Doctors work in hostile environments

With unrelenting pressure and stress for all physicians, there are ever increasing complaints of a hostile work environment.

We have been asked to help deal with many complaints. These are often from younger team members, newly minted physicians, physician assistants, residents or fellows who feel targeted with comments or critique that are unfair. These junior employees usually feel they are helpless to object or that they may suffer consequences if they do.

Today, this is the hallmark of a hostile work environment.  

The challenge is that the instigators usually don’t even know they are causing trouble. The most common scenario is that older well-respected senior physicians or partners are trying to be friendly, joking or teasing. They are only doing what has worked for them their entire career, over the past 20-30 years.  In fact, it was most acceptable and even got laughs through the years. The problem is that expectations have now changed, and quietly accepted behavior from even a few years ago is no longer accepted.

What are some of these behaviors?  

In an effort to be friendly, it might be tempting to give a positive compliment or to bring a little humor into a serious workplace. These might seem like a good idea:

You might notice that someone’s attire or hairstyle is new, or appearance is attractive or has changed. Doesn't everyone like a compliment? For a young possibly insecure junior partner, a comment on appearance can be deflating.

“I’m working hard to contribute to the group. I just finished this big project. I received the highest patient ratings in the department… Am I only appreciated for my appearance?”  

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Your patients have always thought of you as being very empathetic and comforting. When you notice a colleague looks troubled and they tell you about it, it is just natural for you to touch them on the shoulder and empathize. Maybe a hug will make them feel better.

If your colleague has been traumatized in the past by unwanted sexual or romantic advances, this may seem like another attempt, and this time by a respected colleague!

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The welcome party last week was a lot of fun and everybody came dressed up and had a great time. You have a lot of good memories and funny photographs. It would be a great idea to liven up those boring department meeting with some of these pics.

Do you really think that your work colleagues want to have their party attire and their antics after a few cocktails to be the focus of the department meeting?  Would that help support their career…or sabotage it?

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Happy hour was a great idea and meeting the boyfriends, girlfriends and spouses of the new people was enlightening. They had great stories that were eye opening. Sharing the stories around the hospital will get lots of attention. It might even help some of the quiet ones get accepted when everyone hears how much fun they can be.

Do you really think that those amusing personal stories might make it difficult to be taken seriously in the workplace? Do they want their professional workmates to know all of those details?  Does that sabotage their quest for respect and possibly advancement.

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That new kid on the block seems so serious, they never smile. Everything is so formal. I don’t think they are going to stay here if they take everything so seriously. I should be more casual and the informality will help them enjoy their work environment more. A little teasing will bring out their sense of humor and show my fun side how clever I am.

Do you think someone new on the team is going to be amused by a laugh at their expense in front of the rest of the team? While you may think you are laughing with them, it will really seem like everyone else will be making fun of them!  

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The irony is that what we used to think was just fun or teasing or joking around often comes at someone’s expense. It might be fun among friends who know each other well, where friendship and goodwill has been established in a non-work setting. It is not viewed as innocent fun at work where professional demeaner, teamwork and respect are expected, especially in a hierarchy where influence and livelihood are at stake. Bosses are always viewed as those who can influence salary, assignments and career and casual comments or poorly conceived jokes from bosses always carry more weight than a side comment from others.

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What Can You Do?

As physician leaders, you should act proactively. First of all, you need to truly believe that the rules of the game have changed. If you don’t believe it, you may be part of the problem. It is not enough to have an “Open door policy”  Nobody wants to be the tattle-tale or to be known as the complainer.

You need to have active monitoring, by constantly asking  around with genuine interest and better yet, to get trusted colleagues to monitor the complaints and conversations. The boss is always last to hear bad news. Even if all sounds well, training is good.

It must be expected for everyone. The biggest offenders never think they need to hear this message so they will skip a voluntary discussion of the workplace culture. You need to be a role model. Admit when you make a faux pas.

I no longer address the team as “Hey guys”. This sounds innocent, but I was told once that “we are not all guys…” It night not seem important to you, but it is important to someone.  

When you hear of a complaint, an incident or a rumor, check it out. Every complaint should get investigated. Someone thinks it is important and they need to know that their leaders have their back. If the investigation finds something, an action needs to be taken. It could be an informal discussion over coffee, of a formal letter in a file, a new expectation set… and it has to be documented in a private file, even while maintaining confidentiality.

A general vague report needs to go back to everyone that something happened, and something was done.  Most people will not know or care, but someone will. Sometimes it is easier to get an outside investigation to avoid any perception of favoritism or retribution, which is an easy bias after any decision. An outsider investigator can be objective, less likely to be biased, less likely to be caught up in company gossip.

Expect unhappiness and controversy after any investigation result. The goal is to set a new expectation and culture and to convince all of your co-workers and colleagues that you are building a welcoming work environment that includes everyone.

Be patient and the reward will be expectations that everyone understands, fewer misunderstandings and happier employees, partners and colleagues.

It is worth the effort.

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