‘Doc-eat-doc’ world: health sector’s rampant bullying culture

GEORGE TOWN – A former Penang Hospital houseman’s alleged suicide recently has triggered an outcry among his colleagues, who want the authorities to seriously look into the matter instead of dismissing it as a “common” issue.

Several doctors, who preferred to remain anonymous, said bullying in the medical fraternity is a pervasive problem.

A doctor who recently left the profession told The Vibes that bullying happens in almost all departments, and if doctors quit the field, it is not because they have “lost their passion”, but due to exhaustion and mental trauma.

It was recently reported that 66.9% of doctors in Malaysia admitted to being victims of bullying while serving in the public health sector, and that most of those affected are aged between 26 and 35.

Malaysian Medical Association president Prof Datuk Dr M. Subramaniam has said that because of the bullying, some 75% of respondents admitted to losing interest in work, while 80% expressed worry.

A few junior doctors shared their housemanship experience with The Vibes.

“I’ve been chased out of a ward because my superior ‘doesn’t want to work with me’, and so I just go away for a while because I can’t stay if they don’t want me,” said one.

“However, they would report to the specialists, saying I did not report to work, when I did. So, I got penalised by my own department.

“There was once when I was attending to a patient who just had a heart attack, and suddenly, one of the specialist doctors came up to us and shouted at me.

“She was criticising my English, just because I did not have enough of a Malaysian accent. In the end, my patient got angry with the specialist and defended me, asking the specialist what my English had to do with what I was helping him with.

“There are times when these incidents can push people and make them ‘crazy’,” he said, adding that housemen work 12-hour shifts and are often exhausted.

During his first three months as a houseman, he could not take even a day off due to the workload. 

It is acceptable for senior medical officers and specialists to reprimand junior doctors and housemen when they make mistakes, he said, but screaming because one forgets to write down the date is “too much”.

“Some people react this way because they are stressed. After a stint in Sabah, I was transferred to the obstetrics and gynaecology department at a Sarawak hospital, where the stress levels were highest. 

“It is due to the high KPI (key performance indicator), where the maternal mortality level is set to mirror that of First World countries, but the facilities that we have are Third World, so we bear the brunt of the responsibilities, and this creates a group of very angry doctors. 

“In that department, five out of my 10 friends were undergoing psychiatric follow-up treatment,” he said, adding that he, too, suffered depression and panic attacks, which led to him quitting the profession.

He said they are expected to conform to the unhealthy work culture.

“Everyone talks about bullying as if they accept it. And, the current system is bad because the department can extend your tenure if they don’t like you. 

“If you can’t get along with your superiors, they can use their power to cripple you emotionally and mentally. Those people at the top, they delegate their work to the MOs (medical officers), and the MOs, to us. The pressure is then on us.

“If my work is done, and a team member’s isn’t, we are expected to stay back to finish their work and conform to the work culture. Otherwise, we are singled out to be bullied, just because some of us want to head home on time, sometimes. 

“When these incidents happen, you will be bad-mouthed, and the specialist doctors, without context, believe it and classify us as ‘bad doctors’.

“As housemen, we are supposed to be in a particular department for three months, and undertake the necessary tests and procedures. I passed all my tests, but I was not given the opportunity to, for example, conduct a C-section because my superiors kept deferring it. So, in the end, I had to stay on in the department for another few months.”

The system is toxic, he said, and many felt that they had to leave. 

He said there are many cases of doctors committing suicide, but these are not made known.

Another doctor, who is a Covid-19 frontliner, said he was the victim of bullying at a public hospital.

He said housemen are bullied by doctors – consultants, specialists, registrars, medical officers, and even other housemen – and also nurses, with some refusing to do their work, forcing the housemen to take patients’ vital signs, change diapers and carry out other tasks.

“Bullying doesn’t necessarily stop even after you finish your housemanship. In many ways, we have the hierarchical system to blame.

“Whoever is at the top often tends to bully those below them, and this exists at all levels. Not everyone is like this, but it’s prevalent enough that you’ll find this almost everywhere.

“Scolding is necessary sometimes if it’s done for the right reasons, like to reprimand lackadaisical attitudes, or people missing out on important things or making dangerous decisions.

“But, some people cross the line when it comes to scolding, and humiliate the housemen in question. Some don’t realise how malignant they are, some genuinely enjoy tearing other people down. Some people just love to find fault with others because they can get away with the bullying.

“Even among housemen, there are those who think it’s a dog-eat-dog world, and would gladly sabotage their colleagues to make themselves look good. 

“Some are hypocrites who won’t do their work properly or are not very good workers, but will totally rip into others if something is not to their satisfaction. Some push all the work to their juniors while they laze around or play sycophant with their superiors.

“There are those who enter the field with good intentions, but end up becoming victims of bullying. Some think it’s ‘normal’ to treat their colleagues and underlings badly, while some decide to treat others like ‘rubbish’ because they want their juniors to suffer as they did.”

He said he has depression due to the bullying, and although he is willing to talk about it, he does not believe the situation will change. – The Vibes, January 2, 2021