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.
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