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Unmasking Health Care's Hidden Crisis: How to Combat Unprofessional Behavior

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Jordan Keane in Health & Wellness October 2026 • 4 min read.

"Pervasive bullying, discrimination, and harassment undermine health care, but effective solutions are within reach."


The healthcare system, meant to be a place of healing and care, is facing a silent epidemic: unprofessional behavior. Bullying, discrimination, and sexual harassment are widespread issues, creating a toxic environment for healthcare professionals.

Recent surveys paint a concerning picture. A 2016 Victorian Public Sector Commission study revealed that 25% of health agency staff experienced bullying. In 2015, nearly half (49%) of surveyed surgeons reported experiencing discrimination, bullying, harassment, or sexual harassment. These statistics are alarming, but likely underestimate the true prevalence due to underreporting and a lack of awareness regarding subtle forms of unprofessional conduct.

This article delves into the pervasive problem of unprofessional behavior in healthcare, exploring its impact on staff, patient safety, and organizational performance. We'll examine emerging evidence and practical interventions to cultivate a more respectful and professional healthcare environment.

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What the Available Evidence Shows

The listed sources do not provide verified prevalence figures for health care workplace violence or bullying, so no specific rate can be stated from this material. Wifitalents describes its page as compiling 2025 data on threats to health care workers and says risk varies by setting and by when safety systems are difficult to maintain. The 2024 Workplace Bullying Institute survey reports strong public support for a workplace anti-bullying law protecting workers from targeted, health-impairing bullying.

A Multilevel Response to Bullying

A 2025 scoping review identifies workplace culture, hierarchy, inactive institutional power, and conflict as theoretical constructs that may help explain bullying in health care organizations. It argues that understanding these factors can provide a foundation for targeted interventions and organizational policies addressing bullying at multiple levels. The American Medical Association likewise emphasizes changing organizational culture, noting that bullying has significant and lasting effects on culture and professional attitudes. The supplied material does not specify comparative effectiveness or limitations of particular prevention methods.

The Ripple Effect: Understanding the Impact

Healthcare professional unmasking stress and anxiety.

Unprofessional behavior's impact extends far beyond individual discomfort. It creates a ripple effect, negatively impacting staff psychological wellbeing. High levels of stress, decreased teamwork, poor communication, and reduced concentration are commonly reported by healthcare professionals working in hostile environments.

The consequences extend to the quality of patient care. Studies show a direct link between unprofessional behavior and patient dissatisfaction, increased medical-legal risk, and significant financial costs for healthcare organizations. A disturbing study revealed that even low-level incivility can compromise patient safety, with teams subjected to rudeness during simulated medical scenarios performing significantly worse than those treated respectfully.

  • Compromised Patient Safety: Reduced information sharing, poor diagnostic performance, and delayed help-seeking behaviors directly threaten patient safety.
  • Financial Strain: Increased staff turnover, absenteeism, and potential lawsuits drain resources from already stretched healthcare systems.
  • Erosion of Professional Identity: Humiliation, belittling, and verbal abuse, often normalized in healthcare settings, negatively impact the development of professional identity, especially among students and trainees.
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Reviews Point to Gaps in Intervention Rationale

A realist review funded by the National Institute for Health and Care Research (NIHR), award NIHR131606, examined why acute-care staff behave unprofessionally toward one another and how those behaviors might be reduced. A related realist review analyzed 148 sources, including 42 reports of interventions using different behavior-change strategies. Its authors found that interventions insufficiently explain why particular strategies are chosen. The review authors describe unprofessional behavior as an unaddressed health care crisis requiring urgent action and further research.

Mistreatment Across Health Care Roles

A study on workplace incivility and bullying across health care roles concludes that these experiences are widespread, with broadly comparable exposure among clinical staff. It reports that direct experiences of mistreatment show the most consistent associations with psychological distress, and that different dimensions of mistreatment appear in interconnected patterns. Nursing Times also reports that bullying and rudeness can contribute to staff burnout, absences, and resignations, potentially compromising patient care and safety.

These factors highlight an urgent need for hospitals and healthcare organizations to commit towards creating professional work environment.

Charting a New Course: The Path Forward

Addressing unprofessional behavior requires a multi-faceted approach, beginning with acknowledging the problem and fostering open communication. While the 2016 Senate inquiry called for action, concrete guidance remains scarce.

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Emerging Forms of Bullying

A 2026 article on the next wave of workplace bullying in health care says bullying and incivility have continued to escalate and pose risks to workforce well-being, organizational sustainability, and patient safety. It examines emerging dimensions including mobbing, gaslighting, cyberbullying, and bullying in remote and virtual settings. The article builds on a prior four-part series in the same journal.

Impacts Extend to Bystanders

A presentation titled “Healthcare Workplace Bullying: Ethical Implications & Impact” examines bullying’s broader effects beyond direct victims. It specifically evaluates how different bystander roles relate to workplace and professional outcomes. The supplied description does not identify the measured outcomes or report results, so it does not support a more specific claim about those effects.

Effects on Work Quality and Performance

A 2023 report on untapped cases of workplace bullying and its concealed impacts on health care employees states that bullying affects employees’ work quality and negatively affects work performance. The supplied source description does not provide a numerical estimate or further detail about the scale of these effects.

Organizational professional accountability programs, like the Ethos program at St Vincent's Health Australia, offer promise by providing a safe channel for reporting and addressing unprofessional behavior. These programs rely on trained peer envoys who provide feedback about reported behavior to colleagues in an informal, non-punitive manner.

Ultimately, creating a safe and sustainable health system requires a fundamental cultural shift. This shift involves investing in research, rigorously evaluating interventions, and prioritizing respectful, collaborative teamwork. By embracing evidence-based approaches and fostering a culture of civility, the healthcare sector can ensure the wellbeing of its workforce and, most importantly, safeguard patient care.

What the evidence adds up to about unprofessional behavior

Unprofessional behavior is described as persistent across health care systems, with consequences for both staff psychological wellbeing and patient care. The evidence frames these effects as connected, rather than as a problem confined to workplace relationships.[1]

Rudeness in a simulated neonatal intensive care scenario was linked to poorer team information sharing, diagnostic performance, help-seeking, and procedural performance. Because this was a simulation, it shows how rudeness can disrupt team performance in that setting, not whether changing staff conduct improves care in hospitals.[2]

The evidence describes professional accountability programs as based on the premise that early intervention may change behavior and prevent escalation. That premise is not itself evidence that these programs improve care practices.[2]

How the evidence compares across settings and approaches

The realist review included 38 reports in its first step, while a separate assessment of organizational interventions notes limited evidence of effectiveness and no assessment of whether care practices improved. The number of reports alone therefore does not establish that interventions work or improve care.[2] [3]

The CREW approach used facilitated work-unit discussions to identify relationship improvements and create action plans over six months. Professional accountability programs, by contrast, rest on the proposed role of early intervention in preventing escalation; these descriptions show different approaches, not a comparative test of effectiveness.[2]

What evidence still needs to clarify

  • How do experiences of unprofessional behavior differ for non-clinical, non-managerial health care staff, whose experiences are described as little known?[2]

Sources

  1. Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review (2023)
  2. Endemic unprofessional behaviour in health care: the mandate for a change in approach (www.mja.com.au)
  3. Interventions to address unprofessional behaviours between staff Interventions to address unprofessional behaviours between staff in acute care: what works for whom and why? A realist review in acute care: what works for whom and why? A realist review

About this Article -

Written with AI assistance from published research, and reviewed by the Mystum team. See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.5694/mja17.01261, Alternate LINK

Title: Endemic Unprofessional Behaviour In Health Care: The Mandate For A Change In Approach

Subject: General Medicine

Journal: Medical Journal of Australia

Publisher: AMPCo

Authors: Johanna Westbrook, Neroli Sunderland, Victoria Atkinson, Catherine Jones, Jeffrey Braithwaite

Published: 2018-11-01

Everything You Need To Know

1

What constitutes unprofessional behavior in healthcare, and why is it important?

Unprofessional behavior includes bullying, discrimination, and sexual harassment. It's important because it creates a toxic environment, negatively affecting staff well-being, patient safety, and organizational culture. It's a pervasive issue in healthcare, as evidenced by surveys such as the 2016 Victorian Public Sector Commission study, which revealed that 25% of health agency staff experienced bullying. The implications are significant, leading to decreased teamwork, poor communication, reduced concentration, and ultimately, a decline in the quality of patient care.

2

What are the key impacts of unprofessional behavior in healthcare?

The impact of unprofessional behavior extends to various areas. It leads to compromised patient safety due to reduced information sharing, poor diagnostic performance, and delayed help-seeking behaviors. It also creates financial strain through increased staff turnover, absenteeism, and potential lawsuits. Moreover, it erodes professional identity, particularly among students and trainees. Studies show a direct link between unprofessional behavior and patient dissatisfaction, increased medical-legal risk, and significant financial costs for healthcare organizations.

3

What are the key types of unprofessional behavior, such as bullying and harassment, and why are they significant?

Bullying and harassment are types of unprofessional behavior. Bullying involves repeated, unreasonable actions intended to intimidate, degrade, or undermine a person or group. Harassment includes any behavior that creates a hostile environment, often based on factors like gender or race. These behaviors are significant because they create a toxic work environment that affects all aspects of the organization. Such behaviors create high levels of stress, decreased teamwork, poor communication, and reduced concentration, leading to potential patient safety issues.

4

How does unprofessional behavior directly affect patient safety?

Patient safety can be directly compromised by unprofessional behavior in healthcare. Reduced information sharing, poor diagnostic performance, and delayed help-seeking behaviors are all direct consequences of unprofessional conduct. Studies, such as the one involving simulated medical scenarios, demonstrate that rudeness can significantly impair a team's performance, thereby threatening patient safety. The consequences of this also extend into the financial realm, including staff turnover and lawsuits. In effect, a hostile work environment puts patient safety at risk.

5

What steps can be taken to address unprofessional behavior in healthcare?

Addressing unprofessional behavior requires a multi-faceted approach. This begins with acknowledging the problem and fostering open communication. Acknowledging the issue is important because it sets the stage for implementing effective interventions. The 2016 Senate inquiry called for action, but specific guidance is still limited. This means that healthcare organizations must proactively develop and implement strategies to combat these behaviors, aiming to create a more respectful and professional environment. The long-term implication of such a shift is an improved work environment, improved patient outcomes and greater financial stability.

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