Handling Surgeons When You Don’t Want to Fire Them

Aashi Arora 28 Apr 2025

Surgeons often have a reputation for being demanding and difficult, and sometimes it feels like that’s just part of the deal. Hospitals often treat it that way too—because let’s face it, a skilled surgeon brings in serious revenue and isn’t easy to replace. Their “disruptive” behaviors are often tolerated since their professional skills frequently make their positions tough to replace.

Here are a few types of disruptive behaviors most commonly seen when describing a challenging surgeon:

• Condescending communication
• Resistance to feedback
• Temperamental outbursts
• Micromanaging or overstepping
• Passive-aggressive leadership style

However, fear for the bottom line should actually be a strong motivator to address a surgeon’s disruptive behavior before it has gotten out of hand. Surgeons who yell, berate their colleagues, are dismissive to nurses and rude to patients, or otherwise create a tense, hostile environment create a damaging ripple effect that impacts morale, effectiveness of care, and even patient safety. Understanding the behavior and working to mitigate it with strengths-based coaching can significantly benefit the surgeon, everyone they interact with, and your organization as a whole—without having to cut ties with someone whose knowledge and expertise can truly benefit patients.

What Can Be Behind a Surgeon’s Difficult Behavior

Someone who has been on the receiving end of a surgeon’s insults or tantrums can be forgiven for the impulse to simply write them off as a jerk. The motivation behind negative behaviors is often much more complex, though. Surgeons, like other healthcare providers, typically pursue their careers out of a deep desire to help people recover from illness or injury, and seeing their actions solely as a power trip or the result of character flaws misses the opportunity to find solutions for disruptive behavior.

Key reasons that can contribute to a pattern of difficult behavior are:

Cause	Description	Key Contributing Factors
How They Were Trained	Surgeons undergo years of strict training under authority figures like chief residents, who may model disruptive behaviors that yield results.	– Strict supervision – Modeling of disruptive behavior by mentors – Behavior linked to achieving results
Feelings of Inadequacy	Surgeons face pressure to retain vast knowledge and avoid catastrophic mistakes, leading to imposter syndrome masked by displays of power.	– High-stakes environment – Fear of mistakes – Imposter syndrome – Displays of dominance
Circumstances of Modern Healthcare	Modern healthcare challenges divert surgeons’ focus from patient care, causing frustration and disruptive behavior.	– Soaring malpractice insurance – Arbitrary managed care decisions – Declining reimbursements – Heavy caseloads
Personality	Underlying mental health issues, past trauma, or poor interpersonal skills contribute to disruptive behavior.	– Depression or anxiety – Past trauma (abuse/neglect) – Substance abuse – Weak social/empathy skills

Attempting to address the behavior without understanding what’s behind it is unlikely to produce long-term positive change. But you should act without delay. Failures to uphold your organization’s code of conduct—no matter how productive or esteemed the surgeon is—can have cascading detrimental effects.

Unchecked Is Not an Option

In the best healthcare teams, colleagues collaborate with one another so that each can bring their strengths to bear on the cases they work on together. Disruptive behavior destroys the professional relationships necessary for such interactions. Morale plummets. Nurses become afraid to speak up with vital information that might contradict a surgeon’s opinion. Experienced nurses and even other physicians may choose to leave your organization rather than tolerate being belittled or antagonized.

Strengths-based executive coaching can help provide a solution, with a constructive approach that helps surgeons recognize their own problematic behaviors and develop the interpersonal and communication skills to foster healthier interactions moving forward. Whether the problem is of long standing or has only recently cropped up, bringing in outside experts such as iRISE Executive Coaching can be critical in helping to properly frame the intervention as an opportunity for professional growth. We specialize in working with professionals in the healthcare industry and intimately understand the pressures that can contribute to workplace dysfunction in medical settings.

If you’re at a loss to deal with a surgeon’s disruptive behavior, iRISE can help. Our coaching can provide sustainable way to invest in the long-term success of both the surgeon and your organization, for the benefit of your staff and the patients you care for. To schedule a consultation to learn more, contact us here.