Significant numbers of consultant obstetricians and gynaecologists report bullying

BMJ 2016; 353 doi: (Published 27 June 2016) Cite this as: BMJ 2016;353:i3576
  1. Jacqui Wise
  1. London

A substantial proportion of consultants in obstetrics and gynaecology say that they have experienced bullying and undermining behaviour and in many cases the behaviour has persisted for years, according to a survey published in BMJ Open.1

The Royal College of Obstetricians and Gynaecologists (RCOG) carried out an email survey of all obstetric and gynaecology consultants and fellows working in the UK. There was a 28% response rate (664 replies) with 44% saying that they had been persistently bullied or undermined. The 290 that reported themselves as victims of bullying represent 14% of the RCOG consultant workforce.

The types of behaviours most reported were persistent attempts to belittle and undermine an individual’s work; the undermining of an individual’s integrity; persistent and unjustified criticism and monitoring of work; freezing out, ignoring, or excluding; and the continual undervaluing of an individual’s effort.

Copying the victim in to emails containing criticism or alluding to poor performance—that should have been dealt with person to person—was one strategy used by perpetrators to bully and undermine, the study found. Physical and sexual abuse was reported by only a very small number of consultants (0.4% and 1.8% respectively).

Victims reported that bullying and undermining was carried out by those senior or at least close in the hierarchy such as lead clinicians, medical directors, and board level executives. Of the 278 consultants who answered the question on frequency of occurrence, 50% said that bullying and undermining happened on half or more of all encounters with perpetrators, and two thirds reported that it had lasted more than three years.

Two thirds of consultants who said they had been victims of bullying suffered major or moderate effects ranging from taking sick leave, to moving position, depression, suicidal ideation, sleep disturbance, and reduced confidence. Over half reported problems that could compromise patient care. Three quarters of victims said that the problem was not being addressed.

The study authors said that much more needed to be done, including an overhaul of the current reporting and investigation processes within trusts.

Clare McKenzie, RCOG vice president for education, said: “Undermining and bullying behaviour is unacceptable in any workplace, but in our profession it can have devastating effects on patient outcomes, as well as for the individuals concerned. This is both an individual clinician and patient safety issue.”

Study co-author, Joanna Mountfield, consultant obstetrician and chair of RCOG’s specialty education advisory committee, said: “We recognise that, as the survey was self-selecting, the sample may over represent the proportion of victims. Despite this, the results still represent a significant segment of the RCOG membership who need more support and we should acknowledge and address the scale of the problem in all grades of staff.”

The RCOG recently established Workplace Behaviour Champions to offer informal support to trainees, and they are now considering extending this support to consultants and other career grade staff.


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