How to Practice Bullying Prevention in Medicine
July 14, 2017
The road to becoming a physician is difficult enough without having to worry about added stress from your own professors, colleagues, and superiors. However, the unfortunate reality is most doctors to be will experience bullying both in medical school and the workplace—a leading cause of anxiety, depression, dropout, and suicide.
To make matters worse, this bullying is not only done by medical students as one might expect, but from the very professors and fellow physicians they rely on for guidance and support. Here are the various forms of bullying those in the medical field encounter along with a few solutions towards bullying prevention.
Bullying prevention is needed in medical school
When you think of bullying in school, your mind usually goes to the students. However, the sad reality in medical school is that students are often bullied by their med school professors. Burnout is often blamed on workload, long hours, or lack of sleep—while the teacher-student dynamic plays a big role.
One physician sheds light on the real issue at hand: “Current discussions have ignored one of the biggest hindrances for the mental, physical, and emotional health of physicians-in-training: the hierarchical structure of medical training that enables and often encourages bullying of trainees. And, with a new wave of trainees about to begin their careers in medicine, it would serve us all well to remember that we need to curb this bullying—not enable it further.”
Bullying occurs between physicians and nurses
Within the workplace, there is an ongoing epidemic of doctors bullying nurses. Stemming from old school hierarchies and notions that nurses are simply helpers, they often do not get the credit and respect they deserve from their physician colleagues.
A recent survey done by the Institute for Safe Medication Practices Physicians found 87% of physicians refused to answer questions or calls, 74% received demeaning comments from physicians, 28% had objects thrown at them, 42% had rumors spread about them or were humiliated in public. The saddest part about these findings is some nurses didn’t even recognize this behavior as bullying at first, because they assumed it was simply the nature of the job.
Not only is bullying in the workplace detrimental to the nurses themselves, but to the entire medical team and patients they serve: “Bullying the surgical team reduces performance and decreases their desire to learn, grow and engage in their work. Bullying reduces morale and increases staff turnover. Eventually, the most confident and accomplished team members resign, leaving behind the least competent workers—those willing, like battered spouses, to stick around.”
Bullying among doctors themselves
One might think that after paying your dues and rising through the ranks, you would no longer have to worry about being the victim of bullying on the job. One might also assume that even though doctors may not treat other health professionals respectfully, they would certainly band together.
However, doctors themselves are often the worst offenders when it comes to workplace bullying. The high demands and sense of competition instilled in medical school stays with them throughout their careers as they face even greater pressures to perform well and be successful in high stakes situations.
While a healthy sense of competition can be good in the medical field, it’s often taken to extremes—especially with the entitlement that accompanies the current medical hierarchy structure. For example, cyber bullying among doctors in Ontario, as become increasingly troublesome as doctors threaten to sabotage each other’s careers. This not only creates a hostile environment, it prevents physicians from seeking out leadership positions out of fear they may become the next target.
Solutions for bullying prevention
Above all, it’s important to remember that the first step to bullying prevention is refusing to stay silent. Mistreatment and abuse are never OK, no matter what your profession, rank, or title may be. In any environment, the tone and behavior of the leadership has a trickle-down effect. That’s why it’s especially important that you take it upon yourself to create a position environment for the next generation of doctors. In other words, don’t be a thermometer and reflect the negativity around you; rather, be a thermostat and change it.
One way to combat bullying is to properly equip senior doctors and educators with the skills needed mentor students, which could be a win-win for all involved. One one hand, established physicians wouldn’t feel as overwhelmed by the task of teaching junior doctors, and on the other, physicians in training would feel the support they need to both cope with and identify bullying before it gets out of hand. Medical schools and hospitals can also help with bullying prevention in medicine by changing the stringent conditions that lead to a toxic environment.
One physician suggests that even a simple change in perspective can make a big difference in behavior: “By reframing doctor-nurse relationships so that providers view each other as part of a team, managers would convey that every team member deserves to be empowered as they work together toward the ultimate goal: better patient care. And then, finally, the majority of bully doctors—and projectile surgical instruments—can remain the past where they belong.”
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