In Malaysia, the death of a doctor sheds light on long-standing workplace harassment in the public health sector

Workplace bullying more severe in healthcare?

Experts say workplace bullying is a universal problem, not limited to health care.

While previous research has not found bullying to be more common in healthcare than in other sectors, experts believe it may be more visible or more severe in healthcare due to the pressures in which patients’ lives are at risk.

They believe factors such as heavy workloads coupled with staffing issues and a lack of support systems contribute to endemic abuse.

The number of housewives in the Ministry of Health fell by about half between 2019 and 2023, from 6,134 to 3,271, according to official figures reported earlier this year by news website The Star.

The shortage of cardiac surgeons – 14 in the seven public hospitals where heart surgery is performed in Malaysia – was also highlighted in July when four graduates of the Royal College of Surgeons of Edinburgh’s “parallel track” training program in cardiac surgery applied for a Joint Control Fellowship court to challenge the decision of the Malaysian Medical Council to reject their applications for entry into the National Register of Specialists, a database of medical specialists in the country.

In previous news reports, experts have highlighted the need to address the physician shortage and warned of its potential impact on patient care.

Dr Tay’s death comes about two years after a housewife at Penang General Hospital was reported to have committed suicide after experiencing workplace bullying.

The government then established the Health Workplace Culture Improvement Task Force (HWCITF) to investigate the 25-year-old’s death and claims of a culture of bullying in health departments.

The types of abuse mentioned included bullying, isolation, denigration, gender reassignment, inflammatory language, harassment, unfair pay, unfair working hours and unfair workload.

In its report released in August 2022, the task force found no strong evidence of workplace abuse in connection with the homemaker’s death. However, he noted that burnout, bullying and an unhealthy work culture occurred at various levels in the Ministry of Health, although not in all health care facilities.

The report also surveyed over 110,000 employees of the Ministry of Health. About 30 percent admitted to burnout, and 7.5 percent felt they had been victims of bullying at work.

About a quarter of the more than 20,000 respondents at managerial or supervisory level admitted to acts of workplace bullying.

Of those who admitted to bullying, about 20 percent said they had engaged in “severe” abuse, while the remainder said they had engaged in “low” level bullying.

The report, which said the Ministry of Health employs approximately 250,000 workers, also highlighted the significant shortage of doctors, nurses and other health care staff, particularly in rural areas, who face excessive workloads leading to stress and burnout.

Last year, a separate survey of 728 doctors by the Malaysian Medical Association (MMA) found that 30-40 percent of doctors in the country had experienced some form of abuse.

The study also found that victims are more likely not to file a complaint out of fear or unsure how to do so.

In comparison, a 2019 study found that almost 40 percent of Malaysian workers had experienced workplace bullying.

The study, titled “Workplace Bullying and Psychological Distress of Employees Across Socio-Economic Stratagems: A Cross-Sectional Study,” involved more than 5,200 people from 47 organizations in Malaysia and was published in the journal BMC Public Health.

It is said to be the first to report the incidence of workplace bullying and its association with socio-economic factors and psychological distress in a large sample of Malaysian workers recruited from multiple organizations.

The study did not identify the organizations or industries they belonged to, but it did say that people who experienced bullying at work were particularly associated with being female, earning higher incomes and greater psychological distress.