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Vol. 55, No. 3, March 2009, pp.279 - 285
Copyright © 2009 by The College of Family Physicians of Canada
Research |
Disrespect, harassment, and abuse
All in a day’s work for family physicians
Baukje Miedema, RN PhD, Julie Easley, MA, Pierrette Fortin, PhD, Ryan Hamilton, MSES and Sue Tatemichi, MDDr Miedema is Director of Research at the Dalhousie University Family Medicine Teaching Unit (FMTU) in Fredericton, NB. Dr Tatemichi is Unit Director at the FMTU and a part-time family physician in a First Nations community in Fredericton, NB. Ms Easley and Mr Hamilton are doctoral students at the University of New Brunswick in Fredericton and part-time research assistants at the FMTU. Dr Fortin is Chair of the Secteur des sciences humaines at the Université de Moncton in Edmundston, NB
Correspondence: Dr Baukje Miedema, Family Medicine Teaching Unit, Dr Everett Chalmers Hospital, PO Box 9000, Priestman St, Fredericton, NB E3B 5N5; telephone 506 452-5714; fax 506 452-5710; e-mailbo.miedema{at}rvh.nb.ca
OBJECTIVE To examine harassment and abusive encounters between family physicians and their patients or colleagues in the workplace.
DESIGN Qualitative case study using semistructured interviews.
SETTING Province of New Brunswick.
PARTICIPANTS Forty-eight family physicians from across the province.
METHODS A collective case-study approach was developed, with 24 cases of 2 individuals per case. Cases were selected based on sex, location (urban or rural), language (French or English), and number of years since medical school graduation (< 10 years, 10 to 20 years, or > 20 years). Physicians were interviewed in either French or English. Participants were recruited using the College of Physicians and Surgeons of New Brunswick’s physician directory. Based on the rates of response and participation, some cases were overrepresented, while others were not completed. All interviews were audiotaped, transcribed verbatim, and analyzed thematically using a categorical aggregation approach. A coding scheme for the thematic analysis was developed by the research team before the interviews were transcribed.
MAIN FINDINGS Although the original intent of this study was to examine the work environment of family physicians in light of the increasing number of women entering the profession, harassment and abusive encounters in the workplace emerged as a main theme. These encounters ranged from minor to severe. Minor abusive encounters included disrespectful behaviour and verbal threats by patients, their families, and occasionally colleagues. More severe forms of harassment involved physical threats, physical encounters, and stalking. Demanding patients, such as heavy drug users, were often seen as threatening. Location of practice, years in practice, and sex of the physician seemed to affect abusive encounters—young, female, rural physicians appeared to experience such encounters most often.
CONCLUSION Abusive encounters in the workplace are concerning. It is essential to address these issues of workplace harassment and abuse in order to protect physician safety and avoid workplace dissatisfaction. Abusive encounters might push family physicians to leave clinical practice prematurely or refuse to work in higher-risk environments, such as emergency departments or rural areas.
Related articles in CFP:
- In defence of a "good-enough" family physician
- Roger Ladouceur
CFP 2009 55: 237.[Full Text] - Plaidoyer pour un médecin de famille «juste correct»
- Roger Ladouceur
CFP 2009 55: 238.[Full Text]
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