Determinants of doctor-doctor relationships among academic and clinical staff at a university hospital, Cairo, Egypt: a mixed method study

Abstract

Background

Good work boosts mental health, self-esteem, and earnings, while physicians are more likely to experience burnout and dissatisfaction with work-life balance, leading to decreased productivity. This study aimed to identify the factors shaping the relationship between medical staff in academic and clinical departments and to describe the overall working environment.

Methods

The current study was conducted among demonstrators/residents, assistant lecturers, and lecturers from academic and clinical departments of a tertiary care hospital in Cairo, Egypt. Mixed methods were used. For the quantitative part, a comparative cross-sectional study was conducted on 228 clinical and 89 academic participants. The Doctor-Doctor Relationship and Workplace Environment Evaluation Scale (DDRWEE) was computed using 18 statements with a 3-point Likert scale. For the qualitative part, 16 in-depth interviews were conducted with 8 clinical and 8 academic participants.

Results

The mean age of academic staff was 32.8 ± 4.5 versus 30.9 ± 4.2 for clinical staff. The factors decreasing the DDRWEE Score were being clinical staff, weak scientific advantages from colleagues, weak practical advantages from seniors, weak ethical advantages from seniors, and thinking of resignation or changing career. For the qualitative part, six themes were generated: Factors affecting relations with colleagues both specifically and generally; Reliability of the statement: “When I become a senior, I will treat juniors the same way I was treated”; Causes of strained relationships between colleagues and reflections from personal experiences; Factors that enhance colleague relationships and reflections from personal experiences; Behavior of colleagues in the department when someone faces accountability: and Qualities of an ideal doctor and suggestions for creating a better doctor-to-doctor work environment.

Conclusion

The study emphasized the importance of creating a supportive academic and professional environment for medical staff, addressing their practical and emotional needs. This research suggests that while the DDRWEE score has good internal validity, external validation is needed for its wider applicability.

Limitations

The study’s generalizability to Egyptian physicians is limited due to sample convenience, the need for external validation of the DDRWEE score, and potential reporting bias due to the self-administered questionnaire.