Bullying is recurrent abuse of power which can take many forms. According to popular media, it is wide spread and endemic in the medical workplace. It is not an uncommon experience; up to 50% of doctors, doctors in training and international medical graduates report having been bullied or harassed. Bullying can be a damaging influence on the wellbeing of staff, the wellbeing of workplaces and on patient care.
Victims are often the most vulnerable in the workplace; juniors, females, medical students and international graduates, with the most common perpetrators those in positions of power.
Bullying is entrenched in our medical teaching and so engrained in medical culture that in some units it is regarded as normal behaviour by senior staff. Some units in prestigious hospitals have had training accreditation withdrawn, upon external review, because of perceived endemic bullying.
Although bullying (and harassment) are an acknowledged problem, unfortunately the response to resolve it has been less than comprehensive. Many victims experience difficulty in raising issues, as traditional conflict resolution requires them to approach the bully first with their concerns.
This is often unpleasant, with victims worrying about implications for their training, ongoing working relationships, and stigmatisation from often senior doctors and colleagues. They may also feel overly sensitive or as not “tough enough”. Further, many experience a suboptimal response from senior managers (with limited training in conflict resolution), or non-action from organisations such as hospitals and colleagues.
So, what do we do? First, acknowledge our personal responsibility in tackling bullying and no longer tolerate bad behaviour. This means speaking out for ourselves and for others where bullying is seen, especially those vulnerable.
Second, a systematic approach is needed. This includes coordinated actions between hospitals, colleges and organisations where bullying claims are taken seriously, investigated appropriately and the complainant feels heard and respected in the investigation process. Protocols that are fair, visible and sensitive are necessary. A review of our medical training ensures good habits are learnt and reinforced from the first year of medical training.
Ongoing cultural change will take a new generation of doctors and numerous organisational changes. A future medical workforce without the spectre of bullying and harassment is worth the effort for the safety of our doctors, workplaces and patients.
ED: The Australasian Doctors Health Conference is in Fremantle on 22 and 23 November this year “Creating a healthy workplace” is the theme and national and international speakers will present. All doctors and medical students are invited https://ruralhealthwest.eventsair.com/2019-adhc