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Difficult Trainers: The Toxic, the Rigid, and the Impaired

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Learning and Career Development in Neurosurgery
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Abstract

Neurosurgical training programs are competitive and stressful working places. Mistreating residents who work for long hours to look after sick patients can put a high toll on their mental health. Researchers looked into the effect of bullying and a toxic working environment on the rate of burnout, mental disease, and substance abuse. Difficult trainers were the main offenders. Numerous medical societies and health institutions join forces to handle the crisis by better hiring category rating and extensive training. However, many studies show we are getting worst.

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References

  1. Lubit R. The tyranny of toxic managers: an emotional intelligence approach to dealing with difficult personalities. Ivey Bus J. 2004.

    Google Scholar 

  2. Raskin R, Shaw R. Narcissism and the use of personal pronouns. J Pers. 1988;56(2):393–404. https://doi.org/10.1111/j.1467-6494.1988.tb00892.x.

    Article  CAS  PubMed  Google Scholar 

  3. O’Reilly C. Grandiose narcissists, and decision making: impulsive, overconfident, and skeptical of experts-but seldom in doubt. Personal Individ Differ. 2020;168:110280. https://doi.org/10.1016/j.paid.2020.110280.

    Article  Google Scholar 

  4. Brunell A. Using the bogus pipeline to investigate grandiose narcissism. J Exp Soc Psychol. 2014;1988(55):37–42.

    Article  Google Scholar 

  5. Bogart L. Feeling superior but threatened: the relation of narcissism to social comparison. Basic Appl Soc Psychol. 2004;26(1):35–44.

    Article  Google Scholar 

  6. Baskin-Sommers A. Empathy in narcissistic personality disorder: from clinical and empirical perspectives. Personal Disord. 2014;5(3):323–33. https://doi.org/10.1037/per0000061.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Cia A. Sociocultural approach to narcissism: the case of modern China. Eur J Personality. 2012;26(26):529–35. https://doi.org/10.1002/per.852.

    Article  Google Scholar 

  8. Bucknall V. Mirror mirror on the ward, who’s the most narcissistic of them all? Pathologic personality traits in health care. CMAJ. 2015;187(18):1359–63. https://doi.org/10.1503/cmaj.151135.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Prevost S. 8 signs you’re a control. Freak. 2012. https://www.inc.com/shelley-prevost/8-signs-youre-a-control-freak.html.

  10. Rosenstein A. A survey of the impact of disruptive behaviors and communication defects on patient safety. Jt Comm J Qual Patient Saf. 2008;34:464–7. https://www.sciencedirect.com/science/article/abs/pii/S1553725008340586.

    PubMed  Google Scholar 

  11. Merlo L. Psychiatric conditions affecting physicians with disruptive behavior. Psychiatr Times. 2014;31(11):11. https://www.psychiatrictimes.com/view/psychiatric-conditions-affecting-physicians-disruptive-behavior.

    Google Scholar 

  12. Venkatesh B. Prevalence of bullying, discrimination and sexual harassment among trainees and fellows of the college of intensive care medicine of Australia and New Zealand. Crit Care Resusc. 2016;18(4):230–4. https://search.informit.com.au/documentSummary;dn=515237365457343;res=IELHEA.

    PubMed  Google Scholar 

  13. Crebbin W. Prevalence of bullying, discrimination and sexual harassment in surgery in Australasia. ANZ J Surg. 2015;85(12):905–9. https://doi.org/10.1111/ans.13363.

    Article  PubMed  Google Scholar 

  14. Benzil D. Toward an understanding of sexual harassment in neurosurgery. J Neurosurg. 2020. https://doi.org/10.3171/2020.6.JNS201649.

  15. Brousse G. Psychopathological features of a patient population of targets of workplace bullying. Occup Med. 2008;58(2):122–8. https://doi.org/10.1093/occmed/kqm148.

    Article  Google Scholar 

  16. Alahmari A. Workplace bullying among residents in Saudi board training programs of all specialties in Riyadh, Saudi Arabia 2017–2018 prevalence, influencing factors and consequences: a cross-sectional survey. IJACM. 2020;3(3):30–8. https://doi.org/10.33545/comed.2020.v3.i3a.160.

    Article  Google Scholar 

  17. McAbee J. Factors associated with career satisfaction and burnout among US neurosurgeons: results of a nationwide survey. J Neurosurg. 2015;123(1):161–73. https://doi.org/10.3171/2014.12.JNS141348.

    Article  PubMed  Google Scholar 

  18. Pearson C. The cost of bad behavior: how incivility is damaging your business and what to do about it. Hum Resour Manag Int Dig. 2010;18(6). https://doi.org/10.1108/hrmid.2010.04418fae.002.

  19. Light house. Reasons good people become bad bosses. A blog about leadership & management advice. https://getlighthouse.com/blog/bad-bosses-good-people-become/.

  20. Contessa C. Toxic working environment. Career Contessa. 2020. https://www.careercontessa.com/advice/toxic-work-environment/.

  21. Chrisman J. Is your workplace toxic? Nurs Made Incredibly Easy. 2014;12(3):22–29. https://doi.org/10.1097/01.NME.0000445324.55026.76.

  22. Vogel L. Culture of bullying in medicine starts at the top. CMAJ. 2018;190(49):E1459–60. https://doi.org/10.1503/cmaj.109-5690.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Rask B. Influence of the personality factors rigidity and uncertainty tolerance on peer-feedback. https://www.trainingszentrum.hhu.de/fileadmin/redaktion/Fakultaeten/Medizinische_Fakultaet/Studiendekanat/Dokumente/Medizin_Studium/PJ/Poster_RIME_BR.pdf.

  24. Frosch D. Authoritarian physicians and patients’ fear of being labeled ‘difficult’ among key obstacles to shared decision making. Health Affairs. 2012, 31(5):1030–8. Coverage expansion & implications. https://doi.org/10.1377/HLTHAFF.2011.0576.

  25. Levine B. Why many doctors are authoritarians—and harmful. Mad in America. 2019. https://www.madinamerica.com.

  26. Soffer A. Authoritative physician, not authoritarian father. Arch Intern Med. 1980;140(12):1576. https://doi.org/10.1001/archinte.1980.00330230022007.

    Article  Google Scholar 

  27. Pestell R. Authoritarianism among medicine and law students. ANZJP. 1991;25(2):265–9. https://doi.org/10.3109/00048679109077744.

    Article  CAS  PubMed  Google Scholar 

  28. Boardman R. How to manage passive-aggressive behavior in your classroom. Crisis Prevention Institute. https://www.crisisprevention.com/Blog/How-to-Manage-Passive-Aggressive-Behavior-in-Your.

  29. Dimou F. Surgeon burnout: a systematic review. J Am Coll Surg. 2016;222(6):1230–9. https://doi.org/10.1016/j.jamcollsurg.2016.03.022.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Peckham Physician burnout: it just keeps getting worse. Medscape. 2015. https://www.medscape.com/viewarticle/838437.

  31. Shanafelt TD. Burnout and career satisfaction among American surgeons. J Ann Surg. 2009;250(3):463–71.

    Article  Google Scholar 

  32. Shanafelt TD. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600–13.

    Article  Google Scholar 

  33. Hutter MM. The impact of the 80-hour resident workweek on surgical residents and attending surgeons. Ann Surg. 2006;243(6):864–71; discussion 871–865.

    Article  Google Scholar 

  34. Shanafelt TD. Burnout and medical errors among American surgeons. Ann Surg. 2010;251(6):995–1000.

    Article  Google Scholar 

  35. Shanafelt TD. Special report: suicidal ideation among American surgeons. Arch Surg. 2011;146(1):54–62.

    Article  Google Scholar 

  36. Joseph B. Unveiling posttraumatic stress disorder in trauma surgeons: a national survey. J Trauma Acute Care Surg. 2014;77(1):148–54; discussion 154. https://doi.org/10.1097/TA.0000000000000271.

    Article  PubMed  Google Scholar 

  37. Gerada C. Surgeons and mental illness: a hidden problem? BMJ. 2014;348:g2764. https://doi.org/10.1136/bmj.g2764.

    Article  Google Scholar 

  38. Frank E. Mortality rates and causes among US physicians. Am J Prev Med. 2000;19:155–9.

    Article  CAS  Google Scholar 

  39. Lindeman S. A systematic review on gender-specific suicide mortality in medical doctors. Br J Psychiatry. 1996;168:274–9.

    Article  CAS  Google Scholar 

  40. Vayr F. Barriers to seeking help for physicians with substance use disorder: a review. Drug Alcohol Depend. 2019;199:116–21. https://doi.org/10.1016/j.drugalcdep.2019.04.004.

    Article  PubMed  Google Scholar 

  41. Baldisseri M. Impaired healthcare professional. Crit Care Med. 2007;35(2 Suppl):S106–16. https://doi.org/10.1097/01.CCM.0000252918.87746.96.

    Article  PubMed  Google Scholar 

  42. Oreskovich M. Prevalence of alcohol use disorders among American surgeons. Arch Surg. 2012;147(2):168–74. https://doi.org/10.1001/archsurg.2011.1481.

    Article  PubMed  Google Scholar 

  43. Medisauskaite A. Does occupational distress raise the risk of alcohol use, binge-eating, ill-health, and sleep problems among medical doctors? A UK cross-sectional study. BMJ Open. 2019;9:e027362. https://doi.org/10.1136/BMJopen-2018-027362.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Kaliszewski M. American Addiction Center. 2019. https://americanaddictioncenters.org/medical-professionals/substance-abuse-in-doctors-according-to-physician-specialty.

  45. National Institute on Alcohol Abuse and Alcoholism. Alcohol Facts and Statistics. 2019.

    Google Scholar 

  46. Kintz P. Evidence of addiction by anesthesiologists as documented by hair analysis. Forensic Sci Int. 2005;153(1):81–4.

    Article  CAS  Google Scholar 

  47. Skipper GE. Anesthesiologists with substance use disorders: a 5-year outcome study from 16 state physician health programs. Anesth Analg. 2009;109(3):891–6.

    Article  Google Scholar 

  48. Rose JS. Prognosis for emergency physician with substance abuse recovery: 5-year outcome study. West J Emerg Med. 2014;15(1):20–5.

    Article  Google Scholar 

  49. DuPont R. How are addicted physicians treated? A national survey of physician health programs. J Subst Abus Treat. 2009;37(1):1–7. https://doi.org/10.1016/j.jsat.2009.

    Article  Google Scholar 

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Hayek, A., Ammar, A. (2022). Difficult Trainers: The Toxic, the Rigid, and the Impaired. In: Ammar, A. (eds) Learning and Career Development in Neurosurgery. Springer, Cham. https://doi.org/10.1007/978-3-031-02078-0_16

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  • DOI: https://doi.org/10.1007/978-3-031-02078-0_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-02077-3

  • Online ISBN: 978-3-031-02078-0

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