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Service designJun 1, 2023

BACPR and other cardiology societies call for action on bullying, harassment, and discrimination

An association that represents physiotherapists and other professionals involved in cardiovascular disease prevention has backed a bid to stamp out the bullying, harassment, discrimination and other ‘unacceptable’ and ‘unprofessional’ behaviours that plague the specialty.

The British Association for Cardiovascular Prevention and Rehabilitation (BACPR) – whose president elect, Heather Probert, is a physiotherapist – has endorsed a position statement that was published online in the journal Heart earlier this week (31 May).

Ms Probert also an active member of the Association of Chartered Physiotherapists in Cardiovascular Rehabilitation, which lists her as its co-chair on its website.

The statement, which has been endorsed by 18 other organisations affiliated with the British Cardiovascular Society (BCS), urges everyone based in a cardiology team to challenge examples of unprofessional behaviours in the workplace.

Photo Credit: Shutterstock
Cardiology team members must 'call out' poor behaviours and promote a culture change


Bullying a long-standing issue

The statement voices concern over evidence suggesting that poor behaviours are rife in UK cardiology departments, and which could reflect longstanding cultural and practice issues, fuelled by traditional training programmes and unconscious biases.

Data from the General Medical Council trainee survey suggest that bullying in cardiology is almost double the average across all medical specialties: 12.3 per cent compared to 6.9 per cent.

Bullying accounts for half of all stress-related workplace illnesses, the statement points out and is associated with

  • poorer performance
  • a heightened risk of medical error
  • lost productivity, burn-out and absenteeism

Inappropriate behaviour in cardiology departments has a detrimental ripple effect, including on the recruitment and retention of staff, patient care, and other bystanders, the statement suggests.  ‘As such, improving the culture and professional behaviours within UK cardiology departments is of paramount importance,’ it notes.

The statement sets out examples of inappropriate behaviour. These include bullying; sexist, racist, homophobic or belittling language; discrimination; harassment; providing or depriving individuals of opportunities based purely on personal characteristics; outbursts of uncontrolled anger; and unconstructive criticism of performance. 

Outdated misconceptions

There is a common and outdated misconception in the specialty that intimidation helps to ‘build character’, the statement notes. ‘This is an anachronistic and flawed concept: intimidating language or actions do not build character and have substantial negative impacts on those affected. Furthermore, role modelling and learnt behaviours lead to perpetuating the cycle of bullying.

‘While mistakes happen in medicine and may require frank feedback to aid learning, they are not an excuse for intimidating or belittling behaviour or language,’ it adds.

Departments and individuals should

  • set out clear standards and expectations of behavioural norms from all members of the cardiovascular team 
  • encourage the reporting of inappropriate behaviours
  • ensure that clear policies, practices and procedures are in place for dealing with inappropriate behaviour, are reviewed, and included in induction and staff handbooks
  • designate and train a behaviour lead with whom concerns can be raised  
  • consider any episodes of inappropriate behaviour in the selection process for promotions and leadership roles
  • make routine use of multi-source feedback where evidence of all behaviours can be raised
  • provide mandatory training for all on workplace culture; how to give and receive structured feedback; unconscious bias; and cardiology-specific human factors

No-one should be discriminated against at work, bullied, harassed or undermined. In cardiology we have had this pervasive culture for far too long [John Greenwood, BCS]

The statement also makes recommendations for universities and national bodies, which are urged, for example, to develop positive organisational cultures and ensure that similar standards of behaviour are expected of members. They should also establish transparent cardiology reporting strategies for inappropriate behaviour 

‘As with clinical standards, professional societies have a role in developing a standard for appropriate behaviour and a responsibility to ensure that inappropriate behaviour is shown to be unacceptable,’ the statement adds. 

BCS president John Greenwood said: ‘No-one should be discriminated against at work, bullied, harassed or undermined. In cardiology we have had this pervasive culture for far too long.

'This statement and its practical recommendations represent a concerted effort to stop bullying in its tracks and put measures in place to stop it happening in the future.’

Professor Greenwood added that the statement would be aired at the BCS annual conference in Manchester (5-7 June).

To read the full version of the statement – titled Joint British Societies’ position statement on bullying, harassment and discrimination in cardiology doi 10.1136/heartjnl-2023-322445 – click 


Author: Ian A McMillan
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