American College of Cardiology statement aims to build civil, respectful and bully-free work environments

Successfully addressing bias, discrimination, bullying and harassment in the workplace requires institutional dedication; visible, supportive leadership; and adequate financial resources for implementing effective policies and procedures, according to an American College of Cardiology (ACC) health policy statement published in the Journal of the American College of Cardiology.

"This document is not merely a position statement, but it is a call-to-action that articulates solutions and provides resources and tools for individuals, organizations and professional societies who wish to address the widespread problem of bias, discrimination, bullying and harassment in cardiology," said Pamela S. Douglas, MD, MACC, co-chair of the health policy statement. "The ramifications of not tackling these issues cannot be ignored, as uncivil behavior impacts employee retention, well-being, and has potentially high costs for the institution or practice."

Uncivil and toxic behavior, including bias, discrimination, bullying and harassment, has been well-documented in medicine and cardiology. A recent survey found over one-third of resident doctors and faculty reported experiencing bias, discrimination, bullying and harassment at their main place of work, and the behaviors were more commonly reported as directed toward women and racial/ethnic minorities. Uncivil behaviors are a spectrum, including microaggressions and implicit bias on one end, and harassment and violence on the other. The behaviors can be intentional or unintentional, refer to many personal identities (including but not limited to age, religion, sexual orientation, gender identity, physical ability, professional role, appearance, clothing and country of origin) and are the result of individual, organizational and societal issues. Recent years have placed emphasis on diversity, equity and inclusion, but according to the statement authors, "belonging" needs to be recognized to address critical cultural issues.

"In order to implement meaningful, successful approaches to addressing bias, discrimination, bullying and harassment, each initiative must be tailored to individual and institutional needs," said Michael Mack, MD, MACC, co-chair of the health policy statement. "Medical and professional societies have a unique role in setting standards of excellence and acting as influencers to drive change in building safe and healthy work cultures."

Among the recommendations set by the authors to help eliminate bias, discrimination, bullying and harassment:

• Establishing confidential and fair mechanisms for reporting and investigating individuals and/or departments suspected or accused of bias, discrimination, bullying and harassment.
• Creating institutional resources to ensure that hiring decisions and performance evaluations are objective.
• Adopting metrics supported by data collection to track progress and inform future plans.
• Embracing independent evaluation of culture and the effectiveness of efforts to reduce uncivil behavior.
• Recognizing champions and leaders who promote and model excellence in these areas.