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Year : 2007  |  Volume : 53  |  Issue : 2  |  Page : 83-84

Stress in the workplace amongst medical professionals

The Hammersmith Hospitals NHS Trust, Charing Cross Hospital, Dept. Medical Oncology, 1st Floor, E Wing, Fulham Palace Road, London W6 8RF, United Kingdom

Correspondence Address:
J Stebbing
The Hammersmith Hospitals NHS Trust, Charing Cross Hospital, Dept. Medical Oncology, 1st Floor, E Wing, Fulham Palace Road, London W6 8RF
United Kingdom
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0022-3859.32202

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How to cite this article:
Stebbing J, Powles T. Stress in the workplace amongst medical professionals. J Postgrad Med 2007;53:83-4

How to cite this URL:
Stebbing J, Powles T. Stress in the workplace amongst medical professionals. J Postgrad Med [serial online] 2007 [cited 2023 Sep 24];53:83-4. Available from:

The paper on stress in doctors from India and Malaysia in this month's Journal of Postgraduate Medicine is a timely and welcome addition from Asia on the subject of bullying.[1] Such studies are inherently biased in that individuals only answer questions when they have a point to make and all answers are often linked (thus the need for multivariate analyses which were not performed here) resulting in those who answer yes to one question answering yes to all of them. However, the authors importantly found that para-medical as well as medical personnel were often bullies and such bullying goes unreported. The latter finding is not surprising as many were not sure how to complain, while others were afraid.

Stress is an unavoidable and common aspect of a doctor's and researcher's work.[2],[3],[4],[5] It may have positive aspects in that some individuals may feel challenged and raise productivity to meet increasing demands,[6] however, in junior doctors, work-related stress and anxiety have been shown to lead to low morale and poorer work performance and to affect the quality of care provided.[3],[7],[8]

A number of studies have shown that one specific stressor, workplace bullying, is frequently experienced by junior doctors and leads to reduced job satisfaction, depression and anxiety, sickness, absence and intention to leave.[3],[4],[9],[10],[11] The problem has however been difficult to study, for individual responses to stressful situations vary and certain people are more likely to perceive high levels of stress in their job than others.[6],[12],[13] In addition to this, a generally accepted definition of workplace bullying is lacking although it appears to refer to situations in which someone is subjected to social isolation or exclusion, his or her work and efforts are devalued and he or she is frustrated, often threatened and perhaps even abused.[14],[15],[16] Stress and bullying lead to a cycle in which poor health may result and this may in turn result in an increased susceptibility to becoming a victim of bullying.

Though the need for help for stress in doctors, particularly junior ones is widely recognized, it is usually considered that the causes rest with the working conditions which entail long hours of work, disruption of sleeping patterns and dealing with seriously ill people.[3],[5],[6]

In recent years, efforts have been made in Europe to improve working conditions and training for doctors and stress counseling is becoming commonplace. It appears that unsurprisingly, the same lessons apply in India. Several European countries, including England, Sweden, Norway and Finland have implemented general preventative action against workplace bullying. These have included, for example, efforts to increase public awareness, funding for research into stress and bullying and the establishment of protective legislation.[17] A reduction is not only likely to help those being bullied and suffering stress but would also bring economic and other benefits to employers.[9],[18]

Work-related stress can affect a doctor's health and result in poor morale and motivation, poor communication and decision-making as well as poor relationships with colleagues. It also has financial implications through doctors taking sick leave or ceasing to practice medicine.[6],[11],[19] Providing a more supportive work environment with appropriate attention to workloads and provision of guidelines illustrating good practice in supervision may help to protect the health of medical staff doing research. Interestingly, teachers who take a course in human relations appear to suffer less stress[20] although the relationship between a relatively new position (in this case a physician undertaking research) and stress is poorly understood.

It is easy to conclude from the papers on the subject that bullying is a serious threat to psychological health. People do not think of themselves as bullies. They tell themselves that they are just being assertive, giving strong leadership or disinclined to suffer fools gladly. So it might be salutary to visit to check out your management style and make sure that the place where you work really does have an anti-bullying ethos.

 :: References Top

1.Bairy KL, Thirumalaikolundusubramanian P, Sivagnanam G, Saraswathi S, Sachidananda A, Shalini A. Bullying among trainee doctors in southern India: A questionnaire study. J Postgrad Med 2007;53:87-91.  Back to cited text no. 1    
2.Stebbing J, Mandalia S, Portsmouth S, Leonard P, Crane J, Bower M, et al . A questionnaire survey of stress and bullying in doctors undertaking research. Postgrad Med J 2004;80:93-6.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3.Hsu K, Marshall V. Prevalence of depression and distress in a large sample of Canadian residents, interns and fellows. Am J Psychiatry 1987;144:1561-6.  Back to cited text no. 3  [PUBMED]  
4.Daugherty SR, Baldwin DC Jr, Rowley BD. Learning, satisfaction and mistreatment during medical internship: A national survey of working conditions. JAMA 1998;279:1194-9.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5.Stebbing J. Stress in health professionals. J Royal Soc Med 2000;93:208-10.  Back to cited text no. 5    
6.Newbury-Birch D, Kamali F. Psychological stress, anxiety, depression, job satisfaction and personality characteristics in pre-registration house officers. Postgrad Med J 2001;77:109-11.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]
7.Frank E, McMurray JE, Linzer M, Elon L. Career satisfaction of US women physicians: Results from the Women Physicians' Health Study. Society of General Internal Medicine Career Satisfaction Study Group. Arch Intern Med 1999;159:1417-26.  Back to cited text no. 7    
8.Firth-Cozens J, Mowbray D. Leadership and the quality of care. Qual Health Care 2001;10:ii3-7.  Back to cited text no. 8  [PUBMED]  [FULLTEXT]
9.Kivimaki M, Elovainio M, Vahtera J. Workplace bullying and sickness absence in hospital staff. Occup Environ Med 2000;57:656-60.  Back to cited text no. 9  [PUBMED]  [FULLTEXT]
10.Quine L. Workplace bullying in NHS community trust: Staff questionnaire survey. BMJ 1999;318:228-32.  Back to cited text no. 10  [PUBMED]  [FULLTEXT]
11.Quine L. Workplace bullying in junior doctors: questionnaire survey. BMJ 2002;324:878-9.  Back to cited text no. 11  [PUBMED]  [FULLTEXT]
12.Firth-Cozens J. Source of stress in women junior house officers. BMJ 1990;301:89-91.  Back to cited text no. 12  [PUBMED]  [FULLTEXT]
13.Birch D, Ashton H, Kamali F. Alcohol, drinking, illicit drug use and stress in junior house officers in north-east England. Lancet 1998;352:785-6.  Back to cited text no. 13  [PUBMED]  
14.Baldwin DC Jr, Daugherty SR, Rowley BD. Residents' and medical students' reports of sexual harassment and discrimination. Acad Med 1996;71:S25-7.  Back to cited text no. 14  [PUBMED]  
15.Baldwin DC Jr, Daugherty SR. Do residents also feel "abused"? Perceived mistreatment during internship. Acad Med 1997;72:S51-3.  Back to cited text no. 15    
16.Koh TS, Koh TH. Bullying in hospitals. Occup Environ Med 2001;58:610.  Back to cited text no. 16  [PUBMED]  [FULLTEXT]
17.Vartia M. The sources of bullying: Psychological work environment and organizational climate. Eur J Work Organ Psychol 1996;5:203-14.  Back to cited text no. 17    
18.Sibbald B, Enzer I, Cooper C, Rout U, Sutherland V. GP job satisfaction in 1987, 1990 and 1998: Lessons for the future? Fam Pract 2000;17:364-71.  Back to cited text no. 18  [PUBMED]  [FULLTEXT]
19.Quine L. Effects of stress in an NHS trust: A study. Nurs Stand 1998;13:36-41.  Back to cited text no. 19    
20.Rutter H, Herzberg J, Paice E. Stress in doctors and dentists who teach. Med Educ 2002;36:543-9.  Back to cited text no. 20  [PUBMED]  [FULLTEXT]

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