Enablers of Bullying and Harassment in Medicine

Introduction: Bullying, intimidation or harassment, amongst medical professionals occurs across the discipline. This kind of behavior limits the enjoyment of practicing medicine, lead to physician burnout, deterioration in physicians’ mental health and curtails a health care organization’s performance. One aspect of this problem that has not received much attention is who the enablers of bullying and harassment are and what is the best approaches to address the problem. Methods: A literature search on enablers focusing on physicians. Results: An enabler is one who enables another to persist in behavior, by making it possible to avoid the consequences of such behavior. In medicine, an enabler is a physician who has witnessed an event of bullying and harassment or one to whom the event has been reported, but who does not take appropriate action to correct it and prevent other similar events. There are a number of reasons why enablers exist and persist in Medicine ranging from a desire not to ‘hurt’ the offender, fear of the anger or retaliation from an offender especially when he/she is in a position of power controlling allocation of resources, promotion or financial compensation. An enabler may have been a former student or mentor or even a colleague who assisted them in managing a difficult case or situation. The first step is a process that brings the issue into the spotlight. In the cognitive field – lectures or seminars to medical staff and medical leadership at the hospital and if relevant at the University medical school level. Second, a safe mechanism to report, inform and educate enablers is an essential step. Conclusion: First, it is crucial to recognize the role played by enablers of bullying and harassment in Medicine. Second, addressing and correcting the role played by enablers should minimize an issue that is damaging to physicians wellbeing.