Background: Researchers examining the issue of abuse of physicians have largely focused on acts perpetrated by patients, and there is a paucity of data regarding abusive behavior by consultants towards emergency physicians. We conducted an investigation to evaluate the prevalence of consultant abuse as perceived by emergency medicine (EM) residents
Methods: This was a cross-sectional study in which 24 U.S.-based EM program directors (PD) were requested to provide a representative sample resident list, and study authors contacted potential participants via email. Respondents provided answers to closed-ended questions regarding their training level, setting, and perceptions of consultant abuse on SurveyMonkey.com. Categorical data analyzed by chi-square; continuous data analyzed by t-tests.
Results: 17 participating programs; 151/165 (92%) residents responded; 36% female, 80% white race, PGY-1 (31%), 62% university-based. Nearly all (99%) programs allow PGY-1s to call, and they most often speak to other residents (67%) or attending consultants (31%). Residents reported “sometimes” (44%) and “frequently” (26%) that consultants exhibit behavior that could be considered abusive, most frequently as “excessive pushback on seeing or admitting patients” (71%). Most residents (90%) were aware of instances in which abusive consultant behavior “negatively impacted patient care”. 51% are less likely to call an abusive consultant, and nearly half (49%) are unaware if program has a process to address the issue. The majority of residents (61%) rate their institution’s response to abuse as neutral to very ineffective. 83% report that such abuse causes some to very significant burnout/work dissatisfaction. There were no significant differences with respect to abuse experiences and the following variables: gender (p=0.26), race (p=0.89), ED setting (p=0.60). There was a significant difference between training years and experiences of abuse (p=0.04) with the highest proportion observed in PGY-2 year (86%). Attending vs. resident consultants were more likely to perpetrate abuse (83% vs. 63%; p=0.03).
Conclusion: EM residents reported that perceived abuse by consultants is frequent, negatively impacts patient care, and nearly half are unaware of a process at their institution to address such behavior.