GPs are sometimes subject to harassment from colleagues and patients. But in our role as employers, we have as much potential to be accused of harassment as to be the victims of it.
Harassment is akin to bullying, and is defined in the BMA report ‘Bullying and Harassment of Doctors in the Workplace’ as ‘unwanted behaviour that may be related to age, sex, disability, religion, race, or simply be of a psychological nature’. Like bullying, it can be intimidating or offensive.
Harassment is defined in terms of its effect on the victim rather than the intent of the perpetrator. So, if you feel belittled or victimised by someone’s behaviour, they are guilty of harassment.
There is a fine line between firm management and harassment, with potential for misinterpretation. As an employer it is essential to do nothing that may be construed as harassment.
In the context of a small organisation, such as a medical practice, a bit of good-natured banter may be fun, but do be aware that anything of a sexual nature is open to misinterpretation.
Patients who harass
Patients are not often cast in the role of bullies, but they can certainly be guilty of harassment, whether by attempting to manipulate us for medical certificates or by trying to coerce us into prescribing addictive drugs with hard-to-believe stories.
More serious, but fortunately more rare, is the systematic targeting of an individual doctor by a patient. This is stalking and should be treated very seriously as a legal matter.
Harassment from colleagues
Our practice colleagues may harass us, often because of differences of opinion about financial or organisational matters. For example doctors wishing to change their working times due to family commitments may feel they are being victimised, and many practices have split acrimoniously because of these issues.
Harassment may also come from the primary care organisation. This is less personal, but can be damaging just the same.
Salaried doctors can find themselves the victims of harassment simply because of their employed status. This can take the form of unreasonable workload, poor rates of pay and lack of any say in practice decision making.
Although the perpetrators may be displaying a lack of empathy rather than systematic harassment, they are guilty nonetheless.
As a GP registrar you may find you are not exempt from harassment. The use of the registrar as an extra pair of hands, along with over-interpretation of what should constitute the registrar’s working week has meant some registrars missing out on what should be the best year of their medical education.
Registrars are often unsure whether their workload is excessive and their recent experience of teaching hospital educational methods coupled with loyalty to their trainer often persuades them to suffer in silence. If you are in this situation, speak to your peer group, and to your practice if you feel able. If this produces no results, you must contact your local deanery office for advice.
Ask for help
The general guidance on handling harassment is to make a note of specific incidents as evidence and to speak to human resources. At practice level, you need to speak to the manager.
Some people who harass others do so because they have poor communication skills and do not mean to cause upset. You may find that involving a third party as facilitator will allow progress. You should also contact your local BMA office for advice at an early stage.
If things get really serious there are several pieces of legislation that can help. These include the Protection from Harassment Act 1997, the Race Relations Act 1976, the Sex Discrimination Act 1975, the Disability Discrimination Act 2005 and the Employment Equality (Religion or Sexual Orientation) Regulations 2003.
By the time you have reached this stage, however, it is unlikely that you will ever feel at ease working in the organisation again, so take action early if possible.
Dr Glenesk is a GP trainer and summative assessor in Aberdeen
The best way to deal with harassment
- As GPs we are vulnerable both to being harassed and to accusations of harassment.
- It is the effect of harassment on the victim that is important, not the intention of the perpetrator.
- Be careful in your role as employer and GP to do nothing that may be construed as harassment.
- If you feel you are being harassed, keep notes of specific incidents as evidence.
- Don’t suffer in silence — speak to the practice manager, your trainer or local deanery office if necessary.
- If possible, try to sort things out at an early stage.