Workplace Bullying Among Surgeons

The Perfect Crime

Kevin Y. Pei, MD; Amalia Cochran, MD


Annals of Surgery. 2019;269(1):43-44. 

In This Article

The Problem

Surgeon wellness is a hot topic in 2018 and for good reason. In study after study, our colleagues report that both trainees and practicing surgeons are digging deep to mitigate burnout. We are just beginning to understand the detrimental consequences of burnout ranging from job dissatisfaction to suicide. The alarming thing is that suicidal ideation is a real problem. In a study sponsored by the American College of Surgeons, 6% of respondents considered suicide and there was strong correlation with burnout.[1] Bullying represents one of the most fundamental ways in which a surgeon can experience loss of control; despite the attention paid to burnout and surgeon wellness, bullying at the workplace among surgeons is conspicuously absent from the national conversation.

Yet a culture that permits bullying is neither new nor unknown. In a recent study of Australian surgeons, 47% of surgeons (both trainees and practicing surgeons) reported being a victim of bullying and 68% reported witnessing bullying.[2] A US Workplace Bullying Survey conducted by the Workplace Bullying Institute in 2007 reported that 49% of workers are victim of or witness to bullying and a significant number of victims suffer posttraumatic stress disorder. The sad truth is that we would likely to find bullying is endemic if we looked carefully enough.[3]

It is difficult to discuss bullying among surgeons. For one, many instantly picture the overgrown schoolyard bully of yesteryear. Sadly, bullies are real and they are professional adults who may be in senior leadership positions across the country. Additionally, it is confusing to talk about bullying because it is often lumped with harassment and discrimination. To be sure, there is significant overlap among bullying, harassment, and discrimination, but there is a significant difference. Antiharassment and antidiscrimination policies specifically include "protected classes" and address unprofessional behavior specifically targeting a person's race, color, religion, sex, nationality, disabilities, or veteran status. Surprisingly, there is no federal or state policy against bullying at the workplace if not directed at these protected classes.

Bullying is well defined. It is the systematic abuse of power and is defined as aggressive behavior or intentional harm-doing by peers that is carried out repeatedly and involves an imbalance of power, either actual or perceived, between the victim and the bully.[4] According to the Workplace Bullying Institute, bullying is the repeated, health-harming mistreatment of one or more persons (the targets) by one or more perpetrators. It is abusive conduct akin to psychological violence and is characterized by threatening, humiliating, or intimidating actions or words. Most unfortunately, it is not uncommon and very few bystanders speak up.