title: How the medical culture contributes to coworker-perpetrated harassment and abuse of family physicians.
abstract: OBJECTIVE
  Harassment and abuse in the workplace of family physicians has been associated with higher levels of stress, increased consumption of alcohol, and higher risk for developing mental health problems. Few studies have examined issues contributing to abusive encounters in the workplace of family physicians.
  
  
  METHODS
  For the overall study we used a mixed methods design, which included a cross-sectional survey of a randomly selected sample of active family physicians from the database of the College of Family Physicians of Canada and telephone interviews with those who reported experiencing work related harassment and abuse in the last year. The data presented here arise from the qualitative interviews of the study, which were analyzed thematically.
  
  
  RESULTS
  The interview arm of the study included 23 female and 14 male participants. The major themes that emerged from the study were (1) modeling of abusive behaviors, (2) status hierarchy among various medical disciplines, (3) shortage of physicians, and (4) lack of transparent policies and follow-up procedures after abusive encounters. The results are discussed using the broken window theory.
  
  
  CONCLUSIONS
  Many family physicians experience harassing and abusive encounters during their training or in the workplace. The current medical culture appears to contribute to harassment and abuse in the workplace of family physicians in Canada. We described the components that intentionally or unintentionally facilitate abusive behavior in the medical culture.
authors.affiliation: Dalhousie University Family Medicine Teaching Unit, Fredericton, Canada. Baukje.miedema@horizonNB.ca
authors.forename: Baukje
authors.initials: B
authors.lastname: Miedema
authors.forename: Leslie
authors.initials: L
authors.lastname: MacIntyre
authors.forename: Sue
authors.initials: S
authors.lastname: Tatemichi
authors.forename: Anita
authors.initials: A
authors.lastname: Lambert-Lanning
authors.forename: Francine
authors.initials: F
authors.lastname: Lemire
authors.forename: Donna
authors.initials: D
authors.lastname: Manca
authors.forename: Vivian
authors.initials: V
authors.lastname: Ramsden
mesh_terms: D002170:Canada; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015279:Organizational Culture; D010821:Physicians, Family / Q000523:psychology*; D036301:Qualitative Research; D017406:Sexual Harassment / Q000523:psychology; D012919:Social Behavior; D011795:Surveys and Questionnaires; D014754:Violence / Q000523:psychology; D017132:Workplace / Q000523:psychology*