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|Title: ||Medicine needs to swallow a bitter pill for a healthier future|
|Authors: ||Hooker, C|
|Issue Date: ||13-Mar-2015|
|Publisher: ||The Conversation|
|Citation: ||Claire Hoker, Kimberley Ivory " Medicine needs to swallow a bitter pill for a healthier future " The Conversation 2015|
|Abstract: ||Many doctors will recall as a student or trainee hanging nervously off the end of a Deaver – a
large retractor used in pre-keyhole gall bladder surgery – while simultaneously trying to
answer the surgeon’s barked questions about the anatomy in the cavity. The problem is you
can’t actually see into the cavity without loosening your grip. A looser grip means less vision
for the surgeon and usually a torrent of abuse for the trainee.
Such moments of “teaching by humiliation” during medical training underscore the nature of
medical culture: a totem pole that places surgeons very much at the top. Indeed, doctors have
long enjoyed both enormous autonomy and deference to their apparent god-like power to
stave off death.
Within this mythology, medicine has built a hierarchical and autocratic workplace culture in
which incivility, and even frank bullying, towards subordinates is commonplace. Medical
students gradually acculturate to this during their training, often at the cost of their empathy
A recent meta-analysis of 51 studies on harassment and discrimination in medical training
showed 59.4% of medical trainees had experienced at least one form of these. “Teaching by
humiliation” – regarded by some as a kind of necessary hardening experience – was
experienced by 74% of students and witnessed by 84%. Many still felt the sting decades later.
Such power-oriented, stratified workplaces are good for no one. And, in medicine, many of
the worst consequences fall on patients.|
|Description: ||The Conversation article|
|Rights and Permissions: ||CC BY-NC 3.0|
|Type of Work: ||Article, Letter|
|Type of Publication: ||Post-print|
|Appears in Collections:||Research Papers and Publications. Sydney Health Ethics|
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