In this article, I will outline laws and codes of conduct to assist most of the dedicated medical practitioners to manage the minority of colleagues who perpetrate medical workplace abuse.<\/p>\n
God Complex brought into sharp focus what the medical profession has been grappling with<\/a> for a very long time. Hierarchical abuse<\/a> is unlawful, harmful to patients, staff, students and the community \u2014 and a colossal waste of the health system\u2019s scarce resources.<\/p>\n The Australian Medical Association<\/a> (AMA), the Australian Salaried Medical Officers Federation<\/a> (ASMOF), Medical Deans<\/a> of medical schools, colleges<\/a>, medical indemnity organisations<\/a>, movements like A Better Culture<\/a> and Civility Saves Lives<\/a>, as well as many other dedicated clinicians (here<\/a>, here<\/a>, here<\/a>, here<\/a>, here<\/a>) have relentlessly pushed for change and have implemented many worthwhile initiatives to eliminate unlawful bullying, sexual harassment, discrimination and racism in medicine. Despite this concerted effort, annual medical training surveys<\/a> conducted by the Medical Board have documented intractable medical workplace abuse of doctors in training, mainly perpetrated by senior doctors over the last six years.<\/p>\n The ABC\u2019s central question \u2014 why have doctors allowed this to persist? \u2014 deserves a transparent public response.<\/p>\n In my response, let me be very clear.<\/p>\n The purpose of this article is not about any individual. It is to support anyone who was directly or indirectly triggered by the findings of the ABC investigation; to emphasise that all medical practitioners must comply with WHS and other laws and codes to uphold the highest standards of patient care and maintain public trust; to prevent another damaging media expos\u00e9 of medical workplace abuse, and to speak up constructively by focusing on system-wide solutions.<\/p>\n As the first part of this series for the MJA Insight+, I will address some common myths that are deterring the medical profession from speaking up.<\/p>\n Myth 1: what doctors do in their personal lives is none of our business<\/p>\n A medical practitioner\u2019s personal conduct can impact their registration, even if the conduct occurs outside of work. This can be enforced<\/a> by the Australian Health Practitioner Regulation Agency (Ahpra).<\/p>\n These rules under the Good Medical Practice<\/a>: a Code of Conduct for Doctors in Australia apply to any doctor charged with serious criminal offences such as assault, domestic violence, fraud, drink driving convictions, possessing or using illicit drugs recreationally, or alleged criminal vandalism or malicious damage.<\/p>\n Private actions that damage public confidence suggest poor judgement or show a lack of control and may be seen as professional misconduct. Even without a criminal conviction, personal conduct that is dishonest, violent, threatening, discriminatory or exploitive can lead to regulatory consequences.<\/p>\n It is therefore appropriate for employers to remind doctors to always maintain high standards of conduct both inside and outside of work.<\/p>\n Myth 2: work health and safety laws cannot be enforced in health care<\/p>\n Most health care workplaces claim to place patient care first and to have a zero-tolerance\u2019<\/a> approach to staff misconduct and abuse. It is well known that patient health and safety is significantly influenced by the health and safety of the health workforce, and yet, many employers do not comply with or enforce contemporary WHS laws.<\/p>\n Recent government legislated changes to the Managing Psychosocial Hazards at Work Code of Practice<\/a> to prevent work-related mental injury<\/a>, the amendment to the Sex Discrimination Act (here<\/a>, here<\/a>), the national anti-racism framework<\/a>, the Whistleblowers Act<\/a> and industrial manslaughter laws<\/a> (which also address suicide due to work-related mental injury) are relevant to all Australian workplaces and health care is not exempt. In previous MJA Insight+ articles (here<\/a>, here<\/a>), I summarised the major penalties for perpetrators and their employers (including directors and officers) for non-compliance with new WHS laws.<\/p>\n Recent changes to WHS laws are clear, and the moral responsibility of the whole medical profession to uphold them is undeniable \u2014 especially to protect staff<\/a> who may feel powerless to speak up.<\/p>\n Myth 3: doctors cannot speak up without ruining their medical careers<\/p>\n Unfortunately, calling out poor medical workplace cultures and conditions can be detrimental for early career doctors<\/a> because of the highly competitive nature of training programs and the short tenure of their contracts. Often, early interventions by workplace wellbeing officers (when they are available) and harm minimisation strategies<\/a> prevent problems from escalating. However, when there is a climate of fear of health system hierarchies, doctors who raise risks, report incidents or make complaints may be unfairly labelled as troublemakers and sustain career damage.<\/p>\n Notwithstanding these barriers, doctors in training can safely make their voices heard by participating in anonymous AMA and Medical Board surveys, completing deidentified workplace incident reporting systems, attending confidential employee assistance programs, and enlisting protections under the Whistleblowers Act<\/a>. These actions are more powerful than currently realised in exposing the scale of the problem.<\/p>\n Senior doctors have a special responsibility under WHS laws to collectively speak up about hostile work cultures and safeguard our trainees. This means modelling respectful behaviours and mentoring junior colleagues in professionalism<\/a>. When multiple like-minded senior doctors raise concerns to employers together \u2014 and request formal workplace health and safety assessments \u2014 the issues are reframed as systemic failures, not personal disputes. Under contemporary WHS laws, this should activate employers\u2019 legal responsibilities under government legislation on WHS.<\/p>\n Myth 4: Narcissistic doctors lack insight and therefore cannot change <\/p>\n A doctor\u2019s lack of insight into the negative impact of their behaviours can be caused by a number of conditions \u2014 such as substance abuse disorder, other serious mental illness (including narcissistic personality disorder [NPD]), and cognitive impairment. It is the responsibility of medical colleagues to ensure doctors with these conditions receive urgent specialised care.<\/p>\n Narcissism in doctors is often bandied around to excuse uncivil behaviours in the medical profession. Many doctors are aware they can display narcissistic traits when under intense pressure and they possess the self-awareness to immediately apologise for any uncharacteristic behaviours. The more we recognise this, the less it is a problem.<\/p>\n Narcissistic Personality Disorder<\/a> is very different. It is a serious psychiatric condition that requires comprehensive specialised clinical assessment<\/a>. Doctors with NPD may threaten litigation after being slighted by constructive feedback, and then conduct character assassinations on those who could threaten their status. These tactics are very effective ways to deter bystanders from intervening effectively.<\/p>\n While managing damaging behaviours is challenging in any workplace, the medical profession is in a better position than most to intervene early in cases of lack of insight due to temporary or permanent impairment \u2014 to prevent patient harm and reputation damage.<\/p>\n Myth 5: doctors in training should toughen up, especially women<\/p>\n Medical workforce committees<\/a>, surveys, industrial actions<\/a>, and countless first-hand accounts identify the same health system issues: Australia\u2019s medical workforce<\/a> is leaving. We are in the grip of a preventable retention and participation cri<\/a>sis \u2014 fuelled by poor working conditions and chronic under-resourcing<\/a>. Skeleton staffing levels<\/a>, excessive workloads, unsafe rosters, deferral of leave entitlements, and health care access blocks<\/a> due to the financial non-viability of health care are creating disunity, tension and conflict among colleagues and harming clinicians as well as patients. Doctors in training are particularly vulnerable in this environment.<\/p>\n Within this context, safe and healthy workplaces are not optional. They are a legal requirement, a critical measure for patient safety, and a cornerstone for retaining a functioning, skilled medical workforce \u2014 irrespective of gender.<\/p>\n God Complex was re-traumatising for many who have experienced bullying, harassment, and abuse in medicine. Health care systems continue to underestimate the prevalence and impact of work-related psychological injuries, including acute stress and post-traumatic stress disorder (PTSD) in doctors. The re-traumatisation of colleagues demands evidence-based, trauma-informed care, professional support, peer understanding, and a clear assurance from the profession that their experiences will no longer be minimised or dismissed.<\/p>\n Telling doctors in training to \u201ctoughen up\u201d under these conditions is not resilience-building \u2014 it is a form of abuse<\/a>. <\/p>\n The first solution: speak up<\/p>\n God Complex ignited a spark, and it is clear that the medical profession is listening. This moment is more than just another expos\u00e9.<\/p>\n The call to action is different this time \u2014and even more urgent than before.<\/p>\n The health system should be an exemplar of WHS compliance and a leader not a laggard on cultural safety<\/a> in the best interests of a healthy clinical workforce, and by extension, healthy communities and patients. Investment in safe systems of work not only saves lives \u2014 it also saves scarce health care dollars.<\/p>\n The medical profession is at a crucial crossroad.<\/p>\n Do we unite to collectively comply with our positive duty to create healthy, safe medical workplaces to comply with new WHS and other laws together (here<\/a>)?\u00a0<\/p>\n Or do we, through silence and inactions, inadvertently seek enforcement, penalties and fines from work health and safety regulators and invite another media investigation (here<\/a>)?<\/p>\n Do we speak up or are we complicit?<\/p>\n Clinical Professor Leanne Rowe AM is a GP and non-executive director. About two decades ago, her registrar was killed by a patient \u2014 a tragedy that shaped her career-long advocacy for healthy medical workplaces<\/a>. She is a co-author of the 2nd edition book \u2018Every Doctor<\/a>: Healthier Doctors = Healthier Patients\u2019 published internationally by Taylor and Francis<\/p>\n Please consider joining the conversation and using the MJA Insight+ comments section anonymously and constructively.<\/p>\n Where to get help<\/p>\n Your trusted GP or psychologist<\/p>\n Doctors\u2019 Health Alliance<\/a>:<\/p>\n Call the Doctors\u2019 Health Line 24\/7:\u00a01800 006 888\u00a0to be directed to your local doctors\u2019 health service. Doctors\u2019 Health Services are free and available across Australia for doctors and medical students.<\/p>\n OR<\/p>\n NSW and ACT: 02 9437 6552<\/p>\n NT and SA: 08 8366 0250<\/p>\n Queensland: 07 3833 4352<\/p>\n Tasmania\u00a0and ACT:\u00a01300374 377<\/p>\n Victoria: 1300 330 543<\/p>\n WA: 08 9321 3098<\/p>\n New Zealand: 0800 471 2654<\/p>\n OR be connected to a counsellor through\u00a0Drs4Drs: 1300 374 377<\/p>\n Lifeline: 13 11 14<\/p>\n Other supports:<\/p>\n Hand in Hand Peer Support<\/a><\/p>\n Your employer or college may have a wellness program or a confidential employee assistance program (EAP).<\/p>\n Your union (ASMOF, HSU, AMA) for confidential representation or advocacy.<\/p>\n Confidential legal advice, but as this can be personally expensive, combative and time consuming, first seek information freely available through the Human Rights Commission or State Anti-Discrimination Board, the Fair Work Commission, or your state WHS regulator.<\/p>\n There are many other supports available on the websites of our member medical organisations, colleges, movements such as Crazy Socks for Docs and the Hush Foundation, and others.<\/p>\n The statements or opinions expressed in this article reflect the views of the authors and do not necessarily represent the official policy of the AMA, the\u00a0MJA\u00a0or\u00a0InSight+\u00a0unless so stated.\u00a0<\/p>\n Subscribe to the free\u00a0InSight+\u00a0weekly newsletter\u00a0here<\/a>. It is available to all readers, not just registered medical practitioners.\u00a0<\/p>\n![\"Four](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/08\/shutterstock_2513872781-1024x683.jpg\")
Hierarchical abuse is unlawful, harmful to patients, staff, students and the community (Andrey_Popov \/ Shutterstock).<\/p>\n