Nearly one-fourth of physicians who work at a large academic medical center have experienced mistreatment such as sexual harassment or abuse; verbal mistreatment or abuse; or physical intimidation, violence, or abuse on the job in the past 12 months, a study published today in JAMA Network Open has found. Patients and visitors were the most common source of mistreatment, followed by other physicians.
Susannah G. Rowe, M.D., M.P.H. of Boston Medical Center and colleagues analyzed data from 1,505 physicians at Stanford University School of Medicine who responded to a survey on workplace mistreatment and occupational well-being in September and October 2020. The survey included questions from the Professional Fulfillment Index, which measures employees’ intent to leave, and the Mistreatment, Protection, and Respect Measure, which measures respondents’ perceptions of protective factors in the workplace such as institutional systems that ensure employees are treated with respect and the presence of bystanders who speak up or intervene when they witness mistreatment or abuse.
Of 1,397 physicians who answered questions about mistreatment, 23.4% reported experiencing mistreatment in the last 12 months. Patients and visitors were the most common source of mistreatment, accounting for 70.9% of all mistreatment events as reported by 16.6% of physicians. Other physicians were the second most common source of mistreatment, reported by 7.1% of respondents.
Verbal mistreatment was the most frequent form of mistreatment, reported by 21.5% of physicians, followed by sexual harassment and physical intimidation, reported by 5.4% and 5.2% of respondents, respectively. Women were more than twice as likely as men to experience mistreatment, and multiracial and Black physicians were more likely than White and Asian physicians to report experiencing mistreatment.
Examples of mistreatment included complaints or criticisms related to professionalism, such as appearance or behavior; quality of work; sexual comments or jokes, inappropriate sexual attention, unwelcome advances, and requests for sexual favors; use of slurs, insulting jokes or humor, name-calling, swearing, yelling, intimidation, verbal attacks, nonphysical threats, warnings about retaliation; and pushing, shoving, and sexual or racial assault.
“Reducing mistreatment and enhancing protective systems has inherent ethical value, particularly considering that mistreatment is experienced inequitably based on race and gender,” Rowe and colleagues wrote. “Initiatives that prioritize reducing mistreatment of women and physicians of color can help reduce gender- and race-based workplace inequities, and thereby support greater racial and gender diversity among physicians.”
Physicians who perceived that there were no systems in place to protect against mistreatment had 711% higher odds of intending to leave, scored higher on measures of burnout, and scored lower on measures of professional fulfillment compared with those who believed such systems were in place. The researchers wrote that initiatives targeting mistreatment may result in benefits to patients, physicians, and health care organizations through reduction of burnout and its associated effects on care.
“These findings highlight the urgent need for organizations to put systems in place to reduce the incidence of mistreatment and for more research to determine which systems will be most effective,” the researchers concluded.
For related information, see the Psychiatric News article “Patient Characteristics Should Determine Response to Threatening Behavior.”
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