Published 10/19/2025
In May 2024, the Committee on Healthcare Safety revised the Disruptive Behavior and Orthopaedic Patient Safety information statement. Although the document primarily addresses patient safety, its relevance to physician mental health is clear. A respectful, collaborative clinical environment not only prevents medical errors but also supports the emotional resilience and well-being of orthopaedic surgeons and their teams.
Why disruptive behavior matters
Orthopaedic surgeons rely on cohesive, high-functioning surgical and clinical teams. Nurses, anesthesiologists, and surgical staff members all play critical roles in patient outcomes. When hostile, aggressive, or passive-aggressive behaviors undermine team dynamics, patient care suffers. The American Medical Association defines “disruptive behavior” as any abusive verbal or physical conduct that potentially or negatively affects patient care.
Importantly, the revised statement clarifies that occasional frustrations or constructive criticisms of medical systems should not be mislabeled as disruptive. Rather, disruptive behavior refers to repeated patterns — yelling, insults, condescension, or hostile avoidance — that erode team trust and jeopardize safety.
The mental health connection
The theme of this month’s AAOS Now issue — physician wellness — aligns closely with the message of this statement. Surgeons working in toxic or disrespectful environments face higher risks of stress, anxiety, and burnout. Studies have shown that disruptive behavior contributes to staff turnover and can even exacerbate nursing shortages. The Joint Commission has acknowledged the connection between hostile work environments and adverse patient outcomes, mandating that healthcare organizations adopt and enforce codes of conduct to address these behaviors.
For surgeons, this has real consequences. Being subjected to, or accused of, disruptive behavior carries heavy professional and emotional weight. Accusations may harm reputations, and unresolved exposure to toxic conduct increases frustration and emotional fatigue. By setting clear standards, the AAOS statement helps protect physicians from both extremes — ensuring that valid concerns are not mischaracterized and that harmful behaviors are appropriately addressed.
Promoting a culture of respect and safety
The revised statement reinforces that orthopaedic surgeons, as leaders of patient care teams, bear responsibility for cultivating an environment of cooperation, collegiality, and mutual respect. Such environments empower all team members to speak freely about patient-safety concerns without fear of intimidation.
Recognizing the human side of medical practice, the statement acknowledges that stress and conflict are inevitable in high-stakes environments. Still, ongoing patterns of hostile behavior cannot be tolerated. Education, awareness, and accountability are essential to ensuring surgeons and their colleagues maintain professional conduct that protects both patients and each other.
Highlighting this revision at a time when physician burnout and mental health are front-page issues underscores an important truth: Patient safety and physician well-being are inseparable. Disruptive behaviors erode both. By contrast, clear standards, supportive policies, and respectful work environments allow surgeons to thrive and deliver the best possible care.
The Committee on Healthcare Safety’s revision of this statement is more than a policy update — it is a reminder that orthopaedic surgery must continue to evolve toward cultures that value collaboration, accountability, and compassion. In doing so, the profession safeguards not only its patients but also the health of its physicians.