Harassment in healthcare – What can palliative care learn from the RACS?

As many of you would know the Royal Australasian College of Surgeons has recently released its expert advisory group Draft Report into discrimination, bullying and harassment in surgery.  The results of the report are confronting even if they are unfortunately not altogether surprising.

The Draft Report reflects the findings and feedback from a comprehensive body of work which is published on the College website and include quantitative, qualitative and organisational research.

The cited research found that:

  • 49% of Fellows, trainees and international medical graduates report being subjected to discrimination, bullying or sexual harassment
  • 54% of trainees and 45% of Fellows less than 10 years post-fellowship report being subjected to bullying
  • 71% of hospitals reported discrimination, bullying or sexual harassment in their hospital in the last five years, with bullying the most frequently reported issue
  • 39% of Fellows, trainees and international medical graduates report bullying, 18% report discrimination, 19% report workplace harassment and 7% sexual harassment
  • the problems exist across all surgical specialties and
  • senior surgeons and surgical consultants are reported as the primary source of these problems.

The response to these troubling findings has been strong thus far.  A quote from the EAG chair sums up the sense for real change to result from improved understanding of this pervasive culture.

‘Now that the extent and impact of these issues is clear, there can be no turning back….we have been shocked by what we have heard. The time for action has come.’ – EAG Chair, Rob Knowles AO

A similar sense can be seen in the response from the president of the college in his video response.  He voices the need of the college as an organisation to face these real challenges and to earn back the trust of those who have come in contact with this behaviour.

The challenge for us on the sidelines of this process is to recognise that we are not on the sidelines at all.  To claim that the culture of discrimination, bullying and harassment observed by the college of surgeons is limited to surgeons is a continuation of the denial that has plagued drives for genuine change.  Discrimination, bullying and harassment can and do occur in all healthcare settings as suggested by Liz Sturgiss in this article focused on the issue of sexism in healthcare.

With this in mind the appropriate response to this revealing of the depth of these issues within the surgical profession is for palliative care organisations, clinicians, and professionals to reflect on our own day to day interaction with our colleagues and patients. To have open conversations about whether harassment, bullying and discrimination are problems in our own workplace culture, or in those that we come into contact with in other institutions (such as in the hospitals that we consult in).  As wisely observed by Major General David Morrison we all contribute to the culture around us as “the standard that you walk past is the standard you accept”  ¹.  It is time for all of us to ask ourselves, what standards are we walking past?



1/ Message from the Chief of Army, Lieutenant General David Morrison, AO: http://www.army.gov.au/Our-work/Speeches-and-transcripts/Message-from-the-Chief-of-Army

1 thought on “Harassment in healthcare – What can palliative care learn from the RACS?

  1. Hola M – A spot on post, mate. We are complicit, as Major General Morrison aptly states in the pquote. Rajana Srivastava (Melbourne Oncologist who you may well know) did a great piece on “Medicine’s Secret Shame” here: http://bit.ly/1v8IAyE Like racism, we need to call it when we see it. Often Junior Doctors and trainees are not in a position to potentially compromise their assessment, or worse yet, their career, by speaking out. We as specialists/VMO’s/Consultants must take issue and lead the discussion. I believe unprofessional behavior as described in the report is a painful symptom of the same hierarchical traditions of medicine which contribute substantially to patient safety errors. As Rajana and you both note, and no one in health care could reasonably dispute, it is not an issue that is limited to surgeons. Thx for the call to arms.


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