour online class is simple and easy to complete and can be done from any location and from any device.

Just think, you can finish your DUI class from Starbucks, while at the gym or waiting at the airport.  It’s that easy.  Don’t let your DUI get in the way of getting your license back and your life in order.  Get started today.

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In the legal system today, many times they want to teach people how to handle the issues that have caused them to wind up before the court so that the offender doesn’t repeat the behavior once out of jail. This is especially true for crimes that originate because a person has temper control issues. Anger management classes are increasingly becoming one of the penalties that a person must accomplish if they have been charged with a crime of this nature. Taking the course online is a big help to those who can’t make weekly in-person classes because they have odd working hours or who would have to commute to a facility far away. There are other advantages to taking this class online. You will be able to work at your own pace and can always interact with the instructor with a simple phone call. Prior to enrolling, you should check to see if the judge will accept an online class for your particular situation. If it does, then you will be happy to save money and your precious time.

I have had anger issues since I was pretty young. I think it started with my father – he was a short tempered man, prone to hostile outbursts that for a child seemed entirely random. I got used to cowering and apologizing even when I did not know what I was apologizing for. As I got older my own problems with anger began to emerge. I have recently had some situations where I got so angry that I destroyed things around me. Last week I threw my glasses across the room, I’ve broken things on my desk and I actually kicked the door so hard it left a hole. I just had to take it out somehow, but it’s getting embarrassing. People around me are telling me I’ve become increasingly short tempered, snappy and not fun to be around. Since I don’t own a car right now, I researched online and found an online anger management class that looks perfect. It’s designed by a practicing psychotherapist and anger specialist and I can take it each night after dinner for as long as I want. Seems like a stress-free and educational way of addressing the issue. I can take it completely anonymously so I’m going to invest the time without saying anything and see if people notice a difference in my demeanor. I’m looking forward to getting started tonight!

My husband and I used to argue all the time. It had gotten so bad that I filed for a separation and was pretty sure we would eventually get a divorce all because of his quick temper. A few months after I filed for a separation he asked me if I would be willing to go this therapist near our house for marriage counseling. I told him I would but only if he agreed to take some sort of anger management training online. Thankfully, he agreed to do this since it didn’t require missing any work or a long commute. I was really surprised at the difference the anger management classes made as well as the couples counseling. He is so much more laid back now and does not get mad at the slightest thing anymore. We can actually have conversations now and he compromises instead of arguing. Our marriage is so much better and we no longer talk about getting a divorce at all.

Life is stressful, there is no doubt about it. Sometimes we lose sight of how to cope with the craziness of the things around us. Sadly, we take out frustrations on our family, friends, or even co-workers. When you feel like you are at your wits end, it’s best to seek help. There are many different ways to get our anger under control, but people often think that they can’t add a therapy session or class to their already stressful day. A successful way of learning how to manage anger that is becoming more and more popular is to take 12 Hour Online Anger Management Classes. Taking online classes like this is a great refresher course on how to deal with all the unexpected things that come our way, and how to effectively handle such situations. Taking them online allows you to fit them into your busy schedule whenever you have time. You are not a failure for needing help, you are a better person for understanding where your short comings are. Takings these courses will only help you become more confident in your daily life, and help you be a better person, parent and friend. Finding classes are easy, do a quick search online and you will find the right one that works for you!

If you have a problem with getting mad, it may be time to learn some crucial tools for controlling anger. Perhaps, you are worried because you’ve already caused disruption at work and don’t want to cause more problems by taking time off to attend therapy sessions. There are online classes that you can take in the privacy and quiet of your own home after your workday is done. In fact, even if you have not been ordered to take them but feel that you could benefit from some self-improvement skills than online courses are the way to go. There are specialized classes for children, parents and corporate programs to help people with their specific needs. A certificate of completion will be awarded to those who complete the class. These certificates are accepted by most of the courts in the country. All of these courses have been developed by experts in the field. These classes can also satisfy those who need continuing education classes. You’ll save time, money and the hassle of trying to follow a school’s schedule when you can take the classes any time of the day or night from your very own web-based computer. There are many benefits to taking an online class and it’s worth looking into if it’s a right fit for you.

When I was ordered to take a court ordered anger management program, I guess you can imagine that it made me pretty angry. I didn’t think I needed to take classes to manage my anger because I didn’t think I had a problem with it. Sure, I got angry a lot but we live in the kind of world where there are so many triggers, it can happen. I always had an excuse for my anger, and it was never my fault. I figured I would take the classes and just move on with life, but something happened that I was not expecting. I recognized myself in some of the scenarios and it actually frightened me. Looking at it from the outside looking in, I was able to finally identify that I had a problem. Those classes actually changed my life, and I’ve been applying the new tools I learned at work and with my family at home. My coworkers, wife and kids all seem more calm around me and everyone is happier. I didn’t realize how destructive I’d become.

Many people seem to have anger issues these days. With the added stresses from the economy, it is pretty clear why. Losing your job, not getting a promotion, or working twice as hard because other’s have been laid off, can add up. If you find yourself getting angry all of the time, you should try to do something about it. Many people do not realize how angry they have become until they do something stupid and get into trouble with the law or begin having serious health issues. Being angry all of the time is not good for you mentally either. It can add stress and make you sick. Some people also get dark thoughts into their heads about hurting the person who is making them angry. You may think that you have no time to fit another thing into your day, let alone getting to a classroom for a specific class time. But what if you could take an online anger management course? You could work them into your busy schedule at night after work or on the weekends, and go at your own pace. Before you let your behavior get out of hand, step up to the plate and do something about it. Control your anger; do not let it control you.