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Case studies

Case studies are a common tool used by NCAS to:

  • encourage colleagues to share their ideas, 
  • increase knowledge and develop skills in performance management by facilitating debate and promoting reflective practice.


These case studies have been used at NCAS workshops and also at the annual conference, Professionalism - dilemmas and lapses, held in March 2009. They will help you to explore the dilemmas faced in dealing with performance concerns and to identify approaches to assist in their management. The material, all of which is fictitious, may provide the basis for postgraduate education meetings and seminars. 


Disruptive behaviour

The College of Physicians and Surgeons of Ontario defines a disruptive individual as:

“...one who cannot or will not function well with others to the extent that his or her behaviour, by words or actions, interferes

or has the potential to interfere with quality healthcare delivery”.


Whilst this definition provides a broad descriptive, healthcare professionals face many issues in identifying and managing disruptive behaviours as it can be manifest as both aggressive and passive, one-off or persistent problems. Using the case studies below, explore the dilemmas faced when dealing with disruptive behaviour in a consultant and a dentist and discuss approaches to assist in their identification and management. 


Dr Max Lane (Consultant Oncologist)

Dr Max Lane is a Consultant Oncologist at a big teaching hospital.  He has a high profile, reinforced by positive feedback, which has led to him being inappropriately overconfident.  He has a strongly held belief that he is the only person who knows what is right for this patients and how the oncology service should be structured and run.



Dr John Rodger (General Dental Practitioner)

Dr John Rodger is a GDP who works in a small practice where he is the Principal Dentist. His is a busy practice in a small town where there is a shortage of NHS dentists.  John has been a dentist for 30 years and is committed to his patients and proud of his practice which he has built up by himself.