Almost one-fourth of physicians report experiencing verbal, physical, or sexual mistreatment in the workplace.
Patients and visitors are the most common sources of mistreatment.
Mistreatment has clinical consequences, and organizations must take steps to protect physicians’ well-being.
In an already strained healthcare system, reports of mistreatment of physicians by patients, visitors, and other doctors are on the rise. Previous research on physician mistreatment has been aimed primarily at medical students, but a 2022 JAMA study has shed light on mistreatment experienced by practicing doctors.
The study surveyed over 1,500 physicians over a 2-month period in 2020.
Each respondent answered yes or no to a simple question: “Have you experienced the following at work in the last 12 months and if so, from whom?”
Categories of mistreatment included verbal mistreatment or abuse; sexual harassment or abuse; or physical intimidation, violence, or abuse. Each participant also identified the source of mistreatment—patient/family/visitors; colleagues, nurses, other staff members; and/or hospital leadership were all included as choices.
Most mistreatment comes from patients
Of those surveyed, almost a quarter (23.4%) of hospital doctors reported experiencing mistreatment on the job. The data also suggested female physicians are up to two times more likely to be mistreated compared with their male counterparts, especially with verbal abuse and sexual harassment.
Race seems to play a role in whether a physician will experience mistreatment. The JAMA study indicated that Black or multiracial physicians are more likely to be mistreated. Half of all Black doctors surveyed experienced verbal mistreatment, while physical intimidation or abuse was most frequently experienced by multiracial physicians.
Patients and visitors were most commonly cited as the source of physician mistreatment, representing 70.9% of all mistreatment events included in the research.
Perhaps surprisingly, mistreatment from other physicians was identified as the second most common source.
High chance of physical violence
Other data support these findings. According to the World Health Organization, up to 38% of all healthcare workers experience physical violence during their career.
The US Bureau of Labor Statistics reported that healthcare workers are five times more likely to experience workplace violence compared with all other US occupations. In 2018, 73% of all non-fatal workplace injuries and illnesses resulting from violence occurred in healthcare workers.
Implications for physician well-being
Mistreatment has serious impacts on the well-being of physicians.
Burnout, reduced professional fulfillment, and increased intent to leave healthcare have all been linked to physician mistreatment.
Another 2022 JAMA study suggested that, as the frequency of mistreatment increases, so too does emotional exhaustion and depersonalization. These factors are clinically significant; as they worsen, physicians are more likely to believe they have made a major medical error. Suicidal ideation also occurs more frequently.
Protecting doctors in the workplace
In response to workplace mistreatment, the American Medical Association (AMA) has adopted several policies intended to improve the safety of physicians and other healthcare workers.
These policies address multiple sources of mistreatment, including the public and other physicians.
For example, AMA policy H-515.951, addressing bullying in medicine, outlines steps organizations should take to address and prevent bullying among staff, including:
Clearly defining workplace violence, bullying, and harassment, along with other types of aggressive behavior
Defining expected and prohibited behaviors, establishing clear expectations about workplace training, and documenting these requirements
Outlining steps a worker should take if they are subjected to workplace bullying, and providing methods of confidentially reporting it
The World Health Organization also has published detailed steps to help protect physicians from mistreatment, including ways to promote well-being and improve psychological health. To help protect doctors from violence, organizations should:
Create a zero-tolerance workplace culture
Establish confidential reporting methods for workers who feel threatened
Implement policies or regulations to effectively prevent violence toward healthcare workers
Review labor laws and, when appropriate, introduce new legislation to help prevent workplace violence
Obviously, these steps cannot guarantee physicians will not be exposed to workplace mistreatment from patients, visitors, or other staff members. Other interventions such as data collection and surveillance systems, safety response protocols, and strategies to confront and resist mistreatment may help mitigate mistreatment directed toward doctors.
What this means for you
Research indicates that workplace mistreatment against physicians is on the rise. This has serious implications for physician well-being, as mistreatment is linked to burnout, emotional exhaustion, and depersonalization. Healthcare organizations must take steps to protect physicians from mistreatment by patients, visitors, and even other doctors.