George Anderson positioned himself on a stool across the operating table so he could get a good angle on the surgeon’s face. He watched for signs of irritation as the doctor, known for temper tantrums, sewed a valve into a patient’s heart. Then the surgeon’s phone buzzed.
The hospital earlier had called in Anderson, an anger management therapist, to help one of their top doctors -- now cursing into his headset -- control his bad temper. After the operation, the surgeon removed his latex gloves, threw them on the floor and left the operating room in silence.
“Everyone in the room was stunned,” says Anderson, 73.
Anderson & Anderson, the business Anderson founded 30 years ago in Los Angeles, has trained and certified at least 11,000 anger management specialists. Lockheed Martin Corp., Halliburton Co., United Parcel Service Inc. and the federal prison system have used his services to ward off lawsuits and dust-ups. So have cops, athletes and business executives. He was even tapped to consult on Anger Management, the 2003 comedy featuring Adam Sandler and Jack Nicholson.
Last year, for the first time, more than a third of his income came from medical workers. This year he expects to add 125 more of them, sent to him because of their inability to manage the pressures of the job, as well as increased concerns from hospital managers and accrediting agencies about temper tantrums in the medical workplace.
Anderson was among the first of his peers to capitalize on the boom of rageaholic caregivers. It began in earnest in 2009 when the Joint Commission, an independent body that is the largest accreditor of medical programs, mandated that hospitals deal with “disruptive” docs.
A survey published in American Journal of Nursing in 2002, reported that 90 percent of hospital workers, including doctors and nurses, reported “yelling,” “abusive language” as well as “condescension” and “berating colleagues.” A quarter of the 1,200 people surveyed said they witnessed such behavior weekly.
“There isn’t a doctor alive who hasn’t seen it,” says William Norcross, executive director of a program at the University of California at San Diego that uses anger management to treat irascible physicians.
Medical professionals present Anderson with unique challenges. Their hours are brutal, the stakes are high, and the threat of malpractice suits is ever-present. The life-or-death nature of the work wears at steely nerves even on the best days, Anderson says.
“Can you imagine the amount of stress a doctor experiences just by waking up in the morning?” Anderson said.
Many doctors work long hours at the expense of family and exercise, which can dissolve tension. One doctor laughed in his face when he suggested she take a vacation. There’s another factor to consider: Since 2010, doctors’ pay has stagnated, with some specialties weathering a 10 percent cut.
Verbal abuse is among the milder transgressions, according to Anderson. “Throwing instruments, like scalpels, is not unusual,” he said. One surgeon flung a tool after being handed the wrong item twice. It struck the ceiling. Another launched a used instrument, hitting a nurse on the shoulder.
The term “anger management” was coined in 1975 by psychologist Raymond Novaco. Anderson, who studied psychotherapy at Harvard Medical School, first wrote his own curriculum in the mid-1990s to treat offenders adjudicated by Los Angeles County courts. Today there are more than 17,000 businesses and individuals in the U.S. certified to offer anger management, many tailored to specific temperaments of various professions.
Courses meant for businesspeople are often innocuously billed as “executive coaching” because of the corporate desire for anonymity -- a characteristic shared with the medical establishment.
“Physicians are paranoid to have anyone knowing that they received psychotherapy,” Anderson says.
Anderson saw a spike in doctor clients this year after signing a contract with Kaiser Permanente, the California-based managed-care organization that provides health services to almost 9 million people. For some on-site courses, Anderson charges more than $8,000 a session; in his Wilshire Boulevard office in Los Angeles, it’s $5,000. In most cases, hospitals will happily pay to make the rage go away.
To teach clients to defuse a blowup, Anderson has them practice long, slow breaths through their noses and think the word “peace” on inhalation and “release’” on exhalation. In addition, he coaches people to lie down, take a time out and imagine being on a beautiful beach. Or to replace inner dialogue like “I’m such an idiot” or “What a jerk he is!” with a positive statement, such as “Someday we will laugh about this.”
Typically, doctors meet with Anderson face-to-face for a total of six hours. After that, they talk on the phone with him twice a month for six months. At the beginning and end of that time, the doctor takes a test on “emotional self-awareness.” He rates himself on a scale from “never” to “always” in response to statements such as “It’s hard for me to smile” and “I care about other people’s feelings.”
Once problem physicians see how low they score on these tests, Anderson says, they surrender to the process. This stands in contrast with business executives; they tend to resist and ask for further evidence that Anderson’s services are really required.
The first thing Anderson tells doctors is that high intelligence is no protection from stupid behavior. It cannot prevent the flubbing of jobs, marriages, or relationships. Meanwhile, Anderson’s workbook, “The Practice of Control,” which he has adapted specifically for doctors, teaches them that anger is as injurious as “smoking a pack of cigarettes each day.”
Based on follow-up calls with hospitals, Anderson says that four-fifths of his doctors have curbed their workplace explosions. Doctors are motivated to rescue their imperiled careers and love lives, he says. “I can’t imagine any other population of clients that does as well.”
There is one profession with whom Anderson does civility training that tests his own composure. “Lawyers,” Anderson said, “I do not like at all.”