Physician bullying, as described by one Cleveland Clinic oncologist

Bullying in healthcare is happening far more frequently than what is seen through the public eye — and for physicians, and medical students in particular, these behaviors can harm mental well-being, physical health and patient care, Mikkael Sekeres, MD, a Cleveland Clinic oncologist, writes in The New York Times.

Five takeaways from the op-ed:

1. In healthcare settings, the imbalance of power that constitutes bullying typically takes place repeatedly between a fellow or staff physician and a resident or medical student, Dr. Sekeres writes. He describes his own experience as a medical student, where a fellow would punish students for asking when hospital rounds would be over despite students being exhausted and deprived of food. "Whenever you ask me 'When will we round out?'" the surgical fellow told the medical students on multiple occasions, 'I will make it one hour later.'"  

2. "A victim's inability to defend him- or herself is also part of the equation — we feared any grade less than high honors, which could compromise the type or quality of residency we might obtain, and would be determined largely by the fellow," he wrote. "Finally, the intention of bullying is to cause harm or distress — our fellow seemed to delight in our fear."

3. Dr. Sekeres cited a study that found high rates of bullying in U.S. medical schools. In the study, which included 1,387 American medical students in their final year of school, 42 percent of students said they experienced harassment during medical school. The majority — 84 percent — of respondents experienced belittlement. Bullying most often came from the residents and professors supervising them, the medical students reported.

4. The consequences of physician bullying, which Dr. Sekeres said he continued to experience at different points in his career, often are anxiety, burnout and drug abuse, he writes. Dr. Sekeres cited an essay in the New England Journal of Medicine, where a trauma surgeon discusses his experiences with depression and burnout after working in a culture he said wouldn't allow him to share those feelings.

This culture often considers physicians to be "weak" for taking a leave of absence for mental health reasons or encourages providers to push themselves to exhaustion during long hospital shifts.

5. "It is a cruel irony that doctors and nurses are drawn to medicine to care for others, yet the majority have been bullied by their colleagues and superiors," Dr. Sekeres wrote. "We should all be able to turn to one another for support, to be able to admit that we are hurting, and to ask for a system that allows for missing work in the event of illness, without suffering castigation for being weak. It's in our patients' best interests, and in ours."

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Bullying in healthcare is happening far more frequently than what is seen through the public eye — and for physicians, and medical students in particular, these behaviors can harm mental well-being, physical health and patient care, Mikkael Sekeres, MD, a Cleveland Clinic oncologist, writes in The New York Times.

Five takeaways from the op-ed:

1. In healthcare settings, the imbalance of power that constitutes bullying typically takes place repeatedly between a fellow or staff physician and a resident or medical student, Dr. Sekeres writes. He describes his own experience as a medical student, where a fellow would punish students for asking when hospital rounds would be over despite students being exhausted and deprived of food. "Whenever you ask me 'When will we round out?'" the surgical fellow told the medical students on multiple occasions, 'I will make it one hour later.'"

2. "A victim's inability to defend him- or herself is also part of the equation — we feared any grade less than high honors, which could compromise the type or quality of residency we might obtain, and would be determined largely by the fellow," he wrote. "Finally, the intention of bullying is to cause harm or distress — our fellow seemed to delight in our fear."

3. Dr. Sekeres cited a study that found high rates of bullying in U.S. medical schools. In the study, which included 1,387 American medical students in their final year of school, 42 percent of students said they experienced harassment during medical school. The majority — 84 percent — of respondents reported experiencing belittlement. Bullying most often came from the residents and professors supervising them, the medical students reported.

4. The consequences of physician bullying, which Dr. Sekeres said he continued to experience at different points in his career, often are anxiety, burnout and drug abuse, he writes. Dr. Sekeres cited an essay in the New England Journal of Medicine, where a trauma surgeon discusses his experiences with depression and burnout after working in a culture he said wouldn't allow him to share those feelings.

This culture often considers physicians to be "weak" for taking a leave of absence for mental health reasons or encourages providers to push themselves to exhaustion during long hospital shifts.

5. "It is a cruel irony that doctors and nurses are drawn to medicine to care for others, yet the majority have been bullied by their colleagues and superiors," Dr. Sekeres wrote. "We should all be able to turn to one another for support, to be able to admit that we are hurting, and to ask for a system that allows for missing work in the event of illness, without suffering castigation for being weak. It's in our patients' best interests, and in ours."

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