Intended for healthcare professionals


Workplace bullying

BMJ 2003; 326 doi: (Published 12 April 2003) Cite this as: BMJ 2003;326:776

The silent epidemic

  1. Brian R McAvoy, deputy director (,
  2. John Murtagh, adjunct professor of general practice (
  1. National Cancer Control Initiative, 1 Rathdowne Street, Carlton, Victoria 3053, Australia
  2. Monash University, Department of General Practice, 867 Centre Road, East Bentleigh, Victoria 3165, Australia

    Those who can, do; those who can't, bully.

    Tim Field

    Morbidity patterns from general practice worldwide highlight the high prevalence of mental health problems, the commonest being depression, anxiety, and sleep disturbance. Many of the sufferers admit to stress at work, and some of them are casualties of workplace bullying, defined as persistent, offensive, abusive, intimidating, malicious, or insulting behaviour; abuse of power; or unfair penal sanctions. These make the recipient feel upset, threatened, humiliated, or vulnerable, undermine their self confidence and may cause them to suffer stress.1 Rayner and Hoelt describe five categories of bullying behaviour—threats to professional status, threats to personal standing, isolation, overwork, and destabilisation.2

    A deadly combination of economic rationalism, increasing competition, “downsizing,” and the current fashion for tough, dynamic, “macho” management styles have created a culture in which bullying can thrive, producing “toxic” workplaces.3 Such workplaces perpetuate dysfunction, fear, shame, and embarrassment, intimidating those who dare to speak out and …

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