Workplace Harassment: The Acumen of a Submissive Fact in Dentistry

The structure of the dental profession provides unique opportunities for both women and men to exercise a high degree of autonomy and flexibility and at the same time, enjoy the status awards associated with being a healthcare provider. Hence, dentists too encounter numerous sources of professional stress, beginning from the dental college. This stress can have a negative impact on their personal and professional lives. Of all workplace stress; bullying and harassment create a special danger as they operate destructively affecting the person’s physical and mental wellbeing. Hence, this review is to give an insight about the workplace harassment, its short and long term deleterious effects& the legal aspects.


Workplace Harassment: The Acumen of A Submissive Fact In Dentistry
With the crumbling economy, slashing jobs, and sinking home values, world has become more competitive. We live in an increasingly complex world where work weeks seem to be getting longer, not shorter. This struggle to survive and succeed leads to enormous occupational stress in life [1,2]. A survey in India has reported 48% of people have experienced workplace harassment or other [3].

Challenges in Dentistry
Dentistry is a profession dominated by men, but over the last 40 years the proportion of women is increasing steadily raising the question about the effect of feminization in this profession [3,4]. Workplace gender discrimination is illegal in several countries, it is prohibited by Civil Rights Act and was also addressed in academic settings [5][6][7]. Still, research during past 20 years overall in the world have revealed sexual harassment being widespread in general society and in higher education, health profession education, and dental education [4,[8][9][10][11][12][13][14]. Dentists are prone to professional burnout, anxiety disorders and clinical depression, owing to the nature of clinical practice and the personality traits common among those who decide to pursue careers in dentistry [12].

Workplace Environment
Job stress is often confused with job challenge, but these concepts are not the same. Challenge energizes people psychologically and physically, and it motivates to learn new skills and master the jobs. Challenge is an important ingredient for healthy and productive work [11]. When a challenge is successfully met, people feel relaxed and satisfied. Hence a little stress is essential to reach the goal. If stress exceeds, it is devastating & unbearable [1].
To be specific, workplace stress is the harmful physical and emotional response which occurs when there is a poor match between job demands and the capabilities, resources, or needs of the employees [12]. Of all the stressors working in an individual's life, job stress is one of the leading stressor.
Initially, job stress vary from mild irritability, mood changes and short temper to extreme measures like committing suicide [1].

Career concerns
Instability with the career or the profession can lead to internal competition leaving a room for insecurity.

Environmental conditions
High demanding work atmosphere creates a more stress compared to friendly working conditions.

Salaries & Wages
Financial balance with the work is very much required for the one to work. More work and less pay will lead to dissatisfaction causing stress.

Social change
Acceptance among the society due to many internal conflicts can also be a source of stress in this changing social environment.
A study has stated occupation-related stressors are based on two dimensions: Task or organization and interpersonal relations [9]. Burnout is defined by three coexisting characteristics-exhaustion mentally or emotionally, depersonalization or dehumanization, and dissatisfaction with their accomplishments and to evaluate themselves negatively [13][14][15][16]. Along with all these factors, harassment of any kind enhances the stress further.

Harassment
Harassment is any improper and unwelcome conduct reasonably expected or is perceived to cause offense or humiliation to another person. Harassment may take the form of words, gestures or actions which tend to annoy, alarm,

Types of Harassment
Though Indian law speaks significantly about sexual harassment at the workplace, harassment against the employees is not restricted to the sexual alone [9]. There are various categories covered under the purview of harassment at the workplace against the employees due to which the workers have to suffer humiliation, often exploited by their respective supervisors or colleagues.
So, harassment at workplace can be differentiated into various dimensions which are as follows [9]:

Sexual Harassment and General (Non-Sexual) Harassment
Majority of the people believe in the common notion that harassment at workplace can be sexual harassment only.

General Harassment
Generalized harassment has been studied under various labels which differ in emphasis on aspects of the behaviors in question (i.e., duration, motivation, or power differences). These encompass verbal aggression, disrespectful or exclusionary behavior, isolation/exclusion, threats or bribes, and physical aggression, without explicit reference to duration of experiences, perpetrator motivation, or the power relationship between perpetrator and target and that are not obviously related to legally protected characteristics (e.g., gender, race/ethnicity, age, disability). Prevalence rates of nonsexual hostile workplace behaviors have been found to be 30% or higher for men and 55% or higher for women [7].
Workplace harassment remains a salient workplace problem for all irrespective of the genders.  [20].

Difference Between Bullying and Harassment
While these two definitions may sound very similar, how the law deals with them is very different.
There are two key differences between bullying and harassment

Legal Aspects Related to Harassment in India: [21]
When harassment is based on person's race, color, national origin, sex, disability, or religion it is considered a violation of the person's civil rights [15].
Indian labor laws cover many acts under its purview. Currently there are no laws against bullying, whereas sexual harassment or harassment related to caste/ creed/ race/ ethnicity are punishable. But general harassment which can also be done by subordinates comes under neither bullying (as it is not in higher ranking hierarchy) nor harassment with specific reason (discriminatory harassment) hence escapes from the law.
To enjoy satisfying professional and personal lives, dentists must be aware of the large part of effective practice management is to understand the sources and implications of stress, and tackling it in an effective manner.

Measures to be Taken at Workplace
A dental institution or office should have an office policy where the definitions are clearly defined along with the job role/description of employees and they were made aware of the same.
A friendly atmosphere along with teamwork spirit to achieve institutional target lies in an effective management skill by a head / team leader. Transparent communication with the employee builds strength of the institution.
To facilitate a gender-sensitive and congenial working environment at dental colleges, so women at the work place are not subjected to gender specific discrimination or sexual harassment, along with a woman's grievances and Empowerment cell should be formed.
A general committee for grievances with nonbiased people should be formed where the employees can approach during time of need without any hesitation.

Conclusion
Of all workplace safety issues, bullying and harassment create a special danger because they operate so destructively in a cloud of conflicting perceptions about how human beings perform at work.
Both sexual & general harassments negatively influence various mental health outcomes such as depression, anxiety, hostility, alcohol and drug use. Hence, the entire structure of justice needs transformation giving equal importance to overcome general harassments along with sexual harassments which remain always submissive.