A pilot study of bullying and harassment among medical professionals in Pakistan, focussing on psychiatry: need for a medical ombudsman

A A M Gadit; G Mugford

doi:10.1136/jme.2007.021832

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A pilot study of bullying and harassment among medical professionals in Pakistan, focussing on psychiatry: need for a medical ombudsman

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The pendulum could swing the other way: underperforming doctors are left alone
Joseph Ting
Published on: 4 June 2015
Re:PROFESSIONAL JEALOUSY IS HIGH AMONG DOCTORS
Debashish Danda
Published on: 16 July 2014
PROFESSIONAL JEALOUSY IS HIGH AMONG DOCTORS
AMIN ALI MUHAMMAD GADIT
Published on: 15 October 2008

Published on: 4 June 2015
The pendulum could swing the other way: underperforming doctors are left alone
- Joseph Ting, Physician
To the Editor: Harassment and bullying are unacceptable in any workplace, let alone the health professions whose calling purportedly subscribe to healing, compassion and humanity. The highly publicised examples of sexism and exploitation serves notice to perpetrators fuelled by the perverse incentive of hierachical authority gradients. It goes without saying that we need a paradigm shift in standing up to the inertial s...
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To the Editor: Harassment and bullying are unacceptable in any workplace, let alone the health professions whose calling purportedly subscribe to healing, compassion and humanity. The highly publicised examples of sexism and exploitation serves notice to perpetrators fuelled by the perverse incentive of hierachical authority gradients. It goes without saying that we need a paradigm shift in standing up to the inertial stance of "it has always been thus, and ever will be." However, supervisors and senior staff still need a remit to act as fair and assertive counsellors to help underperforming and impaired junior doctors when poor attitudes and errors of diagnosis and treatment lead to harm in patient care. One wonders whether the recent media frenzy swirling around sexism, bullying and exploitation within the surgical specialities in training hospitals and through the two decades I have practiced as a doctor holds a negative sting in its tail. An unintended consequence that erodes our ability to train and graduate the competent specialist is that supervisors of training are now much more likely to walk on eggshells when it comes to fair-mindedly assessing junior staff not truly suited to advanced training in their chosen specialty, possess negative attitudes and are debilitated in their home and work lives. All of us must act against the inertia of institutionalised abuse and the intergenerational transference of the "we all go through it" ethos, but I fear training standards will be allowed to lapse and that supervisors will try avoid any necessary but difficult conversations and interventions with a trainee that is not genuinely performing to a minimum standard.
Conflict of Interest:
None declared
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Conflict of Interest:
None declared.
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Published on: 16 July 2014
Re:PROFESSIONAL JEALOUSY IS HIGH AMONG DOCTORS
- Debashish Danda, Professor
Cannot agree more than this title. This "Live and Let die" attitude is probably highest amongst doctors, whether in academic or non academic set up. You send a manuscript for publication; You will find a jealous reviewer colleague (often donot even know you personally, but have competing interest) will turn it down as "reject" only to publish his similar work in a short time by clever means of planted peer review. So, "o...
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Cannot agree more than this title. This "Live and Let die" attitude is probably highest amongst doctors, whether in academic or non academic set up. You send a manuscript for publication; You will find a jealous reviewer colleague (often donot even know you personally, but have competing interest) will turn it down as "reject" only to publish his similar work in a short time by clever means of planted peer review. So, "offence is the best defence"? This disgustingly painful attitude of grown ups, often called Gods by their patients act in so demeaning way that one needs to think how to purify these souls. I think the so called "publish or perish" culture is responsible for it. One more reason is the rat race of making science more complex and complicated ( and you must know for sure that information not understood easily is far from truth, as all truths are simple) by basic science without clear clinical correlate and industry driven, so called "evidence based medicine". True personalised medicine (and that is true basic science of medicine) may be the answer . Respect for clinical science also needs be preserved at the earliest. Just imagine, there is no nobel prize for true Clinical medicine. Why not - if it can be there for economics and peace? Will the childish behaviour in the form of professional jealousy ever disappear? If only they understand the real ethos of a physician which is forgotten by most of us.
Conflict of Interest:
None declared
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Conflict of Interest:
None declared.
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Published on: 15 October 2008
PROFESSIONAL JEALOUSY IS HIGH AMONG DOCTORS
- AMIN ALI MUHAMMAD GADIT, Psychiatrist
A write up in the form of a filler by an anonymous author in BMJ1 describes with reference to an Italian philosopher who constructed a scale looking at existence of professional jealousy in different professions and finding doctors among the top two, second after the actors. Doctors have this reputation since a long time and most common presentation is by regarding each other as ‘quacks’. The famous ‘Dr.Alabone’ case as na...
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A write up in the form of a filler by an anonymous author in BMJ1 describes with reference to an Italian philosopher who constructed a scale looking at existence of professional jealousy in different professions and finding doctors among the top two, second after the actors. Doctors have this reputation since a long time and most common presentation is by regarding each other as ‘quacks’. The famous ‘Dr.Alabone’ case as narrated by Vaile and Gilbert2 indicates the prevalence of this problem often to the extent vilification leading to ethical concerns. Question arises as to why the medicos are ranking so high when it come to this type of jealousy? If the human factor is to be considered, then, this is relatively common emotion which concerns self perception of an individual and results from resentfully suspicious nature of human being. It results from a multitude of factors including feelings of insecurity, disturbed psychodynamics, personality traits, internal conflicts, personal inadequacies while not ruling out genetic predispositions3. Psychologists believe that jealousy is a life long conditioning process and not just instinctive. One wonders if this is a common human attribute then why the elite medical profession ranks so high just one step below the actors. Could it be because of practice superiority of some over others? Or the intense competitiveness among those choosing this profession or the acquired egoism because of the glitter and respect that this profession carry? Would this be due to the fact some people with paranoid traits are lured into this profession and become the eventual perpetrators? With regard to actors there are suggestions by psychologists that they may carry histrionic traits and if so, there is likelihood of medicos carrying narcissistic traits which manifests itself in sabotaging other colleagues in order to preserve self- inflated identity. There could also be a tendency for the medicos to suffer from “narcissistic injury” in the event of challenge in terms of diagnostic competence, galore of information, high success rates and superior demeanor among other colleagues. This appears to a pivotal issue for the manifestation of professional jealousy. The expression of professional jealousy can be in the form of allegations, defamation, questioning the credentials, spread of rumours, passing remarks, bullying, blocking promotions, verbal abuse and even physical attacks3. This type of jealousy being rampant and widely known needs curbing by means of education in this subject. There is a need to be aware of this problem, to develop further self confidence, talk about it with the rival, not to overreact and be confident. If matters go beyond control, then, the local regulatory bodies can do something about it, there may be a role for human rights organizations as this problem can cause emotional and mental torture among the victims who can even fall prey to physical ailments in the face of such a stress. Some sort of tailored psychotherapy may be a good option for both the victims and perpetrators.
References:
1-Anonymous. Filler: Professional Jealousy, BMJ 2004; 328:887, doi: 10.1136/bmj.328.7444.887.
2- Vaile M, Gilbert S. The curious case of Dr. Alabone-heterodoxy in 19th century medicine. J R Soc Med, 2005; 98:281-286.
3- Gadit AM. Professional behaviour of doctors: are we meeting the criteria? J Pak Med Assoc; 2007; vol 57, no. 8: 425-427.
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Conflict of Interest:
None declared.
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