#MeToo: Addressing Sexual Harassment in Health Care

#MeToo: Addressing Sexual Harassment in Health Care


No more secrets: the outpouring of victims’ stories has impacted every profession, including medicine

We’re in the midst of a movement no one wanted to be a part of. This moment was “borne of a very real and potent sense of unrest,” stated TIME in its Person of the Year issue. In a surprising but timely move, the magazine chose as this year’s “person” a group of women, and a few men, who have come forward to speak about their sexual harassment and abuse. They have been dubbed “The Silence Breakers.”

As more accounts of sexual harassment have surfaced, “CEOs have been fired, moguls toppled, icons disgraced.”

Movie stars, migrant workers, corporate executives, and health care workers are among the group that has launched this powerful movement. Noted TIME: “in the past two months alone, their collective anger has spurred immediate and shocking results: nearly every day, CEOs have been fired, moguls toppled, icons disgraced. In some cases, criminal charges have been brought.” The harsh spotlight has also been turned on doctors.

Olympic gymnast Aly Raisman is one of several gymnasts to accuse the team doctor of sexual assault. He is currently in jail.

An accusation that has sent shock waves through the medical community is that of Olympic gymnast Aly Raisman, one of several U.S. gymnasts who have accused the team doctor, Lawrence G. Nassar, M.D., of molesting them for years. On Dec. 7, the New York Times reported that Dr. Nassar pleaded guilty to sexually abusing gymnasts and was sentenced to 60 years in prison on separate child pornography charges.

The #MeToo movement

Why is this happening now? And why are an unprecedented number of victims coming forward? Social media has played a major role. According to TIME, Tarana Burke, founder of a nonprofit that helps survivors of sexual violence, created the Me Too movement in 2006 to encourage women to show solidarity with one another. It went viral this year after actor Alyssa Milano used the hashtag #MeToo on social media.

Since then millions of people have come forward with their stories about the “inappropriate, abusive and in some cases illegal behavior they’ve faced,” stated TIME. “When a movie star says #MeToo, it becomes easier to believe the cook who’s been quietly enduring for years.”

The layers of privacy health care requires may have shielded the industry from public claims of sexual harassment and abuse – but that is no longer the case.

A reporter’s alarming discovery about doctors and sex abuse

Last year an investigative reporter for the Atlanta Journal-Constitution (AJC) made a shocking discovery: Two-thirds of Georgia doctors who have been disciplined for sexual misconduct with patients were allowed to resume practicing medicine. To see if this was an anomaly, the AJC expanded its scope to the rest of the country, and analyzed more than 100,000 medical board orders relating to disciplinary action against doctors since 1999.

Last year, an Atlanta Journal-Constitution investigation uncovered “disturbing acts of physician sexual abuse in every state.”

The documents described “disturbing acts of physician sexual abuse in every state. Rapes by OB/GYNs, seductions by psychiatrists, fondling by anesthesiologists and ophthalmologists, and molestations by pediatricians and radiologists,” stated the AJC’s website. Their findings turned into a five-part series, Doctors & Sex Abuse, and the newspaper created a hashtag, #DoctorSexAbuse, to spread the word about the investigation.

One of the most insidious aspects of doctor-patient abuse is the veil of secrecy that surrounds it, the AJC found. Hospitals and health care organizations often “brush off accusations or quietly push doctors out … without reporting them to police or licensing agencies. Physician-dominated medical boards gave offenders second chances. Prosecutors dismissed or reduced charges, so doctors could keep practicing and stay off sex offender registries. Communities rallied around them.”

The AJC noted that sexual abuse cases in health care are not as rare as one would hope. “While the vast majority of the nation’s 900,000 doctors do not sexually abuse patients, the AJC found the phenomenon is akin to the priest scandal: It doesn’t necessarily happen every day, but it happens far more often than anyone has acknowledged.”

Make sure that you and your staff are familiar with the American Medical Association Code of Medical Ethics, particularly as it relates to providing patients with appropriate gowns, private facilities for undressing, sensitive use of draping, and having chaperones available for any patient who requests one.

When doctors are the victims

As we all know by now, sexual harassment and abuse is not limited to men victimizing women, or to doctors preying on patients. In a previous post, we discussed how female doctors could handle patients who are “a little too friendly,” and shared physician Elaine W. Joslyn’s response when confronted with a patient who makes inappropriately flirtatious comments: “I immediately redirect the conversation back to the patient’s medical issue.”

Of course, redirecting is not the answer to outright harassment or abuse. But what is the best course of action for victims? Far too often, the victims themselves are blamed. On KevinMD.com, pediatrician Melanie Tioleco-Cheng shared her account of being the victim of sexual harassment by an elderly patient as a medical student. She wrote that she was “trapped” and “interrogated” by the hospital where she worked. “I was so appalled that I was being blamed for Mr. X’s misogyny.”

Unfortunately, too many doctors also report being victims of sexual harassment by colleagues. This includes what some might consider “harmless” nicknames like “honey” or “sweetheart,” or unwanted touching on the arm, as psychiatrist Maria Yang wrote about in another post on KevinMD.com.

As many as 60 percent of women experience sexual harassment on the job, including doctors.

In 1993, the New England Journal of Medicine cited a study that found nearly 75 percent of female medical residents reported harassment — sometimes by patients, but primarily by male physicians. Sadly, things haven’t changed as much as one would hope in more than two decades. A 2016 study published in the Journal of the American Medical Association found that nearly 30 percent of women in academic medicine experience sexual harassment.

Other sources say the numbers are even higher. Medical Economics reported that at least one in four women and as many as 60 percent of women in some professions experience sexual harassment on the job, including doctors.

The stakes are too high to ignore this issue

This is not an issue that can be solved with a list of quick tips or best practices. But having a clear anti-harassment policy in place and posting it in your office is a good place to start. More than that, though, there needs to be a commitment from the very top of the hospital or health care organization, Emily Martin of the National Women’s Law Center told Medical Economics.

“Leaders need to be vocally and publicly committed to ensuring that … there will be real remedies and prompt action in the event of sexual harassment.”

“Leaders need to be vocally and publicly committed to ensuring that a workplace is respectful and that there will be real remedies and prompt action in the event of sexual harassment,” said Martin. This includes having “clear complaint procedures, plus a variety of ways they can complain, so it’s not just going through a supervisor.”

We don’t need to tell you that now more than ever, the stakes are high. Your practice can’t afford to ignore the issue of sexual harassment. If you don’t address it, the victims might—on social media. “One of the painful things about the situation is that there wasn’t any clear action,” wrote Dr. Tioleco-Cheng of her harassment in medical school. “Should we have sued the hospital? Gone public? Gone to a trusted advisor in the medical program for help? In retrospect, it seems clear: Demand a better response from the normal channels, and if that doesn’t work, go public.”

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