Workplace bullying is a widespread problem in the medical profession and can be a difficult path to navigate for all involved. Avant’s SONYA BLACK examines how to identify it and manage complaints.
Dr James is an ophthalmologist in a busy city practice. His last patient complained that the orthoptist, Jenny, was rude to her and rough during the examination.
This is the final straw for Dr James. He’s fed up with having to manage complaints about Jenny, so he calls her into his office and says: “I’ve just had another complaint about you. This can’t continue. How many times have I told you to be nice to patients? It isn’t rocket science.”
Jenny responds with a shrug of her shoulders and a comment about the patient being “old and cranky”.
Dr James raises his voice and says, “Enough! You cannot keep doing this. If I get one more complaint, I’ll get you fired!”.
Later that day, the practice manager, Savannah, tells Dr James Jenny has made a bullying complaint. Savannah says she will be investigating and would like to speak with Dr James about it later that day.
What is bullying?
Bullying is behaviour that is unreasonable, repeated and creates a risk to health and safety. There are many actions that may constitute bullying, including: intimidating, coercing, threatening, humiliating, shouting, victimising, terrorising, singling- out, belittling, harassing, isolating, freezing out, ganging up, ostracising, rumour- mongering, disrespecting, being sarcastic, mobbing, mocking, victim-blaming, discriminating, using innuendo, malicious pranks, physical, verbal or emotional abuse, acting in bad faith and participating in a conspiracy to harm.
Good medical practice: a code of conduct for doctors in Australia states there is no place for bullying in the medical profession.
Reasonable management action carried out in a reasonable manner is not bullying. This means that appropriate performance management and disciplinary action are not bullying if these processes are carried out reasonably.
Bullying requires repeated behaviours. While a single incident of inappropriate behaviour may not be bullying, it may still be inappropriate, and an employer should take some action to respond to it.
So, what legal issues arise from bullying? A worker who believes they have been bullied can:
- Complain to his or her workplace about the bullying.
- Complain to Ahpra about bullying by a healthcare worker.
- Make a workers’ compensation claim or complaint to the workplace health and safety regulator.
- Seek an order from the Fair Work Commission for the bullying to stop.
- Seek compensation for breach of contract or negligence.
The workplace should investigate all bullying complaints and take appropriate action (which may include dismissal) against the perpetrator.
A workplace must ensure, as far as reasonably practical, the health and safety of all workers by eliminating or minimising risks to health and safety.
In practical terms, this means an employer must:
- Have a policy about bullying in the workplace which extends to contracted doctors.
- Train staff (including contracted doctors) about bullying.
- Manage bullying complaints if they arise.
- Review the bullying policy on a regular basis.
What about Dr James?
Dr James reflects on his behaviour earlier in the day. He realises he shouldn’t have raised his voice at Jenny but he was frustrated and Jenny wasn’t listening. Dr James has raised concerns with Savannah many times before, but she hasn’t taken any action.
Dr James speaks with Savannah that afternoon. He acknowledges he should not have raised his voice and he should have reported the patient concerns to the practice manager and let her manage it.
He offers to apologise to Jenny.
However, Dr James uses the meeting as an opportunity to explain to the practice manager that he cannot work with Jenny and asks that Jenny not be involved in the care of his patients moving forward. As practice manager, Savannah explains that will not be immediately possible from a practice perspective but she does commit to commencing a formal performance management process with Jenny. In addition, she says she will implement an interim arrangement to ensure the situation does not escalate.
Tips for practice doctors:
- Don’t raise your voice at a co-worker.
- If you do raise your voice or act poorly, apologise as soon as you can if possible – that may prevent a complaint. • Leave performance management to the practice manger.
Tips for practice managers:
- Implement a bullying policy explaining what bullying is and what staff should do if they witness or experience it.
- Make sure all staff are familiar with the policy.
- Develop a complaints handling process for your practice.
- Be alert to signs of conflict and act early.
- Encourage and support staff to resolve conflict with colleagues as informally as possible before a situation escalates.
Need more information? Avant factsheet: Workplace bullying
ABOUT THE AUTHOR: Sonya Black is Avant’s Special Counsel, Employment. With over 20 years’ experience as an employment lawyer, she advises doctors and medical practices across Australia on a broad range of employment issues.