The Price of Incivility 

The former CEO of a Louisiana health system adopted the 10 and 5 rule — more commonly used in the hospitality industry — which dictates that when staff are 10 feet from a person they smile and make direct eye contact. At 5 feet, they say “hello” or another verbal greeting.

After adopting the practice, patient satisfaction scores and patient referrals went up, according to Christine Porath, PhD, associate professor at the McDonough School of Business at Georgetown University.

This simple technique shows the benefits — to workplace culture and the bottom line — of being civil.

Data show that incivility, such as rudeness and bullying, harms workers’ performance, and in a health care setting can lead to diminished patient experience, higher turnover — and even harm.

Porath offers an example of a doctor who shouted at his team. Right after that interaction, the team gave the wrong medication dosage to a patient. The information was correct on the chart, but each member of the team missed it.

Christine Porath, PhD, Associate Professor

McDonough Scool of Business at Georgetown University

This anecdote is backed up by data that show incivility does harm to performance and the bottom line. One study found that among employees who were exposed to incivility, 66% cut back on work effort, 80% lost work time, and 12% left jobs.

Porath has experienced incivility on the job first-hand, saying at her first job as a college graduate, she was berated and bullied. She also saw the emotional and physical toll that an uncivil boss had on her own father, who ended up in the hospital after experiencing ill effects of stress.

Data further show that just witnessing incivility can be harmful, resulting in 25% less work and 45% fewer ideas.

In a hospital setting, where high stress from life-and-death decisions and a fast pace can often lead to incivility, the cost can be high.

One major international firm estimated that uncivil behavior in their own offices could be costing the company as much as $12 million annually.

On the other hand, fostering a culture of civility in your hospital can pay off, according to Porath.

That can mean a strategy like the 10 and 5 rule or routinely showing employees they are respected by thanking them, sharing credit, and actively listening.

“Whether you’re a CEO, a team leader, or a person from any walk of life trying to make a difference, you’re going to be judged for the little moments, so please make the most of them,” Porath says. “In every interaction you have a choice. Do you want to lift people up or hold them down? Who do you want to be?”

To learn more about “Mastering Civility in Healthcare,” Christine Porath will discuss the varied ways incivility wrecks performance and robs the bottom line at the Maryland Healthcare Education Institute’s Leadership Conference October 18. Registration is open.


6820 Deerpath Rd
Elkridge, MD 21075


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