UK Edition
Badly-behaved surgeons are putting patients' lives in danger due to 'culture of bullying', report finds
Trainee surgeons are being assaulted during operations for raising safety concerns as part of an ‘endemic culture of bullying’ that causes patient deaths, the professions leadership has warned.
The Royal College of Surgeons Edinburgh (RSCE), which represents members across the UK, said a “visceral” atmosphere of fear among younger surgeons is leading to failures in concentration that directly harms patients.
In a new report, the college also warns the profession’s “macho” attitude makes it difficult to challenge bad practice, a culture which enabled disgraced breast surgeon Ian Paterson to mutilate victims unchecked for two decades.
It follows research published in June which found that one in six trainee surgeons are suffering from battlefield-type Post Traumatic Stress Disorder.
Senior doctors have warned that the bullying culture among surgeons is negatively affecting recruitment, making entry into the discipline less competitive.
RSCE is calling for bullies to be removed from their posts and has set up a task force to send into affected hospitals.
Dr Alice Hartley, a Newcastle-based registrar who co-chairs the college’s trainee committee, said a senior colleague had flung instruments at her during an operation after she asked a question, a situation she described as “not uncommon”.
In another incident, a surgeon slapped her hand as she was preparing to make an incision.
She said fear of older colleagues was forcing junior surgeons to cut corners, such as avoiding asking for advice in complicated cases.
“It’s getting more and more of an issue,” she told The Sunday Telegraph.
“If you’ve been shouted at first thing in the morning you carry that with you for the rest of the day. You won’t be concentrating on your job.”
Last year’s NHS staff survey found that, across all disciplines, one in five doctors had suffered bullying.
However, previous research indicates that surgical trainees are three times more likely to suffer abuse and that as many as 27 per cent of patient deaths during or shortly after surgery can be attributed in part to “disruptive behaviour”.
Victims who gave evidence to the RSCE said they had surgical leaders had spread false rumours and publicly humiliated them after they asked awkward questions.
Earlier this year West Midlands surgeon Ian Paterson was jailed for 20 years after being convicted of deliberately performing unnecessary and incompetent operations on 10 patients, although the true number of his victims is estimated to be several hundred.
Campaigners for the victims have called for the system, which allowed his butchery to go unchallenged in both the NHS and private sector, to be overhauled.
Last night RSCE leaders directly linked the current bullying culture with the risk of another rogue surgeon.
Professor Michael Lavelle-Jones, President of RCSE, said: “The sentencing of surgeon Ian Paterson has once again raised the issue of bullying and undermining in healthcare, and highlighted the terrible consequences that this behaviour can have for patients.
“We want to change the culture of healthcare to ensure that this kind of behaviour becomes so unacceptable it can no longer go on.
“As professionals, we have a duty to protect our patients from damaging and unnecessary treatments, and, as professionals, we have a right to be protected from being bullied and undermined.”
The college wants the General Medical Council, which regulates doctors, to introduce compulsory training on bullying in Foundation Year training.
Charlie Massey, GMC Chief Executive, said bullying and undermining behaviour should “never be tolerated”, but said the organisation’s standards already made it clear that medical training environments should encourage trainees to raise concerns about patient safety.
“We welcome the college’s efforts to build on those standards and tackle bullying and we are keen to support those delivering training to raise awareness of the issue,” he said.
Danny Mortimer, Chief Executive of NHS Employers, said: “Bullying is completely unacceptable and the ongoing work to tackle it is vital for all NHS organisations, leaders and staff.
“We support any initiative which addresses bullying in our profession.”