A medical journal published an anonymous essay last month by a physician recounting other doctors’ crude and sexual comments and behavior with patients during obstetric and gynecologic surgeries.

From rude and disparaging remarks about a nurse’s special needs son, to joking about a patient screaming in pain because the doctor did not use enough anesthetic, political correctness has clearly not penetrated into the operating room. Whether it’s angry outbursts, lewd remarks or passive aggressiveness, bad conduct by those in the medical community is called  “disruptive behavior.” It’s considered such a risk to patient safety that hospitals must have a system for addressing it in order to meet accreditation standards.

Disruptive behavior leads to increased medication errors, more infections and other bad patient outcomes — partly because staff members are often afraid to speak up in the face of bullying by a physician. Since the majority of medical mistakes can be traced to poor communication, any barriers to communication (including operating room disruptions) represent significant health risks to patients.

Most experts estimate that up to 5% of physicians exhibit disruptive behavior, although fear of retaliation and other factors make it difficult to determine the extent of the problem. A 2008 survey of nurses and doctors at more than 100 hospitals showed that 77% of respondents said they witnessed physicians engaging in disruptive behavior, which often meant the verbal abuse of another staff member. Sixty-five percent said they saw nurses exhibit such behavior.

At Vanderbilt University Medical Center, 90% of team members don’t get any complaints, 6-8% get occasional complaints and 2-3% account for more than 40% of complaints. said Gerald Hickson, a doctor and senior vice president for quality, safety and risk prevention. Of that 2-3%, more than three-quarters turn their behavior around and don’t have recurrences. Only a couple medical professionals out of about 1,600 lose their staff privileges each year, meaning they are no longer able to see patients, for this sort of behavior, he says.

For more, read the USA Today.