Doctors taking selfies with unconscious patients. A Twitter rant about a patient who can easily be identified. Constant bullying or harassment of fellow physicians or staff.
Reports of physicians misbehaving, whether in their work setting, personal life, or on social media, have seemed more frequent lately, and new data may back that perception. Medscape recently surveyed more than 2000 physicians to uncover the extent and nature of bad behavior among physicians within the past 5 years.
According to the report, more than half (56%) of physicians said they have witnessed or have experienced other physicians behaving inappropriately. Forty four percent said bad behavior most often happens in the workplace, 33% said that it occurs on social media, and 23% said it happens outside the workplace. The survey defined “inappropriate behavior” as being disrespectful to patients, medical professionals, or others; being visibly inebriated or scantily dressed; harassing others; using offensive sexual or racist language in front of others; making fun of patients or disregarding patient privacy on social media; or other clear examples of poor behavior choices.
In the past 5 years, physicians personally witnessed or experienced between five and six instances of inappropriate behavior on average, both inside and out of the workplace. Bullying other medical personnel and making fun of patients unbeknownst to them were the most frequent infractions in the workplace. Both were reported at about 80%. The third most common survey response was “using racist language,” with just over half of physicians reporting it. Nearly half (44%) of physicians reported that they had seen other doctors “becoming physically aggressive,” and 40% reported witnessing inebriation. Outside of the workplace, the most commonly observed bad behaviors were “making fun of patients” (68%) and inebriation (58%).
“It’s sad, but not surprising, to see these results, especially the bullying or disparaging behaviors toward patients,” said Peter Yellowlees, MD, chief wellness officer at UC Davis Health. “The results show how most of us have interacted with some difficult and disruptive colleagues, as well as those who are burned out, who are more likely to behave inappropriately. We should not tolerate these behaviors, and the next question to ask ourselves is, ‘Have I done anything to prevent this from happening again?’ “
Physicians were also asked to report the most egregious instances of bad behavior they had witnessed. Responses ranged from “a physician continually joking to patients and staff about his own genital size” and “a drunk physician posting online that he wanted to have sex with two of his patients” to “dirty hands and nails.” They also reported seeing other doctors partying with many people while unmasked during the pandemic.
A New Home for Doctors’ Bad Behavior: Social Media
Physicians also said that in total, they had witnessed an average of eight misbehaviors by other doctors on social media. When asked to elaborate, their answers revealed that social media has become a prime locale for bad judgment. Physicians most often behaved inappropriately on Facebook, the platform they use most regularly. One respondent said they saw physicians post pictures of themselves at a party where they and everyone else were “clearly on drugs.” Others witnessed doctors post a photo making fun of an unconscious patient or pictures of rashes in sexually explicit areas in women. They also reported the use of hateful, racist, sexist, or anti-Semitic remarks.
Eighty percent of respondents said they had witnessed other doctors making inappropriate comments about themselves or other nonpatients on social media, 39% said that they had seen other doctors post inappropriate pictures of themselves, and 43% said they had come across doctors’ inappropriate comments about or pictures of patients.
“We Have to Change the Culture of Medicine”
Surprisingly, about one third of physicians said that workplace misbehavior has decreased in recent years. Some attributed that to more surveillance cameras, more employees with smartphones who record and report bad behavior, more attention to the issue of harassment and bullying, more lawsuits associated with bad behavior, and less acceptance by professionals. Still, more than half of physicians felt that the amount of bad behavior has remained the same, both inside and outside of the workplace.
Most thought that misbehaving physicians should be reported or warned, should experience some type of negative consequence, or at least have their behavior brought to the attention of those above them. When witnessing bad behavior, 37% of respondents spoke directly to the doctor in question, 25% reported the behavior, and 35% did not act at all.
According to respondents, half of misbehaving physicians in all settings were in their 40s, although physicians in their 30s and 50s held their own with a fair share of infractions, at about 40% each. Strikingly, respondents felt that more men (80%) than women (20%) misbehaved.
“We know that we have to change the culture of medicine and increase the number of women and physicians from diverse racial and ethnic backgrounds,” says Yellowlees. “Thankfully, this is happening, and with our current awareness of the existence of these inappropriate behaviors — which used to be hidden or ignored — I hope we’ll see less of all these behaviors in the future.”
Should Physicians Be Held to a Higher Standard?
Three quarters of respondents thought that physicians should have a higher standard of behavior than the general public, and 80% of physicians reported that bad behavior by doctors reflects badly on the medical profession.
Just over half of respondents blamed individual physicians’ personal arrogance and loosening standards of behavior. “I think society’s standards for doctors in the workplace are about right,” says Arthur L. Caplan, PhD, bioethicist at New York University Langone Medical Center. “Remember, people set expectations according to your role and are always looking for hypocrisy and always trying to take down people in authority. Any doctor who cares about their reputation should not be seen dancing around drunk.”
Two thirds of physicians said they didn’t think it was appropriate for doctors to post photos of the drinking of alcohol, use of recreational drugs, or the wearing of revealing clothing online. However, 28% said they thought depicting the drinking of alcohol online was acceptable, and 20% said the same of revealing clothing. One respondent suggested that many physicians who misbehave don’t believe that they are doing so, because others around them are acting similarly or are posting similar behaviors online.
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