Don’t be cruel

While none of us are eager to admit it, many of us have witnessed bullying in the healthcare environment. Sometimes it’s senior physician versus junior physician or medical student. Sometimes it’s physician versus nurse. Almost invariably it involved the presence of a power differential, someone who is advantaged versus someone who is not.

This past week, this podcast was released as part of the JAMA Podcast series.  If you’re not familiar with the JAMA Podcasts, they are pretty terrific.  In this one, Ed Livingston cites much of the data about the prevalence and impact of abuse/ bullying, with a particular focus in this podcast on medical students. If you want background reading for the podcast, the original case and discussion are here.  I want to highlight the importance of ignoring behavior like that described in the podcast (as do Dr. Lucey and Dr. Livingston)- if we ignore this behavior, we’re implying that this is okay.  Note: I am particularly heartbroken by the surgeons who were so terrible to the medical student- I promise we don’t eat our young. Also, if you’re in training as a student or resident and have someone in a position of power who is bullying you, it’s likely not just you they are picking on…find someone safe to report it to who can hold them accountable.

Interesting timing of course means that during the same week something came across my email talking about how to overcome bullies at work.  An important point that he makes is at the very end: If you’re surrounded with jerks, you’re at higher risk to become one.  Choose your environment wisely. (((Related but unrelated: some of you have heard me talk about Eric Barker’s blog in the past, and this piece is no exception to his usual brilliance.  I try to subscribe wisely to things, and his weekly blog is a highlight in my email inbox on Sundays.)))

And what if this isn’t about a power differential, but is more about a peer who is a jerk when they aren’t being watched? Remember not to get hooked, and that it’s really not about you.  Then refer back to the prior piece.





Mean girls: Our own worst enemy?

“There is a special place in Hell for women who don’t help other women.”  Madeleine Albright

I have participated in a number of leadership training seminars targeted for women in academic medicine.  These seminars spend lots of time helping us career plan, helping us communicate more effectively, helping us run meetings effectively.  What they don’t teach us is the sociology of organizations and leadership and one of the lingering barriers to women’s success: the role that relational aggression can play in women’s career development.

What is relational aggression? Quite simply, it’s manipulation of someone in a way intended to damage their relationships with others.  While it’s behavior that may be displayed by men or women, in American culture it’s a predominantly female behavior.  It consists of isolating someone socially through whisper campaigns.  It preys on the desire for connection and belonging.  It compounds workplace stress, something little needed in some of the environments where it is best described (nursing, I’m looking at your sisterhood on that one– stop eating your young!).  It’s often insidious, smoldering…and incredibly hurtful.  The most damaging piece of relational aggression is that those who see it for what it is often stand on the sidelines, afraid of becoming the next target.

Ladies, admit it:  You’ve either experienced it or witnessed it.  Gentlemen, I suspect you’ve had the opportunity to see these things occur as well.  This isn’t unfamiliar territory, but it is dangerous territory.

The reasons for relational aggression are likely complex, myriad, and something I will dig into when/ if I am reincarnated as a sociologist whose work focuses on power dynamics (because really, it is ALL about power).  What is perhaps more important is to be cognizant that it exists, and to figure out how we nip this phenomenon.

Organizational interventions can certainly help if it’s a pervasive part of culture.  In academic surgery we don’t have enough powerful women (yet!) for relational aggression to be a real danger in most settings.  Where we can have an impact in places where women are still a minority is to be individually accountable for our behavior and to hold our friends and colleagues accountable as well.

What is my commitment to help halt relational aggression?

  • As a leader, to insure that those who need access to me have that access
  • As a peer, to insure awareness of opportunities for participation and leadership
  • As a human, to not get sucked into smear campaigns and dirty gossip.
  • As a friend, to continue the work that a couple of colleagues and I have begun of nominating one another- or other Worthy Women whom we identify- for awards and opportunities.

It’s all about valuing people and their contributions, really.  I’ve never aspired to be a Mean Girl, and there is no time when that’s been more important than now for me.