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Invited Commentary| Volume 220, ISSUE 2, P274-275, August 2020

Physician mistreatment and toxic teams: Incivility in clinical learning environments

      Compromised employee wellness and the relationship to workplace culture have received increased attention across all industries and economic sectors, and healthcare should be no exception.
      • Shanafelt T.
      • Goh J.
      • Sinsky C.
      The business case for investing in physician well-being.
      In this important study, Grover and colleagues evaluate and characterize the incidents of mistreatment at their institution experienced by residents and faculty.
      • Grover A.A.N.
      • Santen S.
      • Lee N.
      • Hemphill R.
      • Goldberg S.
      Physician mistreatment in the clinical learning environment.
      A critical self-study of this nature provides a cornerstone for understanding workplace culture at any healthcare organization. Among members of the Department of Surgery, the authors discovered that nearly half of all residents and more than one-quarter of faculty surgeons experienced some form of mistreatment, and that reporting of mistreatment was low for a variety of reasons.
      • Grover A.A.N.
      • Santen S.
      • Lee N.
      • Hemphill R.
      • Goldberg S.
      Physician mistreatment in the clinical learning environment.
      In a larger context, the findings of this study draw a concerning relationship between individual “bad” behaviors such as public humiliation and embarrassment, and the tolerance for these transgressions within this workplace and learning environment. Although this study summarizes the experiences of individuals within one Department at one center, they are emblematic of implicit issues and explicit challenges facing healthcare teams across contexts.
      • Hu Y.-Y.
      • Ellis R.J.
      • Hewitt D.B.
      • et al.
      Discrimination, abuse, harassment, and burnout in surgical residency training.
      ,
      • Hasty B.N.
      • Miller S.E.
      • Bereknyei Merrell S.
      • et al.
      Medical student perceptions of a mistreatment program during the surgery clerkship.
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