On Sermo, 56% of physicians report experiencing incivility from colleagues occasionally, frequently, or almost daily, and 88% have dealt with toxic coworkers at some point in their careers. Those numbers come from Sermo community polls of over 1,000 physicians, and they’re also consistent with what broader research shows. It has been reported that more than 75% of healthcare employees have witnessed uncivil behavior from physicians, and 31% receive rude, dismissive, or aggressive communication from colleagues on a weekly or daily basis.
An orthopedic surgeon described what happens when incivility shuts down communication in real time. “Witnessing incivility in the hospital feels like watching a slow-motion fracture in the very foundation of our care. I recall an instance where a colleague’s sharp dismissal of a resident didn’t just hurt feelings; it sucked the oxygen out of the room, leaving everyone too hesitant to speak up during rounds.”
Incivility isn’t just an interpersonal problem. The Joint Commission has identified this behavior as a direct threat to patient safety, connecting it to medical errors, preventable adverse outcomes, and clinician attrition. Yet most physicians have never received training on how to handle incivility when they experience it, witness it, or even accidentally contribute to it. This article draws on research as well as the candid physician-to-physician conversations happening on Sermo to give you a practical framework for recognizing the behavior —and doing something about it.
Physicians on Sermo are sharing firsthand experiences with workplace incivility and comparing strategies that work. Join the conversation to see what your peers are saying.
What is incivility in healthcare and how is it different from peer bullying?
Incivility in healthcare describes low-intensity negative interactions where the intent to harm is ambiguous or otherwise unclear. It shows up as condescending remarks during a handoff, dismissive body language in a case discussion, passive-aggressive communication, eye-rolling, or constantly interrupting a colleague mid-sentence. These behaviors are subtle enough to get dismissed as personality quirks or a bad day, and the person on the receiving end is often left second-guessing whether it even happened.
Bullying is different in that it’s repeated, targeted, and carries a clear intent to harm. Harassment goes a step further by targeting protected characteristics like race, gender, or disability. All three fall on the same spectrum, but incivility is the most common and normalized, as well as the most underreported.
It’s also worth distinguishing incivility from what institutions usually call “disruptive physician behavior.” Disruptive behavior is the louder end of the spectrum, things like intimidation, throwing instruments, or verbal abuse, and that’s what hospital bylaws and credentialing committees are built to handle. Most institutions have policies for “disruptive physicians” but they usually don’t address incivility, which means one of the most widespread forms of workplace mistreatment often goes unaddressed until it escalates and crosses a formal line. Accepting incivility as just part of working in a high-stress environment, or excusing it in physicians that are considered “too valuable” to be confronted, only perpetuates that cycle.
A maternal-fetal medicine specialist on Sermo framed it as something that often predates the workplace entirely. “Incivility in some professionals is acquired from family and life experience dysfunctions, often unaddressed before and during professional careers. Early discovery in professional relationships should be addressed immediately, through therapeutic mechanisms.”
When we asked Sermo members which form of incivility they most commonly observe among colleagues, passive-aggressive communication topped the list at 39%, followed by condescending remarks at 25%, dismissive body language at 20%, and deliberate exclusion at 14%.
How common is incivility among physicians?
The short answer: more common than most institutional reports suggest, largely because it rarely gets formally documented.
In a Sermo community poll of 1,027 physicians, 41% said they experience incivility from colleagues occasionally, 13% said it happens frequently, and another 2% said it’s almost a daily occurrence. Only 8% said they’ve never experienced it.
A Vanderbilt University study found that 77% of healthcare workers reported disruptive behavior by doctors. By contrast, a 2024 systematic review and meta-analysis put the pooled prevalence of experienced incivility in hospitals at 25%, with witnessed incivility at 30.1%. Both sets of figures likely understate the true scope of the problem, but the Vanderbilt finding suggests reports of physician disruptive behavior are substantially higher than the pooled estimates for hospital incivility.
A Sermo member and general practitioner described how multiple factors overlap: “In my experience, incivilities have several factors. I have encountered some just because I’m a GP, from male or female of other specialties, and or a woman, from men, because I take care of highly disabled patients, and of course because of stress and workload, especially when addressing patients at the ER.”
Incivility particularly in the training environment is a known common occurrence, often because medicine’s steep hierarchy can create an imbalance of power where attendings may feel insulated and able to mistreat trainees or junior colleagues without immediate consequences. That dynamic can normalize disrespect, especially when learners depend on supervisors for evaluations, recommendations, and career advancement, making it difficult to speak up.
Research suggests that incivility towards medical students and residents has become especially normalized. One 2025 study explored how incivility is directed at residents during their training, finding that students are subjected to “belonging games,” wherein their superiors use incivility as a way to reinforce their own power within the healthcare hierarchy. The targets of incivility in these environments often face barriers to formally reporting the issue, often accepting it as the status quo, thinking the problem isn’t severe enough to warrant a report or fearing repercussions, according to the authors of a 2023 study.
Junior faculty are also a common target, according to an internal medicine physician on Sermo. “Heavy workload, time bound work, endless duties and differences in clinical opinion most commonly lead to bullying, [especially] with junior faculty,” they shared. They further added that condescending behaviours—such as sarcastic comments, belittling juniors with questions in rounds, eye rolling and other dismissive body language—are common.
The problem is compounded by the fact that toxic physicians are often hard to remove from practice, whether because of institutional inertia, fear of retaliation, or the complexity of documenting and acting on repeated behavior. Together, these factors can allow incivility to persist, eroding morale, increasing burnout, and driving talented physicians away from the profession.
What drives incivility among physicians?
The causes are structural and individual, and they often reinforce each other. When we asked Sermo members to identify the most significant driver of incivility, the answers reflected a mix of systemic and cultural factors.
- Hierarchical structures (30%): The power dynamics between attendings and residents, and the rigid pecking order across specialties, can create environments where junior physicians are expected to tolerate disrespectful behavior.
- Workload and time pressure (29%): Physicians running on too little time and too many demands are more likely to snap at colleagues or skip basic courtesies.
- Lack of support or recognition (19%): When institutions have no defined policies or reporting mechanisms for incivility, the behavior faces no real consequences.
- Stress from patient care (18%): Burnout and emotional exhaustion wear down people’s ability to regulate their emotions and how they treat each other, especially during high-acuity situations.
Other factors may include:
- Learned behavior from training: Research identifies that learners exposed to incivility are more likely to exhibit it themselves, creating a cycle that passes from one generation of physicians to the next.
- Disproportionate targeting: The Canadian Medical Association’s 2025 report found that physicians from underrepresented backgrounds are hit hardest, with the top two reasons for bullying being gender expression or identity (47%) and ethnicity or culture (27%).
Another general practitioner was blunt about it. “Incivility between doctors is unfortunately not uncommon and is mostly due to overwork and feelings of helplessness. It’s a shame to turn on each other when we all suffer from the system’s shortcomings.”
An emergency medicine physician made the same point. “Addressing these behaviors is important because they can negatively affect teamwork, well-being, and ultimately patient care.”
How incivility affects patient safety and clinical performance
Incivility goes beyond unprofessional behavior. It’s also clinically dangerous. The Joint Commission’s Sentinel Event Alert 40 states that intimidating and disruptive behaviors can lead to medical errors, poor patient satisfaction, preventable adverse outcomes, and higher costs, and that they cause qualified clinicians to walk away from their positions. Communication breakdowns play a role in an estimated 70 % of medical errors according to a 2023 systematic review, which also found that interprofessional incivility directly compromises both patient safety and quality of care.
When we asked Sermo members what impact they believe incivility has on patient care in their setting, 39% said moderate impact, 24% said significant impact, and 28% said minimal impact. Only 5 % said no impact at all. That means nearly two-thirds of responding physicians see incivility as having at least a moderate effect on the care their patients receive.
A GP on Sermo saw the poll results as confirmation of something systemic. “The poll’s expected high ‘yes’ response reflects a systemic problem where the cumulative effect of subtle, often overlooked behaviors is eroding teamwork and directly jeopardizing patient safety by impairing clinical judgment and communication.”
A hematologist brought it back to basics. “Respectful communication and genuine collaboration are essential. We should strive to listen, share perspectives thoughtfully, and remember that our common goal is always the well-being of the patient, not proving who is right.”
How incivility drives physician burnout and attrition
The CMPA reports that healthcare team members who experience incivility show decreased well-being, higher burnout, more absenteeism, and earlier departures from their roles. Tolerating incivility erodes psychological safety and can make burnout and anxiety more likely.
This creates a self-reinforcing cycle. Incivility drives absenteeism and turnover, which worsens the staff shortages and workload pressures that fuel incivility in the first place. Understanding this dynamic is critical, especially as the broader mental health crisis among doctors continues to intensify.
As one GP on Sermo put it, institutional pressures make it worse. “The work environment is becoming more complex every day. From my perspective, they only focus on the financial targets that must be met, without looking beyond them because they’re unattainable. This creates demands on people that are exhausting, fatigued, and damaging to their personal lives.”
Another general practitioner learned that lesson firsthand. “When the environment became toxic, I overloaded myself with work to avoid thinking about it. But I learned the hard way the following: if the workplace becomes toxic, it’s time to make many changes.”
One of the most telling findings is that 51 % of Sermo respondents said they haven’t found any useful resources or support groups for dealing with a toxic workplace. That lack of institutional support can intensify burnout, leaving physicians feeling isolated and with few viable ways to recover or re-engage. In the same vein, a 2025 Sermo Barometer report has found that 43% of surveyed physicians were actively pursuing or exploring a hybrid or alternative career path outside full-time clinical practice due to burnout.
When we asked Sermo members at what point they seek management or other help for dealing with a toxic workplace, the top responses were when patient care is at risk (23%) and when their physical or mental health is declining (23%), followed by when they see something unethical (22%). For coping mechanisms, physicians most commonly reported exercise (25%), prioritizing self-care (22%), and leaning on social networks (17%).
An OB/GYN resident described what the alternative should look like. “Hospitals also need to foster cultures where rest is respected, workloads are reasonable, and teams feel safe voicing concerns. Simple measures, like protected breaks, clearer protocols, or more equitable shift distribution, can have a profound impact.”
What physicians can do about workplace incivility
Physicians have more tools to push back than many realize. The challenge is that incivility thrives on ambiguity, and breaking the pattern starts there.
Recognize and name the behavior
Naming what is happening, whether to yourself or directly to the person doing it, is the first step. Use specific and objective language, for example, “When you interrupted me during rounds, it made it harder for me to communicate my clinical concern.”
One pediatrician and adolescent medicine specialist on Sermo explained why this matters. “Often incivility is driven and misdirected from the person delivering not being aware they are doing so. It is important to call this out to break the loop and stand up for yourself and others, as they might be receiving it too.”
Document incidents
Keep a private record of each incident with the date, time, what happened, and who was present. This paper trail is very helpful if you decide to escalate, and it also helps you spot patterns that might otherwise feel like isolated events.
Report through institutional channels
Know your institution’s code of conduct and reporting process. If there’s no formal process for addressing incivility (as opposed to overt disruptive behavior), that itself is worth raising with leadership.
When incivility leads to medical errors, the consequences extend well beyond the interpersonal. One hospitalist on Sermo offered a useful reframe. “Incivility is often framed as an interpersonal problem, but it may be more structural than personal. What appears as disrespect between physicians often reflects misaligned incentives rather than individual attitudes. Many systems are driven by narrow performance metrics such as productivity, throughput, and documentation targets. When everyone is pressured to meet different benchmarks, collaboration can easily give way to frustration.”
Advocate for institutional change
Within your own practice you can push for leadership training, clear definitions of incivility in institutional policy, better reporting mechanisms, and a fair, consistent approach that focuses on changing behavior for the long term, instead of just punishing it.
Protect your own wellbeing
Set boundaries, build a peer support network, and importantly: seek professional help when you need it. If you feel that the environment isn’t going to change despite sustained effort, leaving for an alternative practice setting is a legitimate option. Incivility can also compound the emotional toll of medical errors, making an already difficult experience harder to recover from. Some physicians in persistently toxic environments find that exploring other career paths is the right next step.
When we asked Sermo members what would help reduce incivility at their workplace, enhanced communication training led the vote at 27%, followed by clearer policies and consequences at 21%, more leadership involvement at 18%, better reporting mechanisms (16%), and peer support programs (15%). In a separate poll on navigating a toxic workplace, the top strategies were controlling the things you can (20%), prioritizing self-care (19%), separating work and personal life (19%), and documenting everything (15%).
A Sermo member and internal medicine physician shared what worked for them. “Only twice have I experienced this and it was the same colleague. I believe it was some type of ego thing. I stood my ground and it did not happen again. If a colleague realizes that you truly advocate for your patients, provide good care, and you let them know that you appreciate their contributions, they are less likely to act that way.”
Another physician, a pediatrician and general practitioner, described a similar experience. “Yes, I have experienced occasional incivility from colleagues. These situations were brief but still disruptive to communication and teamwork. Fortunately, addressing the issue early helped restore a respectful working environment.”
Key takeaways
- On Sermo, 56% of physicians experience incivility occasionally, frequently, or almost daily.
- The primary drivers are hierarchical culture, workload pressure, burnout, and lack of institutional accountability.
- The Joint Commission identifies disruptive behavior as a direct contributor to medical errors, patient dissatisfaction, and clinician attrition.
- Incivility fuels a feedback loop of burnout, absenteeism, and turnover that deepens healthcare’s existing staffing shortages.
- Physicians can push back by naming the behavior, documenting incidents, using institutional channels, advocating for policy change, and protecting their own wellbeing.
Incivility is common, documented, and clinically dangerous
Workplace incivility among physicians drives medical errors, accelerates burnout, and pushes experienced clinicians out of the profession. While individual physicians can and should push back, lasting change requires institutions to treat incivility as a systemic patient safety problem rather than a personality issue.
Sermo is where physicians are already having these conversations. Join the community to share how you’re navigating workplace incivility and what institutional changes have made a difference, alongside thousands of verified physicians who understand these challenges firsthand.
