Bullying In Medicine: Just Say NoPosted: August 19, 2012 | |
The internationally award-winning documentary film, Bully, tells the story of four kids who were victims of bullying in their respective schools. Tyler Long, who committed suicide because of the unrelenting physical and mental abuse he endured each day in school, was one of the kids whose stories was shared in the making of the film. A short trailer for the film follows.
While filmmaker Lee Hirsch focused on school age children, physician and author Pauline Chen MD recently wrote about the bullying that goes on in medical schools in the NYTimes Well blog (see The Bullying Culture of Medical School.) Bullies, and the pain they inflict upon others, does not stop in middle school, and according to Chen:
…For 30 years, medical educators have known that becoming a doctor requires more than an endless array of standardized exams, long hours on the wards and years spent in training. For many medical students, verbal and physical harassment and intimidation are part of the exhausting process, too…early studies found that abuse of medical students was most pronounced in the third year of medical school, when students began working one on one or in small teams with senior physicians and residents in the hospital. The first surveys found that as many as 85 percent of students felt they had been abused during their third year…
Lucian Leape MD published two papers this past July in Academic Medicine on the disrespectful behavior that continues to occur in medicine, further confirming Chen’s assertions. A Culture of Respect, Part 1: The Nature and Causes of Disrespectful Behavior by Physicians, and A Culture of Respect, Part 2: Creating a Culture of Respect both address this problem, and share that patients, as well as medical professionals, suffer when bullies are allowed to reign. Lucian says:
…Students and residents suffer from disrespectful treatment. “Education by humiliation” had long been a tradition in medical education and still persists. Patients suffer when physicians do not listen, show disdain for their questions, or fail to explain alternative approaches and fully involve them in the decision-making process…
We have talked often in this blog about creating high reliability organizations (HROs) in healthcare. Other high risk industries do not tolerate bullying like healthcare does. Why is that? Does healthcare lack the strong leadership needed to eliminate it? Bullying does not belong in healthcare period, or anywhere else in learning cultures for that matter. While it is allowed to persist in any given health system, it will be almost impossible to achieve high reliability.