ObjectivesTo estimate prevalence of and factors contributing to bullying among senior doctors and dentists in New Zealand’s public health system, to ascertain rates of reporting bullying behaviour, perceived barriers to reporting and the effects of bullying professionally and personally.DesignCross-sectional, mixed methods study.SettingNew Zealand.ParticipantsMembers of the Association of Salaried Medical Specialists (40.8% response rate).Main outcome measuresPrevalence of bullying was measured using the Negative Acts Questionnaire (revised) (NAQ-r). Workplace demands and level of peer and managerial support were measured with the Health and Safety Executive Management Standards Analysis tool. Categories of perpetrators for self-reported and witnessed bullying and barriers to reporting bullying were obtained and qualitative data detailing the consequence of bullying were analysed thematically.ResultsThe overall prevalence of bullying, measured by the NAQ-r, was 38% (at least one negative act on a weekly or daily basis), 37.2% self-reported and 67.5% witnessed. There were significant differences in rates of bullying by specialty (P=0.001) with emergency medicine reporting the highest bullying prevalence (47.9%). The most commonly cited perpetrators were other senior medical or dental specialists. 69.6% declined to report their bullying. Bullying across all measures was significantly associated with increasing work demands and lower peer and managerial support (P=0.001). Consequences of bullying were wide ranging, affecting workplace environments, personal well-being and subjective quality of patient care.ConclusionsBullying is prevalent in New Zealand’s senior medical workforce and is associated with high workloads and low peer and managerial support. These findings help identify conditions and pressures that may encourage bullying and highlight the significant risk of bullying for individuals and their patients.

ObjectivesTo explore the prevalence of, and associated factors contributing to burnout among senior doctors and dentists working in the New Zealand's public health system.DesignCross-sectional, mixed methods study.SettingNew Zealand's 20 district health boards (DHBs).ParticipantsA total of 1487 of 3740 senior doctors and dentists who are members of the Association of Salaried Medical Specialists working in DHBs were recruited (response rate 40%).Primary and secondary outcome measuresGender, age, self-rated health status, vocation and hours of work per week were obtained from an electronic questionnaire. Burnout was measured using the Copenhagen Burnout Inventory. Qualitative data taken from an open-ended comments section was coded using grounded theory and used for contextual data.ResultsThe overall prevalence of high personal burnout was 50%. Women aged <40 years had 71% prevalence of high personal burnout. Prevalence of high work-related burnout and patient-related burnout was 42% and 16%, respectively. Those working in emergency medicine and psychiatry had significantly higher mean work-related burnout than other specialties (p<0.001). On multivariate analysis, having fair or poor health status (OR 10.8, 95% CI 6.8 to 17.1), working more than 14 consecutive hours (OR 1.43, 95% CI 1.12 to 1.82) and being a woman (OR 2.14, 95% CI 1.68 to 2.73) were independently associated with high personal and work-related burnout. Personal burnout rates decreased with age (age 30–39 OR 2.86, 95% CI 1.78 to 4.59, age 40–49 OR 2.45, 95% CI 1.70 to 3.55, age 50–59 OR 1.70, 95% CI 1.17 to 2.46, compared with age>60). Qualitative data emphasised intense and unrelenting workloads, under-staffing, onerous on-call duties and frustrations with management as factors contributing to burnout.ConclusionsHigh burnout appears prevalent in New Zealand's senior doctors and dentists. Many attribute their feelings of burnout to work conditions. These findings may assist with understanding contributors to burnout and with developing strategies to ameliorate the high burnout found across this cohort.

This paper examines how CCTV-assisted bird-watching mediates people's relationship with a particular representation of an animal world. By focusing on people's interpretations and responses to CCTV camera technology at three bird-watching sites around Scotland, it is argued that the use of CCTV technology represents a qualitatively different mode of engaging with birds which has bearing on how this mediated animal world appears in and to people's everyday lives. It is asserted that the spatial relations invoked in the act of looking at birds through a CCTV lens inscribe a conceptual hyper-separation between see-er and seen that serve to normalise a vision of humanity inherently separate from and dominant over the wildlife on screen. As a technologically mediated way of seeing, the paper explores the use of CCTV cameras as inscribing particular 'ways of being' that serve to define and limit people's conduct towards the birds on view. By drawing attention to the conservation discourses that support, and are supported by the use of CCTV-assisted bird-watching, it is argued that the notion of 'keeping an eye on nature' is embedded in a cultural agenda that assists with the construction of nature as tele-visual commodity.

Background Demand for mental health services in New Zealand and internationally is growing. Little is known about how psychiatrists are faring in this environment. This study aimed to investigate wellbeing of psychiatrists working in the public health system in New Zealand, identify the main risk factors for work-related stress, gauge perceptions of how workload has changed over time, assess job satisfaction and whether individuals intend or desire to leave their work. Methods Psychiatrists working in New Zealand who were also members of the Association of Salaried Medical Specialists were invited to participate in an online survey. Main outcome measures were degree of burnout and stress experienced at work. Supplementary measures included perceived workplace demands and levels of support. Predictor variables included perceptions of changes to workloads over time, degree of job satisfaction and intentions to leave work. Logistic regression assessed characteristics associated with burnout and job satisfaction as well as intentions to leave work. Free text comments were analysed thematically alongside quantitative trends. Results 368/526 responded (70% response rate). 34.6% met the criteria for burnout and 35.3% scored with high work stress. There were no significant patterns of association with demographic variables but significant correlation with all but one predictor variable; having experienced a change to the demands of the on-call workload. 45% agreed they would leave their current job if able and 87% disagreed that they are working in a well-resourced mental health service. Respondents emphasised the impact of growing workloads and expressed concerns about their ability to provide optimal care in these circumstances. Conclusions High burnout appears to affect one in three psychiatrists in New Zealand. Many attribute their feelings of burnout to demand for their services. These findings may assist with better workforce planning for psychiatry and emphasises potential consequences of demand for and poor resourcing of mental health services for the retention and wellbeing of doctors in psychiatry worldwide.

ObjectivesTo estimate the gender gap in hourly wages earned by medical specialists in their main jobs after controlling for age, number of hours worked and medical specialty.DesignObservational using governmental administrative and survey data.SettingNew Zealand public employed medical workforce.Participants3510 medical specialists who were employed for wages or a salary in a medical capacity by a New Zealand district health board (DHB) at the time of the March 2013 census, whose census responses on hours worked were complete and can be matched to tax records of earnings to construct hourly earnings.Main outcome measuresHourly earnings in the DHB job calculated from usual weekly hours worked reported in the census and wage or salary earnings paid in the month recorded in administrative tax data.ResultsIn their DHB employment, female specialists earned on average 12.5% lower hourly wages than their male counterparts of the same age, in the same specialty, who work the same number of hours (95% CI 9.9% to 15.1%). Adding controls for a wide range of personal and work characteristics decreased the estimated gap only slightly to 11.2% (95% CI 8.6% to 13.8%). At most, 4.5 percentage points can be explained by gender differences in experience at the same age.ConclusionsMale specialists earn a large and statistically significant premium over their female colleagues. Age, specialty and hours of work do not appear to drive these wage gaps. These findings suggest that employment agreements that specify minimum wages for each level of experience, and progression through these levels, are insufficient to eliminate gender wage gaps between similar men and women with the same experience.