Rudeness has already been proven to have a toxic effect on job performance. But now, a new study shows that rudeness in the medical field can have grave consequences on patient care and doctors’ accuracy.

A joint Tel Aviv University-Technion Israel Institute of Technology-University of Florida study shows that even the most benign forms of impoliteness may hinder care.

“Relatively benign forms of incivility among medical staff members — simple rudeness — have robust implications on medical team collaboration processes and thus on their performance as a team,” says study supervisor Prof. Peter Bamberger of TAU’s School of Management. “This is important because rudeness is rampant in many medical contexts. Patients and their families may be rude to caregivers, and caregivers may be rude to one another.”

For the purpose of the research, 24 neonatal intensive care units (NICU) teams from hospitals around Israel participated in a simulation exercise involving a premature infant suffering from the common but severe medical complication necrotizing enterocolitis (in which bowel tissue disintegrates).

The teams were told that an expert on team reflexivity from the United States would be observing them by live video throughout the stimulation. Half of the teams performed in the presence of a “rude” expert who made disparaging comments about the medical personnel, whereas the other half completed their tasks under the gaze of a “neutral” commentator.

The researchers found that teams exposed to ill-mannered behavior demonstrated poorer diagnostic and procedural performance than those not exposed to rudeness.

The lead researcher in the study was Dr. Arieh Riskin of the Technion’s Rappaport Faculty of Medicine and the Bnai Zion Medical Center in Haifa. Among others involved in the study were Dr. Ayala Gover, a neonatologoist at Lady Davis Carmel Medical Center, Haifa, and Rappaport Faculty of Medicine, Technion; and Prof. Amir Erez and Trevor Foulk of the University of Florida’s Warrington College of Business Administration.

“We hope our findings will shift the focus of research on medical error toward interpersonal interactions and cognition,” says Bamberger. “From a practical perspective, we hope it will call attention to the need to shift behavioral norms in medical contexts.”

The study was recently published in the Pediatrics journal.