The American Medical Association (AMA) today adopted new policy aimed at preventing bullying among health care professionals. Specifically, the new policy, approved by physicians at the Special Meeting of the AMA House of Delegates, provides a formal definition of “workplace bullying” as well as guidelines for health care organizations, including academic medical centers, to use in developing policies, procedures, and training to help them prevent and address bullying in their workplaces.

The new policy also encourages health care organizations to create a culture in which bullying does not occur, and outlines guidance they can follow to foster respect and appreciation among colleagues across disciplines and ranks and ensure a safe work environment.

“Bullying in medicine not only negatively impacts the mental and physical health of the professional being bullied, but can also have lasting adverse effects on their patients, care teams, organizations, and their families. Bullying has no place in the medical profession and we must do everything we can to prevent it for the sake of the wellbeing of the health care workforce,” said AMA Board Member Willie Underwood III, M.D., MSc, MPH. “Putting an end to bullying in the practice of medicine will require the health care industry, local organizations and individual members of the health care team to acknowledge the problem, accept responsibility, and take action to address it at all possible levels.”

In the health care setting, individuals who have been bullied have reported experiencing burnout, depression, anxiety and worsened performance. According to a 2008 report of The Joint Commission, intimidating and disruptive behavior can result in medical errors, poor patient satisfaction and preventable adverse outcomes. To help health care organizations prevent workplace bullying, the AMA’s new policy offers the following guidance that should be used to establish an effective workplace policy:

• Describe the management’s commitment to providing a safe and healthy workplace. Show the staff that their leaders are concerned about bullying and unprofessional behavior and that they take it seriously.
• Clearly define workplace violence, harassment, and bullying, specifically including intimidation, threats and other forms of aggressive behavior.
• Specify to whom the policy applies (i.e., medical staff, students, administration, patients, employees, contractors, vendors, etc.).
• Define both expected and prohibited behaviors.
• Outline steps for individuals to take when they feel they are a victim of workplace bullying.
• Provide contact information for a confidential means for documenting and reporting incidents.
• Prohibit retaliation and ensure privacy and confidentiality.
• Document training requirements and establish clear expectations about the training objectives.

Additionally, given the lack of a legal definition, the number and variety of definitions in use, and the continued need for more universally accepted policies to prevent bullying in the workplace, the AMA’s policy provides an inclusive, universal definition of bullying. The AMA defines “workplace bullying” as repeated, emotionally or physically abusive, disrespectful, disruptive, inappropriate, insulting, intimidating, and/or threatening behavior targeted at a specific individual or a group of individuals that manifests from a real or perceived power imbalance and is often, but not always, intended to control, embarrass, undermine, threaten, or otherwise harm the target.

In light of ongoing attacks on physicians and public health officials during the COVID-19 pandemic, the AMA also adopted policy today aimed at improving the safety of and preventing violence against physicians, as well as other health care workers, first responders, and public health officials.