A recent article written by Dr. Leanne Rowe, Endemic Bullying: Narcissistic Personality Disorder in Medicine, gained a lot of well deserved attention on social media this week following its publication in the Medical Journal of Australia. You may be thinking - wait, bullying in medicine? Isn't bullying reserved for schoolyards and social media platforms? Sadly no, as most of us in medicine are aware.
This bullying may take the form of not so overt bad behaviour, such as intimidation, harassment, and sarcasm; to more overt bad behaviour, such as violent outbursts and outward aggression. Some organizations use the term "disruptive physicians", or more appropriately, "physicians who are disruptive", to describe such behaviour.
The Canadian Medical Protective Association describes disruptive behaviour in general as: "inappropriate conduct, whether in actions or in words, that interferes with or has the potential to interfere with quality healthcare delivery. Examples include inappropriate words, abusive language, shaming, outbursts of anger, throwing medical instruments, and use or threat of unwarranted physical force."
In Dr. Rowe's article, she identifies a common underlying characteristic in these bullies, or 'physicians who are disruptive', as being narcissistic personality disorder (NPD) - where "a doctor with NPD may seem charming on the surface and have many admiring followers. Generous one day and dismissive or aloof the next, they justify their quick temper as necessary to keep other doctors on their toes and to uphold a high standard of patient care." Sound like someone, or some people, you've met along your own medical journey?
The disruptive behaviour may also be the result of other underlying mental health disorders, physical health conditions, or personal issues such as relationship discord. The physician who is disruptive may often need help or outside support due to the underlying causes to change their behaviour and prevent poor outcomes in their victims and/or patients.
Unfortunately, many of the physicians that are "bullied or harassed are too afraid to speak up". Ultimately, they may leave the workplace, and therefore, the situation never gets resolved. Ideally, they seek actionable solutions recognizing that their mistreatment isn't their fault and that they may be suffering consequences that in turn may be impacting both their own emotional well-being and work performance. Dr. Rowe offers some suggestions for the victims of such bullying in her article.
No matter what the underlying cause(s), the physician who is disruptive needs to be held accountable and witnesses to the behaviour need to speak out. Many lives could be helped from bystanders taking action.
“Knowing what's right doesn't mean much unless you do what's right.” ~ Theodore Roosevelt