ChesterCountyMedicineSpring2019 - 26

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Physician Burnout
and Medical Bullying
Two sides of the
Same Coin?
BY JOHN P. MAHER, MD, MPH

A

s seen in much of American society, violence is
commonplace. Depending on how one defines the
term, violence has many faces, coming in many guises
depending on where in our society it happens, who is perpetrating
it, and what person(s) or groups are being victimized.
Many years ago, we at the Chester County Health
Department, with the backing of then Commissioner (now
State Senator) Andy Dinniman, had declared violence to be the
number one public health issue in Chester County - not because
it caused more deaths than heart/cancer/stroke, - but because
unlike those, [a] it was becoming increasingly common, [b] was
like a cancer eating at our society or perhaps an infectious disease
(you injure me and I and my friends will attack you, etc.), [c] it
affected all aspects of society (EMTs, police, courts, jails, prisons,
families, legal system, schools, workplaces, employment and
medical insurance, you name it); [d] the costs associated with all
those mentioned items was enormous; and finally, [e] unlike heart/
cancer/stroke , et al., we did not know how to prevent or stop it.
Bullying, as commonly used in the media, and in daily news
stories, usually has to do with child abuse, schoolyard violence,
domestic or spousal abuse, date rape, and generally refers to overt
physical abuse or, at least, such verbal and psychological abuse
as might result in physical, social, developmental or emotional
damage to the individual victim. Add these to violence against
churches, synagogues and mosques, and one cannot deny the
prevalence and impact of violence in our society.

26 CHESTER COUNT Y Medicine | SPRING 2019

So, now, almost 1/5th through the 21st century, the problem
continues and worsens. But what makes it relevant to this article
is that violence has not failed to impact the Medical profession.
While the number of burnout articles seems to have leveled off or
diminished, we are seeing more articles about something called
"Medical Bullying." When this phrase of "Bullying In Medicine"
first came to our attention, it caused us to stop, and to think "No
way!", and "This is crazy - it can't be real!" But then came the
afterthought, if violence is so omnipresent in our society, wouldn't
it be logical that it could be affecting the Medical profession in
some way as well?
As a personal note, this author feels obliged to stress here
that after 53 years as an active physician before retiring he does
not recall ever being "bullied" anywhere along that track. Of
course, times were different, the American ethos was different.
Our attendings and residents could be tough and held us to high
standards and expectations. And, yes, we did "the scut work" and
those long obsessive histories and physicals, and worked those long
hours which were standard then. But we never felt "bullied" -
perhaps worn out, but never bullied. So what has changed?
A quick scan of the topic, by Googling the phrase, shows that
bullying (as rather broadly defined these days) of medical students
and young physician trainees is in fact fairly common, and not
just in the US. Similar reports are found from numerous countries
and cultures around the globe. The most recent expose article, sent
to us by a relative, was the one which grabbed our attention and
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