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Exploring its effects in Healthcare
Unprocessed anger is often not talked about. The transference of anger without having understood the root cause of it is sometimes seen as the rite of passage amongst medical professionals the world over. Some doctors believe that the junior doctors must be put through the same hardship that they once underwent.
This brings us to recognizing the term ‘Transgenerational Trauma’.
Transgenerational trauma is also referred to as ‘intergenerational trauma’, refers to how trauma passes through generations. A new field of research, which started in the 2000s, refers to the idea that trauma is passed on behaviourally and biologically. This means that not only can someone experience trauma, they can then pass the symptoms and behaviours of trauma survival on to their children, who then might in turn pass these further along the family line, to the grandchildren and so on. 5 It can manifest as lack of trust of others, anger, irritability, nightmares, fearfulness and an inability to connect with others. 19
With the ongoing generations of doctors that work together in medical institutions, this transgenerational trauma becomes apparent as described below.
Psychological Trauma is prevalent amongst Medical Professionals and healthcare workers. McManus et al. (2006) found that the person who took up a medical career had a correlation with their personality type. Persons who chose medicine to help others were more agreeable and had higher scores in empathy. 6 Empaths and sensitive people often experience some level of post-traumatic stress. This is because they are exposed to sensory overload for many years, and this floods their systems with adrenaline. 7
In a recent report by The Hindu, in April 2023, 64 MBBS and 55 postgraduate medicos were found to have died by suicide in the last five years. 8 Mental ill-health was found to be the next most common reason in medical students and physicians and of the 26% who had exhibited suicide warning signs, only 13% had sought psychiatric help before ending their lives. 8 How likely is a distraught, short tempered senior medical professional likely to seek psychological help before displaying their anger towards a junior doctor?
Communication, collaboration and teamwork is the cornerstone of the effective running of any organization but it is not always seamless amongst medical professionals. A study by Sutcliff 9 revealed that social, relational, and organizational structures contributed to communication failures and contributed largely to adverse clinical events and outcomes.
Much original research has been conducted recently on the impact of physician disruptive behaviors (such as inappropriate behavior, confrontation, or conflict, ranging from verbal abuse to physical or sexual harassment) and its effect on staff relationships, staff satisfaction and turnover, and patient outcomes of care.
The effects of the above would influence patient complications, medical errors, compromises in patient safety, poor quality care, and links to preventable patient mortality. Many of these undesirable effects can be traced back to poor communication and collaboration, and ineffective teamwork. 10
Hierarchies tend to sometimes pose a barrier to effective communication and collaboration.11-15 A study by Sutcliff 16 concluded that communication failures in the medical setting arose from vertical hierarchical differences, role conflict, ambiguity and struggles with interpersonal power and conflict. Communication was likely to be distorted or withheld in situations where there were hierarchical differences between two communicators, particularly when one person was concerned about appearing incompetent, and did not want to offend the other, or believed that the other was not open to communication.
These reasons contribute towards the psychological trauma meted out to junior doctors, and hence perpetuates the unsafe work atmosphere. This translates to poor patient outcome and increased attrition of medical professionals in the organization. 17
This unreasonable anger by senior medical professionals need to be addressed before it passes on to successive generations of doctors and healthcare professionals. It would be useful for the senior medical professionals to become more aware of their own triggers and how their experiences influence their behaviour towards the junior doctors. 18
Sharing what one is burdened by can be one of the first steps to mitigating the trauma. To begin healing, the senior medical professional needs to know the extent of past issues. Once identified, he or she can begin to see the impact of the trauma. Anger, sadness, anxiety, and substance use could all arise out of trauma. Working as a team can help improve the health of the department instead of blaming one another. It is important that they learn how to change habits rather than carry forward the cycle of abuse. The thoughts, feelings and behaviour from trauma must be ended. Seeking professional help from a clinical psychologist or psychiatrist to help in the healing process is invaluable. 19
The above measures would contribute to a safe workplace and direct a better outcome for patients as well as the healthcare worker.
These pieces are being published as they have been received – they have not been edited/fact-checked by ThePrint.