Citation

Bravo-Jaimes K, Costello BT, Reza N, Sanghavi M, Tamirisa KP, Mehta LS, Mamas MA, Taub CC, Volgman AS, Mieres JH, Ijioma NN, Douglas PS, Hayes SN, Bullock-Palmer RP. J. Am. Coll. Cardiol. Case Rep. 2023; 22: e101988.

Copyright

(Copyright © 2023, Elsevier Publishing)

DOI

10.1016/j.jaccas.2023.101988

PMID

37790768

PMCID

PMC10544275

Abstract

Patient care and outcomes are cornerstones of decision making in health care systems. Civility, collaboration, and mutual respect among workforce members are vital for the overall success of health care delivery to patients. Cohesive health care teams and effective communication influence health care delivery positively.1 However, mutual respectful interaction is not always present in the health care workplace. This is underscored by the Global Prevalence and Impact of Hostility, Discrimination, and Harassment in the Cardiology Workplace survey, which found that of 5,931 cardiologists (77% men; 23% women), 44% reported an adversarial work culture, and 79% of those working in a hostile work environment reported adverse effects on professional activities with colleagues and patients. Women and Black cardiologists were more likely to report hostile environments (68% vs 37%; OR: 3.58 women vs men) and (53% vs 43%; OR: 1.46 Blacks vs Whites).2 The publication of the 2022 American College of Cardiology (ACC) Health Policy Statement on Building Respect, Civility, and Inclusion in the Cardiovascular Workplace outlines solutions and provides resources when addressing these institutionally engrained issues.3 Cultures are flawed with microaggressions, macroaggressions, blatant disrespect, or discrimination that require institutional change and individual accountability. The well being of all health care staff has become a focus to improve work satisfaction, deter burnout, and ultimately deliver better quality and more equitable patient care.

Historically, bias, discrimination, bullying, and harassment (BDBH) in the health care workplace did not receive attention for a multitude of reasons. The road to becoming a cardiologist and other subspecialties in medicine is long and grueling with an expectation to “grin and bear it.” Although BDBH exists in many forms, many hesitate to report these experiences for fear of retribution. For cardiology, like many specialties, the hierarchical system in medical school persists throughout training and encourages many to remain silent. Although these issues affect daily life for those who experience them, they also lead to career-related repercussions and decreased quality of life for health care professionals and their patients. The consequences of BDBH include mental health conditions that were prevalent in nearly one-third of survey respondents in a recent global survey of practicing cardiologists and were more often present in early career cardiologists and those experiencing emotional harassment or discrimination.4 These statistics constitute a need for significant and coordinated actions to change the current culture within cardiology.

Language: en