C L O S L E R
Moving Us Closer To Osler
A Miller Coulson Academy of Clinical Excellence Initiative

The human cost of toxic work culture 

Takeaway

Healthcare professionals often experience unrealistic work expectations. If this becomes too much, clinicians can seek support, set boundaries, and even consider making a change. 

Thankfully, I was only yelled at once during residency by an attending physician. But believe me, I remember the spot in the hallway where it happened and exactly how I felt when yelled at me in public for something out of my control. It was uncalled for and demeaning.

 

Some of you may have read or heard about the recent “Washington Post” article about a George Washington University resident who died by suicide. It included the work his family is now doing to amplify the message that physician mental health needs to be addressed. Although more groups, including the Dr. Lorna Breen Heroes’ Foundation, are working hard on this, there is still much to be done.  

 

One of the pieces that impacts us is the negative messaging we may receive at work. Some of this is subtle, and those sending them may not realize that the messages are hurtful. We may not even be aware that the messaging from our leaders/ colleagues is harming us. Whether they be microaggressions, unrealistic expectations, or putting people down, over time these messages can build up and negatively impact us. What can you do to protect yourself and your colleagues?

 

1. Recognize when words/actions are hurtful and wrong.

This may sound obvious; however, we don’t always notice when people are saying or doing hurtful things to us. As clinicians, we often take care of people who feel scared, upset, and/or angry because they are our patients. Because part of our job is accepting and managing challenging emotions from patients, we may forget that our employers and colleagues should not be putting those types of emotions on us.   

 

2. Make an immediate plan to support yourself. 

Step away from the email or the situation that is upsetting or angering you. Talk to a friend or colleague. Call your employee assistance program for short-term counseling.  

 

3. Identify where the negative messaging comes from.  

Sometimes a colleague or supervisor is the messenger; however they may just be delivering the message. Have you been told you need to see three extra patients each half day? Your medical director may be telling you this, however it may be the case that she is just passing along a message from leadership. 

 

4. Ask questions and determine if you can improve the messaging.  

Sometimes we have the energy and the ability to change a hurtful culture. Sometimes we don’t. If you feel safe doing so, ask more questions about why negative messages were sent, and see if you can change them for the better. We increasingly work in large, complex organizations where the person writing a policy doesn’t know the people who have to follow it. They may change their approach if you tell them how it is hurtful.  

 

5. Decide if you can stay in the situation or not.  

You deserve to work in a place that supports you and values your contributions. Sure, we all have tough days, and no one expects working in healthcare to be easy. But that doesn’t mean that toxic messaging should be tolerated. If things continue or are very serious, you may decide that you need a new workplace or training program. It’s a hard choice to make, but in the end, you need to care for yourself in order to care for patients. 

  

Mental health resources:  

988 offers emergency emotional support to all, 24/7. Simply dial 9-8-8.

The Physician Support Line offers free and confidential support to physicians and medical students, M-F, 8am-12am. 1-888-409-0141. 

 

 

 

 

 

 

 

 

 

 

This piece expresses the views solely of the author. It does not necessarily represent the views of any organization, including Johns Hopkins Medicine.