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25 Jul 2022
Poor culture is associated with poor patient outcomes, which places the issue firmly within the scope of regulators.
Doctors in training have told us in the Medical Training Survey that there are serious cultural problems in medicine, including bullying, harassment, racism and discrimination. Results of many other surveys across medicine and the wider healthcare sector reveal similar problems.
There is no place for bullying and harassment in healthcare because it harms the lives and careers of doctors and it harms patients.
Many health sector agencies share a commitment to building a positive culture in medicine. This cultural challenge extends to behaviour online. Social media is not a forum to bully, harass or intimidate. The same standards apply online and in person. It’s about respectful engagement, not freedom of speech. As others have noted, the standard we walk past is the standard we accept.
Communication and conduct – online and in person – involve both what we say and how we say it. Oversimplifying this debate to freedom of speech fails the first challenge in improving the culture of medicine – the ability to disagree with respect.
Sharing different opinions in person and online is core to healthy debate. Bullying, harassing or intimidating others while doing so is unprofessional, breaches the Code of conduct and increases risks of harm to patients and colleagues. It is not ok to yell at patients. It’s not ok to yell at colleagues. It’s not ok to intimidate others. It is not ok to communicate disrespectfully.
Part of creating a positive culture involves calling out the unacceptable. It involves having the courage to no longer turn a blind eye. We look forward to addressing this challenge with agencies across the health sector, because collaboration is the key to change.
Failing to stand up for a culture of respect fails our patients and our profession.
Three recent independent tribunal decisions are on point:
In Ellis v Medical Board of Australia, the Victorian Civil and Administrative Tribunal remarked:
Doctors are free to make contributions towards the advancement of medicine. Ordinarily, they do so through appropriate discourse within the professional community. In this context, there is an obvious difference between publication via social media and, say, publication in medical journals. But there is a broader point. Dissemination of material by a registered medical practitioner to the general public that is disparaging, denigrating and demeaning, or that otherwise has the capacity to cause harm to the community in the ways we have identified, is expression of a different kind altogether. To take lawful, appropriate measures against the kind of expression that Dr Ellis has engaged in cannot reasonably be claimed to deter doctors from making contributions towards the advancement of medicine. The Code and Social Media Guidelines make clear where the lines are drawn.
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