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Unprofessional behaviour in Australian hospitals

Anthony Scott and Danny Hills
Med J Aust 2021; 214 (1): . || doi: 10.5694/mja2.50891
Published online: 18 January 2021

Inappropriate behaviour harms health workers and patients, and evidence‐based solutions are needed

Health care is the largest employment sector in Australia, more than 1.7 million workers (14% of all employees).1 Incivility, bullying, aggression, and negative workplace cultures seem endemic and have repeatedly been associated with poor workforce and clinical outcomes, but high quality evaluation of interventions for eliminating these behaviours are rare.2,3,4


  • 1 Melbourne Institute: Applied Economic and Social Research, Melbourne, VIC
  • 2 Federation University Australia, Ballarat, VIC


Correspondence: a.scott@unimelb.edu.au

Competing interests:

No relevant disclosures.

  • 1. Australian Bureau of Statistics. 6291.0.55.003. Labour force, Australia, detailed (May 2020). June 2020. https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia-detailed/may-2020 (viewed Sept 2020).
  • 2. Westbrook J, Sunderland N, Atkinson V, et al. Endemic unprofessional behaviour in health care: the mandate for a change in approach. Med J Aust 2018; 209: 380–381. https://www.mja.com.au/journal/2018/209/9/endemic-unprofessional-behaviour-health-care-mandate-change-approach
  • 3. Mannion R, Davies H. Understanding organisational culture for healthcare quality improvement. BMJ 2018; 363: k4907.
  • 4. Choo EK, Byington CL, Johnson NL, et al. From #MeToo to #TimesUp in health care: can a culture of accountability end inequity and harassment? Lancet 2019; 393: 499–502.
  • 5. Westbrook J, Sunderland N, Li L, et al. The prevalence and impact of unprofessional behaviour among hospital workers: a survey in seven Australian hospitals. Med J Aust 2021; 214: 31–37.
  • 6. Hills DJ, Joyce CM, Humphreys JS. A national study of workplace aggression in Australian clinical medical practice. Med J Aust 2012; 197: 336–340. https://www.mja.com.au/journal/2012/197/6/national-study-workplace-aggression-australian-clinical-medical-practice
  • 7. Hills D, Lam L, Hills S. Workplace aggression experiences and responses of Victorian nurses, midwives and care personnel. Collegian 2018; 25: 575–582.
  • 8. Fear NT, Seddon R, Jones N, et al. Does anonymity increase the reporting of mental health symptoms? BMC Public Health 2012; 12: 797.
  • 9. Edwards P, Roberts I, Clarke M, et al. Methods to increase response to postal and electronic questionnaires. Cochrane Database Syst Rev 2009; MR000008.
  • 10. Joyce CM, Scott A, Jeon SH, et al. The “Medicine in Australia: Balancing Employment and Life (MABEL)” longitudinal survey: protocol and baseline data for a prospective cohort study of Australian doctors’ workforce participation. BMC Health Serv Res 2010; 10: 50.
  • 11. Saini V, Garcia‐Armesto S, Klemperer D, et al. Drivers of poor medical care. Lancet 2017; 390: 178–190.

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