Bullying of senior doctors rife in public health system, report finds
A major survey published today of senior doctors and dentists working in New Zealand’s public health system found more than a third had been bullied at work, and two-thirds had witnessed others being bullied.
The Association of Salaried Medical Specialists (ASMS) will be presenting the findings of its survey to the ASMS Annual Conference in Wellington today, attended by some of the country’s most senior doctors.
The report, Bullying in the New Zealand senior medical workforce: prevalence, correlates and consequences, is available on the ASMS website at https://www.asms.org.nz/wp-content/uploads/2017/11/ASMS-Health-Dialogue-Bullying-WEB.pdf. The research was carried out by ASMS Principal Analyst Dr Charlotte Chambers, with statistical analysis by Professor Chris Frampton from the University of Otago. The survey of ASMS members was carried out in June 2017, with a response rate of 40.8%.
ASMS National President Dr Hein Stander says in a foreword to the report that he felt a deep sense of sadness on reading the survey findings.
“I knew workplace bullying has been a concern for some time and continues to be an ongoing problem in our public health service,” he wrote. “However, the high prevalence and nature of it shocked me.
“We cannot ignore the potential impact bullying has on patient safety and care. You cannot “attack” a doctor without the risk of harming the patients he or she cares for.”
Behaviour described in the report ranges from violence, threats and intimidation through to humiliation, persistent criticism, allegations, gossip, exclusion and excessive monitoring of work.
Key findings included:
- More than a third of respondents (37.2%) said they had been bullied, and more than two-thirds (67.5%) reported witnessing bullying of colleagues.
- The prevalence of bullying in New Zealand’s senior doctors appears higher than shown in comparable international surveys of health sector workers.
- The prevalence of bullying is strongly associated with high workplace demands, and low peer and non-clinical managerial support.
- Workplace bullying occurs more often, and in different forms, for certain groups of senior doctors, eg overseas-trained doctors working in New Zealand, women, doctors aged 40 to 59, and in some specialties (emergency medicine, general surgery and specialist surgery).
- Only a third of doctors who said they had been bullied reported what had happened, with the main reasons for not reporting being fear of not being supported, and concern that reporting would make the situation worse.
ASMS Executive Director Ian Powell says the survey findings are very concerning and the union would be discussing them further with DHB chief executives and senior managers. Copies of the report had been sent to all DHB Chief Executives, as well as new Minister of Health, Dr David Clark.
“The prevalence of bullying, coupled with the findings of our previous research into burnout and SMO presenteeism, is yet another symptom of a health system groaning under the pressure of years of neglect and under-resourcing,” says Mr Powell.
“A number of DHBs are already making very positive moves in taking up initiatives to address bullying and other unprofessional behaviour, but much more is required at a systemic level to provide adequate levels of workforce resourcing and to bring about meaningful culture change within hospitals.”
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NZMA released the following media statement:
The New Zealand Medical Association (NZMA) is concerned by the findings of the Association of Salaried Medical Specialists’ (ASMS) study on bullying in the New Zealand senior medical workforce, and encourages employers and colleges to continue their focus on eliminating these unprofessional behaviours.
“It is deeply disappointing and distressing to read the accounts of bullying behaviour set out in the study,” says NZMA Chair Dr Kate Baddock. “While some of our colleagues experience bullying behaviour from patients, most of what is described comes from colleagues—both clinical and managerial—and that is just unacceptable.”
Released today, the study shows that more than two-thirds of respondents experienced work-related bullying of some kind—either themselves or through witnessing colleagues being bullied—with the most common culprits being senior colleagues.
“The stressful environment in which many of our members work—lack of resources, staffing shortages and long working hours—is a contributing factor,” says Dr Baddock. “But there is no excuse. Given that clinical managers, clinical directors and those in leadership positions were commonly cited as perpetrators, work remains to ensure that everyone is held to account for negative behaviours, no matter where in the organisation they stand.
“The recent policy statement on bullying by the World Medical Association, put forward by the NZMA, makes it clear that this is an issue of professionalism. It is not just about how we treat our patients, but how we treat our colleagues. The responsibility lies with all of us to collectively seek a change in culture.
“Our Code of Ethics is also very clear on this: doctors have a responsibility to behave cooperatively and respectfully towards team members, and a responsibility to assist colleagues under stress. This sort of behaviour is bad for individual doctors, for our profession and for patients.”