The Relationship of Workplace Bullying with Health Outcomes, the Intention to Leave the Profession and Medical Errors: A Cross-sectional Study among Medical Assistants in Germany

Introduction Research has shown that workplace bullying (WB) is associated with adverse health outcomes, career choices (i.e. intention to leave the profession [ITL]) and poorer patient care (e.g. medical errors), though evidence for the latter remains inconsistent. We examined those associations for the first time among medical assistants (MAs).

Methods We surveyed 994 MAs (09/2016-04/2017). WB was measured by an item from the Copenhagen Psychosocial Questionnaire (“At work, I feel wrongfully criticized, bullied or put in a bad light in the presence of others”). Responses were dichotomized (i.e. feeling bullied = rather or fully agreeing with the statement). We also inquired after the perpetrator (i.e. supervisor, colleagues, patients). The dichotomized health outcomes comprised poor self-rated health ([very] poor health vs better), depressive symptoms (Patient Health Questionnaire-2) and anxiety (Generalized Anxiety Disorder-2). ITL was captured by the frequency of thoughts about leaving the profession (a few times per year or more often vs never). We measured self-reported concerns about having made a major medical error in the last three months (yes/no). Associations were estimated by multivariable logistic regression.

Results 26 % of the MAs reported exposure to WB, mostly due to supervisors (62 %), followed by colleagues (47 %) and patients (35 %). WB was significantly associated with poorer health (all odds ratios [OR] ≥ 3.2), increased odds of ITL (OR = 2.0) and medical errors (OR = 2.1). Associations were strongest and most consistent when supervisors were perpetrators.

Conclusion If corroborated by prospective evidence, our findings suggest that prevention of workplace bullying may improve MAs’ health, career prospects, and patient care. Addressing bullying when supervisors are the perpetrators may be particularly promising.

Publication History

Article published online:
02 September 2021