* This post first appeared on The PediaBlog on May 4, 2015 (before #MeToo).


Doctors Behaving Badly


When, last week, I first read Alexandra Robbin’s Slate article “Doctors Throwing Fits,” I must say I was shocked. I’ve since had the chance to speak with a few nurses and doctors about this “doctor-bullying epidemic” — some mothers of patients who I know are nurses, and some nurses and doctors who are my friends — and the reaction has been the same: “Yeah, that happens. All. The. Time.” Then, a look that asks me: “What planet have you been living on?”


A 2013 Institute for Safe Medication Practices survey found that in the year prior, 87 percent of nurses had encountered physicians who had a “reluctance or refusal to answer your questions, or return calls,” 74 percent experienced physicians’ “condescending or demeaning comments or insults,” and 26 percent of nurses had objects thrown at them by doctors. Physicians shamed, humiliated, or spread malicious rumors about 42 percent of the surveyed nurses. A New York critical care nurse told me, “Every single nurse I know has been verbally berated by a doctor. Every single one.”


The Joint Commission (an independent organization that accredits health care organizations and hospitals) has weighed in on physician bullying, stating that such behavior endangers patients lives, leads to medical errors, and increases the cost of health care. Robbins isn’t making excuses as she puts the problem in perspective:

Certainly, only some doctors exhibit such behaviors, and incidents should be viewed in context. Tensions run high in life-or-death situations; doctors may not have time to monitor their tone or language when their priority is saving a life. The doctors considered the worst offenders are the specialists whose work is consistently urgent and carries the highest stakes. The hospital departments most likely to host doctor bullying are operating rooms, medical surgery units, ICUs, and emergency rooms. In the OR, surgeons are more than twice as likely as anesthesiologists and nurses to exhibit disruptive behavior.


And Robbins says this problem of doctors mistreating nurses isn’t new:

The doctor-nurse hierarchy is rooted in the past, in remembrances of outdated traditional roles. Up until the mid-20th century, nurses, almost always women, were expected to stand when a doctor, almost always a man, entered the room. Nurses were to offer him their chair and open the door so that he could walk through first, in chivalric reverse. Nurses were expected to await instructions passively without questioning the physician. By the 1960s, nursing schools were still teaching that, as one nurse described it, “He’s God almighty and your job is to wait on him.”


Once you’re done gagging, you can read the rest of Alexandra Robbins’ article here.