2021 m. gruodžio 7 d., antradienis

In order to force doctors to slave for pennies in Lithuania, they are broken psychologically using the methods employed by professional criminals in prisons.

 "The latest Laisvės TV journalistic research shows that the harassment, exploitation and psychological destruction of doctors is a systemic problem that is widespread and hidden in almost all Lithuanian hospitals." 

 

    Surveys show that at least a third of Lithuanian doctors experience psychological violence on a daily basis.

 

    The study reveals what methods are being used to destroy the doctor and force him to quit his job. Documents show that state-funded hospitals intimidate and legally persecute those medics who dare to talk about the violence they have experienced. 

 

Experts say the ongoing psychological violence, exploitation and burnout make medical services unsafe.

 

     Even future doctors face bullying, insults, humiliation and threats already during their studies. From the first days, they realize that there are different rules of communication between doctors. "A joke like that: a woman, it's a temple on two legs. Or: I find the most pleasant sound when a girl asks to repeat. And this is usually the case if the student asks to repeat, because she simply did not manage to write down something that the teacher dictated, ” - said Rasa, a medical student studying at the Lithuanian University of Health Sciences (LSMU).

 

Young people in their medical student's years are either frustrated or learn to adapt to a violent culture.

 

    "Silk wool is made from a student," says A. Gerliakienė. Representatives of LSMU did not answer the written questions.

 

    Residents are forced to work for free

 

    Later, when the residency begins, future doctors have to endure not only humiliation - they also have to put up with exploitation. In order to establish themselves in hospitals, residents are required to work for free during their holidays, to be on duty instead of their managers, and even to write research papers for them. "I remember working all night and wanting to go home the next day. I’m already putting things in when one doctor comes and says, where are you going? How are you going home here? You what, not a man? What will you do at home? I say: I would like to sleep. He just laughed,  and went away,” - says surgeon Vytautas, who did a residency in Kaunas clinics. The Laisvės TV research shows real documents of Kaunas clinics, which show that the official schedules according to which salaries are paid do not correspond to reality. There are cases where a young doctor has a day off scheduled, even though patient examination reports show that the doctor actually worked. And he didn't get a penny for it. “The time sheet that is on the paper, it does not correspond to reality even 5 percent. In my practice, I did not receive at least one extra euro for the hours worked during my employment,” - said the resident Vytautas. Tomas Lapinskas, one of the managers of Kaunas clinics, says that the hospital administration learned about this problem recently and has now started looking for solutions.

 

    The method of destruction is the manipulation of the work schedule

 

    Not only young but also experienced doctors face psychological violence in Lithuanian hospitals. The Laisvės TV study highlights key methods used to disrupt an unbehaving physician. One of the most common methods of mobbing is everyday schedule. Danutė Andriulienė, the head of the cardiology department of Šiauliai Hospital, suffered from the schedule of her line manager for two years. The hospital management illegally restricted her ability to perform her duties and she was forced to resign. "I can say: get up in the morning, brush your teeth, and feel sick, you can't brush your teeth. It was a humiliation, the crush was complete," - said the cardiologist. Finally, D. Andriulienė appealed to the Labor Disputes Commission and proved that she was forced to work in emotionally unhealthy working conditions. She received compensation of € 500. Remigijus Mažeika, the former head of Šiauliai Hospital, says that the hospital did not agree with the conclusions of the labor dispute commission, but they were not disputed out of respect for the doctor.

 

    Another method of psychological pressure is to change work schedules.

 

    Doctors often work in more than one hospital to earn a decent salary.

 

    So they desperately need a flexible work schedule. And that gives extra power to their managers, who can use schedules as a means of pressure. If the doctor does not suit his / her supervisor, his / her work schedule may be arranged in such a way that additional work, studies or raising children becomes impossible. “Because I was studying, I said from the beginning that I wanted to work nights and days in a row to simply have more of those holidays. They made me work for days from Monday to Friday, ” - says Jurga, an assistant nurse working in a Vilnius hospital.

 

    Crying surgeon request: allow surgery

 

    Deprivation of surgery or patients from another doctor is another common method of psychological violence. "One surgeon from an adjacent ward tried to kill himself precisely because he was deprived of all operations," -  says A. Gerliakienė, the head of the Medical Movement. Lina, who worked in the Vilnius Medical Institution, tells a similar story: “I saw a surgeon standing at the door of his Department head's office and begging him to have more surgery. The request ended in tears. The male surgeon cried. And says: I have a family, I have children, give me a job. And the head replies: Go away from my office.”

 

    The study tells a specific story when two surgeons from Klaipėda University Hospital were left without surgery because they were critical of the management of the pandemic at that treatment facility. In retaliation, one of the surgeons was overwhelmed with official warnings.

 

    The leader's command to the team is to ignore one colleague

 

    There are also cases when the managers of a medical institution turn one unbehaving doctor into a target for the whole team. "When you come to work, you say 'hello', but if there is a boss, all the colleagues even turn away," says psychologist Janina, who worked in Šiauliai. "You go alone and see that everyone is somehow avoiding you, they are afraid to communicate." Although Janina initially rejected the offer, she eventually decided to leave the job, unable to endure the psychological pressure and reduction in number of patients. "One employee went to the office secretly, the one with whom we agreed very well. Imagine: see if anyone sees, comes to my office, hugs, kisses, wishes to have a good road, a good life. And when she needs to leave the office, she says: open the door, see if anyone can see it,” - says Janina.

 

    Classical threat - audit threat

 

    Sometimes, in order to get rid of an unbehaving doctor, efforts are made to find even the slightest medical errors. Then even a trifle can make a doctor lose his job. Last year, Izabelė Juškienė, a family doctor at Antakalnis Polyclinic, was fired. During the pandemic, she headed outpatient fever clinics where COVID-19 tests were performed. One of the tests was not delivered to the laboratory on time. It was decided that this was a grave violation and Izabelė was fired. The secret audio recordings held by Laisvės TV reveal how Evaldas Navickas, the director of Antakalnis Polyclinic, was pressuring just before her dismissal. "There are two options," - E. Navickas said in the recording. - "Either you write a request and quit voluntarily (you don't have to smile here, there's a very serious offer here), or we'll actually do an audit that will put you to shame in this office." She applied to the Labor Disputes Commission and achieved a kind of victory there - Antakalnis Polyclinic concluded a peace agreement with the doctor. The serious violation allegedly committed by the doctor was revoked, and the grounds for dismissal were changed to dismissal by consensus. Antakalnis Polyclinic also paid compensation of about 20 thousand euros. Rūta Vanagienė, a representative of Antakalnis Polyclinic, stated that after concluding a peace agreement with the doctor, both parties had signed a confidentiality agreement, so they could not comment on the situation.

 

    Most doctors feel burnout

 

    Surveys of doctors show that more than 60 percent Lithuanian medics need however do not seek psychological help. They are afraid that this will be known at work and that they will be ashamed of it. 

 

"A person can get involved in tunnel thinking when he no longer sees another way out, because for him his specialty, his field, his choice is the only visible option. If you receive the right help from the environment or decide to seek that help yourself, you can get out of that tunnel thinking, see everything more widely and choose another path,” - said Kristina Norvainytė, President of the Young Doctors Association.

 

    Surveys show that 63 percent feels mild to moderate psychological burnout.

 

    According to experts, the widespread burnout among doctors makes medical services unsafe. "It seems 27 percent mortality rate in hospitals is due to the fact that employees experience mobbing,” - says A. Gerliakienė.

 

    After questions from journalists - lawyers threatening doctors

 

    Many of the medics interviewed by Laisvės TV were afraid to speak in public. They were afraid to be recognized by the persecutors, they were afraid of revenge. It is an uncommon practice for doctors to make a written commitment to remain silent about hospital problems. Sometimes even doctors who have won legal disputes cannot tell about the psychological violence they have experienced because they sign confidentiality commitments on labor dispute commissions. 

In one case, they have received letters from expensive lawyers representing hospitals. A concrete example: on the same day that the journalists of Laisvės TV wrote a letter to the Antakalnis polyclinic and asked about the doctor I. Juškienė, who was fired due to one COVID-19 test, the polyclinic immediately sent a threatening letter to the doctors. "We remind you of your commitment not to disclose or comment on confidential information," -  the threatening letter said. "If you find that you are in breach of this obligation, Antakalnis Polyclinic will defend our rights in accordance with the law: we will apply to the court asking you to pay a fine of 10 thousand euros."

 

    This may be one of the reasons why we know so little about psychological violence in hospitals. Doctors are systematically intimidated and punished for talking about their problems. And it's for taxpayers' money."

 

 


 

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