How can it be that parts of the medical sector, which should arguably have this country's most intelligent, well-educated and compassionate workforce, have such an appalling track record on bullying, harassment and sexual and racial discrimination?
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The release this week of a report showing junior doctors at the Canberra Hospital experience bullying, harassment, sexism and, to add insult to injury, "management failures" when they do complain, are the latest entries on a long, and disturbing, table of woes in some ranks of Australian medicine.
Medicine in 2015 appears to be coming to a similar point the Australian Defence Force reached in 2011, when after too many scandals it turned to the then sex discrimination commissioner, Elizabeth Broderick, for help in driving cultural change.
While the ADF would be the first to admit it still has a long way to go, four years of strong leadership from the top has sent a clear message down the line that bullying, sexism and misogyny are not acceptable.
The Royal Australasian College of Surgeons, hospitals and health services could all do a lot worse than adopt former chief of army Lieutenant-General David Morrison's pithy observation that "the standard you walk past is the standard you accept" as their new mantra.
As a 21st century paraphrase of Edmund Burke's "In order for evil to flourish, all that is required is for good men [and women] to do nothing", it is hard to beat.
As was the case in defence, the medical sector's troubles lay as much with the vast majority of non-abusers who turn a blind eye as it does with the bullies, harassers and sociopaths who are directly responsible.
Why do otherwise decent human beings tolerate repugnant behaviour to the extent where a Sydney surgeon, Dr Gabrielle McMullin, was moved to say earlier this year a young woman would have been better off accepting a senior colleague's sexual advances than complaining about his behaviour?
Dr McMullin was not endorsing the harassment; she was making the point the medical culture was so toxic any person who took a stand against abuse was punished, through professional ostracism, far more severely than the perpetrator would likely be.
An inquiry report, commissioned by the RACS in response to Dr McMullin's complaints, confirmed what she had been saying for years. Expert advisory group head Rob Knowles, a former Victorian health minister, admitted he was "surprised and disturbed" by the depth and entrenched nature of the bullying and harassment.
The report, made public last month, found 40 per cent of surgical fellows, trainees and international medical graduates had been bullied, almost 20 per cent had experienced discrimination and workplace harassment and 7 per cent had experienced sexual harassment.
Cultural discrimination, against people from non-Anglo, non-Christian ethnic and cultural backgrounds, was the most prevalent issue.
These findings, coupled with a well-documented culture of working trainees and interns to the limits of their endurance and beyond, paint a very unattractive picture of medicine as a career despite the financial and professional rewards it offers.
With a recent British study indicating a similar culture in that country has dissuaded women from seeking careers in surgery, this issue needs to be addressed to ensure future health care staffing targets are met, not just for reasons of natural justice alone.
Many of the passages identified in the latest report on the Canberra Hospital could have been cut and pasted almost directly from the RACS report, which came with an apology from college president David Watters, who said "too many of us have been silent bystanders".
Reasons advanced for this have an eerily familiar ring for anyone with any knowledge of the various scandals that have plagued orphanages, schools, defence colleges and other public institutions over the decades.
They include a view, by members of the old guard. that as they had been bullied and survived it was only reasonable for the latest entrants to be subjected to the same Darwinian behaviours.
This appears to be based on an early 19th century belief surgeons had to be psychologically tough to the point of almost total indifference to the suffering of the patient, physically strong enough to cut through the largest and hardest human bones with crude hand powered instruments, and able to complete major surgeries in the shortest possible time so shock didn't kill the subject.
Times have changed with medicine among the swiftest of all human fields of endeavour to adopt new technologies, which mean such traits are no longer mandatory.
We are now at a point where a similar effort needs to be applied to "rebooting" the psychological programming of the human element.
