Psychological and physical abuse causes depression and anxiety.
Highlights:
- 83.9% of Mexican residents consider being a victim of abuse during their residency.
- The figures are alarming: depression rates in Mexican doctors reach up to 79.6 percent, and anxiety rates reach up to 69.9 percent.
- We calculate that there are 36,000 Mexican doctors with suicidal thoughts.
- In most hospitals in Mexico, there is no psychological safety for those working there.
- We must move towards a ZERO tolerance policy for violence within hospitals.
83.9% of residents consider being a victim of abuse during their residency. Still, only 34.3% report it out of fear, according to data from Derive et al. Talking with multiple doctors about the situation of violence that many experiences inside hospitals, I have realized that there is interest in changing this situation. Still, a reflective analysis within the medical community is lacking. Phrases like “this generation do not know the difference between violence and academic rigor” make me think that they are merely justifications that allow the violence that historically exists in hospitals.
Although there are still difficulties in discussing this issue openly, it is being discussed more frequently within institutions. Unfortunately, this is in a context where the figures are alarming: depression rates in doctors reach up to 79.6 percent, and anxiety rates reach up to 69.9 percent, according to data from Lugo-Machado et al. In addition, we calculate that there are 36,000 doctors with suicidal thoughts. To put it in perspective, this represents filling Mexico’s National Auditorium more than three times.
Several authors have verified the number of suicides in medical professionals, and up to 60% refuse to seek help for fear that it could affect their medical license.
Lugo-Machado et al.
Examples such as the case of the ISSEMyM Regional Hospital, which was published on the front page of newspapers a little over a year ago, in which residents of the Traumatology and Orthopedics service were physically abused by their peers, or the recent case of Doctor Fernando, who was unjustly detained on the assumption of theft of medical materials, shed light on the need to speak openly about these issues. In most hospitals in Mexico, there is no psychological safety for those working there. This is the shared feeling that you can freely express your thoughts and ideas or make mistakes and ask for help.
Physical abuse or being treated like a criminal only exemplifies the long way to go. Without psychological safety, the health of patients is affected. What if a resident realizes that a physician prescribed a patient a medication wrongly and, out of fear, says nothing, and the drug is administered to the patient? What would be the magnitude of not asking for help in a hospital when making a mistake and only trying to cover it up out of fear? These two scenarios violate the principle “primum non nocere” (the first thing is to do no harm), which has accompanied our profession since its inception.
Unfortunately, these cases are not just examples but occur within hospitals due to the lack of psychological security. Although all is not lost, we must begin by self-analyzing, thinking about those times when you did not necessarily hit the resident or deprived the student of his freedom, but rather that time when you humiliated your peer, made her feel less or when you were not able to work in a team with those who in the “hierarchical ladder” were lower in rank than you. We must work to create environments where one can speak openly. We can start by being grateful to the people we work with. It costs us nothing to show appreciation. And although it sounds paradoxical, we must move towards a ZERO tolerance policy for violence within hospitals.
