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How to Combat Toxic Behavior in Medicine

It does not take much research to find out how difficult a job medicine can be. Articles on Medscape, Doximity, and KevinMD frequently discuss the stress that doctors go through taking care of a multitude of sick patients and facing countless difficult decisions on a daily basis.

In addition, physicians are often at the whim of frequent administrative policy changes and yet, in order to remain within best practice guidelines, are expected to adhere. Hospital administrators constantly push physicians to produce as many relative value units (RVUs) as possible or face salary cuts.

Finally, many of these stresses leave out the very human and personal issues doctors may be going through in their own lives, such as familial or personal emotional anxieties.

While doctors tend to be resilient individuals (having gone through the grueling trials of medical school and residency), they are by no means invincible to burnout. Burnout manifests in various forms, and the most heartbreaking form is when physicians displace their anger onto their residents, students and each other. Such displacement is as multiplicative as it is harmful to the recipient of such behavior. More damning, however, is that the acceptance of said behavior sets the precedent that it is appropriate in a professional environment.

We know medicine is an inherently difficult job, so why should we allow such behavior to make a challenging job any worse for one other?

More importantly, how can we combat such harmful behavior?

While it is easy to point the finger at everyone else, the easiest first step is examining one’s own role in this environment and adjusting the factors that one can control.

First, it is helpful to keep in mind that, in many instances, such nasty behavior is not always a personal attack, but rather a displaced expression of frustration that is not related to you.

Also, ask yourself a few questions:

1. Has there been a time you have taken your own knowledge for granted, and disparaged or humiliated a new medical student for not doing a job correctly or having adequate knowledge?

2. Has there been a time you have had a heated conversation with a consulting service because your pager was blowing up with other tasks and work?

3. Have you ever felt tired and lazy, and consequently left work for another colleague to complete, which may have caused undue duress?

Being human, perhaps all of us have had moments of weakness and have been guilty of such behaviors. However, improving the culture of medicine begins with being the leader and role model that people can follow.

Be the person who breaks the cycle, and not dish it onto someone else.


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