Just under one in four physicians have experienced workplace mistreatment, according to a new study that warns these incidents may be driving people away from the profession.
The study, published in JAMA Network Open, found that patients and visitors were the most common source of the mistreatment reported by physicians — representing over 70 per cent of all events — followed by mistreatment from other doctors. The most common forms of this behaviour included verbal mistreatment (21.5 per cent), sexual harassment (5.4 per cent) and physical intimidation or abuse (5.2 per cent).
The survey also found differences across genders with women more than twice as likely as men (31 per cent vs. 15 per cent) to report mistreatment. They were also more likely to experience any form of mistreatment and more likely to experience verbal abuse or sexual harassment.
While such mistreatment was associated with an increase in occupational distress, researchers found this distress was lowered by the perception that protective systems were in place to guard against such behaviour. In light of the findings, the team is calling on healthcare providers to implement such systems.
“Organizations must first recognize its prevalence and then know where to look,” said Susannah Rowe, first author of the study and an ophthalmologist at Boston Medical Center. “With the strong association of mistreatment to workplace dissatisfaction and physician burnout, it is imperative that health care organizations take steps to address these issues as quickly as possible for the well-being of their staff as well as their patients.”
The survey, which was completed by 1,505 clinical physicians at the Stanford University School of Medicine, found that protective measures were associated with an increase in occupational wellbeing among those who have been mistreated and those who have not. Mistreatment was strongly associated with a decrease in this sense of wellbeing, including increased levels of burnout and a higher reported intent to change jobs.
“All members of the healthcare team share the responsibility to mitigate mistreatment,” said Mickey Trockel, senior author of the study and a clinical professor of psychiatry and behavioural sciences at Stanford. “Those wielding leadership influence hold particular responsibility to establish policies and expectations of civility and respect from all members of the healthcare community — including patients and visitors.”
Although the small sample size precluded more detailed analysis, the survey indicated significant variability in rates of mistreatment by race that researchers found to be consistent with previous research into mistreatment and ethnicity among medical students and residents.
With recent research from the Canadian Medical Association indicating that the pandemic has contributed to around 53 per cent of Canadian doctors experiencing burnout and 46 per cent considering cutting back their practice, the team said greater efforts must be made to make the industry a more inviting place to work.
“As an organizational ombuds for many decades, I am unaware of prior quantitative research in any industry that so clearly establishes a connection between perceptions of bystander action and occupational wellbeing,” said Mary Rowe, co-author of the study and an adjunct professor at the Institute for Work and Employment Research at MIT Sloan School of Management.
“Together with qualitative research suggesting that bystanders are much more likely to act or come forward when organizational leaders are perceived to be receptive, these new findings highlight the major potential for organizations to support occupational well-being through enhancing leadership receptivity to bystanders.”
Dave Yasvinski is a writer with Healthing.ca