Building Respect: The World's Shifting Understanding of a Good Surgeon and Good Work Culture
RCSEd Communications Team
The Royal Australasian College of Surgeons (RACS) introduced their 'Building Respect, Improving Patient Safety' campaign in response to highly publicised incidents of sexual misconduct, and are planning on also launching the 'Let's Remove It' campaign, developed originally by RCSEd, in Australasia. Courtney Rhone, Project Lead for 'Building Respect, Improving Patient Safety' at RACS, explores the need for campaigns such as these and what they aim to achieve.
Surgery, the world over, known for its dedication to patient care and high standards, faces significant challenges regarding workplace culture, affecting the well-being and performance of our practitioners. No one knows this more than surgeons. For years a quiet wave has been growing. A building presence of those who know and have experienced the pain and humiliation of workplace bullying, sexual harassment, and discrimination.
This is why the Royal Australasian College of Surgeons launched our 'Building Respect, Improving Patient Safety' campaign in 2016. Since then, the many parallel goals of RACS and RCSEd have come to the fore.
At the core of both our colleges is the understanding that a respectful and inclusive workplace is vital for the well-being of medical professionals and the quality of patient care. Both our initiatives emphasise the importance of respect, dignity, and professionalism in the workplace. Without these core values we see quality of patient care decreases while also impacting the overall health and wellness of the caring physicians themselves.
The mental health of doctors in Australia has been a growing concern, with significant rates of depression, self-harm and suicide reported within the profession. According to data from various studies and reports, approximately one in five doctors in Australia experiences depression, and the rates of self-harm and suicidal thoughts are higher compared to the general population.
The Australian Institute of Health and Welfare (AIHW) has also reported alarming rates of self-harm among healthcare professionals, including doctors. According to the AIHW, the rate of self-harm among healthcare professionals has been increasing, with an estimated 3.4% of healthcare workers engaging in self-harm behaviours in recent years. Additionally, a study published in the Medical Journal of Australia found that the suicide rate among doctors is notably higher than that of the general population.
We can no longer pretend these dire statistics on physician mental health are somehow divorced from the job itself. The pressure and expectations of all doctors, worldwide, are extremely high, but when you couple these pressures and expectations with a culture of blame, shame, intimidation, and verbal or physical harm you find surgeons who are no longer able to cope with the pressure system they have been trapped in.
Clearly a change is needed. But how?
In Australia, we have also found it very beneficial to view these discrimination, bullying, and sexual harassment issues through the lens of workplace health and safety. Rather than a feel good, fluffy campaign criticised by the toughest and most loyal to the status quo, these operations now put emphasis on the requirement of workplaces (hospitals) to provide a safe and productive environment to work and provide patient care. We can no longer look past the organisations and structures themselves who benefit from individuals carrying the weight of discrimination, bullying, and sexual harassment.
At times there is hesitancy from the old guard to incorporate a change in values when it comes to deeply held beliefs. Surgery is a hard profession, so it would stand to reason that you need to be a hard person to withstand such a profession. There is a belief that through the fires of bad behaviour and bad treatment a surgeon will emerge stronger for it. But one of the many benefits of now living in the age of technologies and international partnerships is that we get the opportunity to test these age-old beliefs.
We now know that resilience comes not from berating, bullying, and public shaming. Resilience is forged in the hot fires of personal connections, strong relationships, and a meaningful life. If we want to create the best and brightest of surgeons to come, we must do what all great doctors do, follow the research, fight the status quo, and create something never known before.
It is within each individual grasp to make their own surgery, their own hospital, and their own network a place where all people are treated with respect and value.
While DBSH is surely an issue we understand as interpersonal, it’s also absolutely necessary to implement policies that promote system-wide zero tolerance for bullying and harassment, holding leaders accountable and equipping them with tools to foster a positive work environment. Strong, ethical leadership is what gives those under their care the confidence to live up to the values being espoused in our parallel campaigns.
Historically, surgery has struggled with deeply ingrained issues of racism and sexism, which were once even codified into laws and practices. Over time, these discriminatory practices have been recognised as unjust and harmful. Let us not forget that progress is happening before our eyes. Advancement is at the fore. Equity is at the fore. Change is at the fore.
In the high-stakes world of medicine, where lives hang in the balance, the well-being of the caregivers is paramount. The 'Let's Remove It' and 'Building Respect' campaigns are more than just initiatives—they are lifelines for medical professionals navigating the often turbulent waters of their careers. They represent a collective commitment to fostering environments where surgeons, doctors, and nurses can thrive without fear.
These campaigns matter because they champion the fundamental human right to work in a place of respect and dignity. They matter because every surgeon deserves to feel valued and supported, allowing them to perform at their best and provide the highest standard of care to their patients. By addressing the poisonous behaviours that have plagued the medical field for too long, the 'Let's Remove It' and 'Building Respect' campaigns are not only transforming workplaces but are also paving the way for a new era of empathy, compassion, and excellence in healthcare.
Ultimately, these campaigns are about improving lives—not just the lives of patients but also the lives of the medical professionals who dedicate themselves to healing others.
