Unfortunately, we did not request respondents' gender in the original survey. However, many of the surveys and follow-up letters indicated that both male and female physicians behaved inappropriately.

In regard to assessing disruptive behavior by area or unit of specialty, we conducted a separate analysis comparing the results from high-intensity units: the CCU or ICU, emergency department, surgery or perioperative area, and obstetrics. (These data weren't included in the published article because of space constraints.) We found that disruptive behavior was much worse in all of these high-stress areas, compared with the total aggregate scores. These results were not surprising-working in a high-stress environment is one of the known causes of inappropriate or disruptive behavior.

Alan H. Rosenstein