Bullying culture is ‘endemic’
In an accompanying editorial, consultant cardiologist Resham Baruah, MBBS, PhD, of Chelsea and Westminster Healthcare NHS Trust, London, and independent professional coach Emma Sedgwick said the findings offer a “sobering insight into current practice” and indicate that “a bullying culture is endemic in many U.K. cardiology departments.”
“These trainee cardiologists are actually quite senior doctors with many years of experience. They work extremely hard. These surveys show that we are not valuing them enough,” Dr. Baruah said in an interview.
“Cardiology is a really competitive specialty. There is a lot of pressure. All the way through training the message is competitive,” she said. “Being collegiate and working as a team is not rewarded. We have to rethink this as we train the next generation.”
“We believe that publishing these data acknowledges bullying is not going unnoticed, although this alone is not enough,” the editorialists said.
Noting that labels matter, they propose a rejection of the term “juniors” and a return to the old system of calling colleagues senior house officers, registrars, and senior registrars.
They also proposed sanctions for institutions that ignore bullying, but stress that better working conditions for all staff are needed.
“Bullies are usually feeling defensive, overwhelmed, and stressed and take these feelings out on others,” Dr. Baruah commented. “I think what we are seeing in this paper is not just restricted to cardiology but happens all though the NHS and is related to workload, lack of autonomy, and burnout. Work culture is crucial to well-being and job satisfaction. Nobody wants to work in a toxic environment.”
She emphasized that bullying behaviors must not be accepted. “They can have catastrophic consequences for the trainees and for patient safety. While working in high-pressure specialties and emergency situations may foster such behavior, it is vitally important to arm trainees with the recognition of bullying and how to deal with it. They must feel empowered to speak up in an appropriate way.”
The editorialists noted that the Royal College of Obstetricians and Gynaecologists responded to high levels of bullying by creating behavior toolkits, workshops, and behavior champions. “This survey should act as a call to arms for cardiology to introduce similar initiatives,” they stated.
“While times are changing, the corporate environment has moved forward in encouraging positive workplace behavior faster than is happening in medicine,” Dr. Baruah said. “But there is an appetite for change. We have to have an environment where people can speak up.”
The study received no specific funding. The authors reported no competing interests.
A version of this article first appeared on Medscape.com.