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A RECENT article in MJA InSight about aggression in medicine attracted many comments from doctors who had experienced bullying.
The article, based on research published in the MJA, indicated that bullying (or workplace psychological abuse) is alive and well in medicine.
But what exactly is bullying? It is mostly defined as repeated unwelcome behaviour which makes the recipient feel humiliated, intimidated and belittled.
It can take the form of undue public criticism, excessive or unreasonable monitoring of work, overwork, withholding necessary information, consultation or resources, and yelling, shouting and undermining behaviours, such as setting people up to fail.
Unfortunately there are usually more than two people involved when there is psychological abuse in the workplace. There are also the bystanders — the people who witness the behaviour and silently condone it because they feel scared, don’t recognise it as bullying or don’t know what to do about it.
Then there is the family of the person being bullied, and, sadly, the patients who receive a lower standard of care because everyone is preoccupied and watching their backs.
The person being bullied or abused becomes anxious and avoidant. They second-guess what might provoke the bullying and constantly recheck their work. They start to isolate themselves because they are embarrassed by the negative attention or, often, due to fear.
They might become distracted and make simple errors. They leave work feeling worried and are edgy at home. They find they aren’t sleeping well and so they are caught in the cycle.
They withdraw from social events and abandon the lifestyle that was keeping them well. They get sick and take time off work, compounding the problem. As one comment on the recent article pointed out, the end result can be depression and suicidal thoughts.
What can we do about it?
Once someone realises they are being bullied, they are often too exhausted and demoralised to act. They can’t work out what to do.
First, they need to find a “safe” person to talk to. This may be someone within the organisation, such as a member of a peer support group, but often it is someone outside.
For GPs it might be the support service offered by the Royal Australian College of General Practitioners. It could be a union, such as the Australian Salaried Medical Officers Federation, your indemnity insurer or your local AMA branch, which usually provides legal and industrial relations advice for members.
Medical support services, such as the Doctors Health Advisory Service and Medical Benevolent Association of NSW, can also help.
If you are being bullied you need to be reminded that the behaviour is not reasonable or fair and not something you deserved or “asked for”.
However, this is not something that will go away if you ignore it. It is more likely to escalate.
Just as important is keeping yourself well. Don’t let go of your usual routines, no matter how tired and demoralised you are. If you usually go for a run, play tennis or do yoga, keep doing it. Make an effort to eat well and see your GP for a check up and support.
Don’t allow yourself to become isolated, at work or socially. Once your world starts to shrink, so do your options and your outlook.
Bullying is never acceptable and is distinctly unhealthy, especially in a “caring” profession like medicine.
Ms Meredith McVey is the social worker with the Medical Benevolent Association of NSW.
Posted 2 October 2012
I would like to commend the author on a nicely written article. It is refreshingly devoid of stereotypes and weaselwords. The author does not pretend to have an easy solution, because there isn’t one. The important statement (also seen in other literature on this topic) is that sadly, bullying victims often become “paralysed” and unable to do something about their situation. To keep doing usual routines and pastimes is an important recommendation, but I am not sure how well it works to keep these up.
The comments that I have read re. bullying have been refreshingly aware of the often abstract nature of bullying.
However, more often than not, people who are young, inexperienced in life and those that have, by chance never been a target, simply don’t comprehend what they are told by the victim.
Human Resource staff have all the correct words but actions rarely occur, even the repeated statement “Bullying is never acceptable and is distinctly unhealthy” makes me cringe as these are still empty, lip service words used more to go through the motions of being seen to be doing something.
Even in recent well publised cases where the victim was paid out, the bully invariably remains in their job and the victim is forced to leave their job.
Whistleblowers characteristically are bullied and mobbed out of their jobs. Has there been research done on all of the health whistleblowers? Are they still in their jobs? Have they been revered and respected for speaking out? Have they been apologised to and compensated?
Targets/victims are routinely blamed. Bullies, especially those in the professions are clever, high functioning and usually have ingratiated themselves to the administration staff and superiors.
The recent increase in “lip service” given to bullying may actually cause even more isolation and “crazey-making” in the victim.
To change the culture, one has to revere and uphold with great respect those that speak out.
Australia has a long way to go in comparison to Europe with respect to how they treat those that speak out against wrong doing of any type.
The AMA Victoria Peer Support Service receives many calls from doctors in training who are experiencing bullying. The worst cases result in loss to the profession of highly trained doctors who decide to leave medicine. Any Victorian doctor who wishes to talk in confidence and anonymously to a colleague can phone 1300853338 anytime between 8am and 11pm 365 days of the year.