Diagnosis: Rude

Why would a doctor treat you for anaphylactic shock when you’re really bleeding to death?

It might not be ineptitude, or a medical degree purchased online—the answer could be as simple as their boss yelling at them, or someone flipping them the bird in traffic.

A single dose of rudeness can make doctors fixate on a wrong initial diagnosis, according to new research from a UMD management professor and collaborators. At a Florida hospital, they arranged an experiment with resident anesthesiologists, half of whom witnessed a staged encounter where a senior doctor upbraided a colleague just before examining a simulated patient described as having a penicillin reaction.

The result: Those who’d experienced rudeness looked at the world as if they were wearing blinders, he said. They perceived only the initial diagnosis in front of them, and were less able to think more broadly to recognize clear symptoms of internal bleeding from a botched surgery.

“We’re all subject to what’s known as the anchoring bias, when we latch onto that first bit of information we get,” said Trevor Foulk, assistant professor of management and organization in the Robert H. Smith School of Business, and a co-author of a paper on the research published recently in the Journal of Applied Psychology, written with collaborators from Carnegie Mellon University and the University of Florida. “But the experience of rudeness reinforces the bias, and makes it more difficult to move off that anchor.”

It’s the latest in a larger body of research Foulk has conducted on how rudeness affects the workplace, including a paper showing it can transmit like a cold from person to person. While no one questions that abuse and aggression in the workplace are harmful, he says, there’s an easy assumption that less severe but far more common experiences like rudeness have only minor consequences.

“In reality, it affects performance, it affects cognition, it affects mood state—it affects everything,” he said.

But the research also shows that doctors and others can recover from the perception-altering effects of rudeness by deliberately seeking more information and striving to see the world as others do, Foulk said. While rudeness causes a “narrowing of perception," he said, “Looking at things through someone else’s eyes expands the world again.”