What We Can Do Together to Fight Sexual Harassment in Medicine

Gregory A. Hood, MD

Disclosures

June 13, 2018

In This Article

The Pace of Change Is Quickening

In the healthcare professions, we're committed to being of service to others, to maintain a higher standard, and, above all else, to do no harm. There may be no greater abrogation of our responsibilities than to commit an infraction of a personal, sexual nature upon another person. Equally bad would be to witness another person engaging in such activity without taking appropriate action in response. Therefore, I welcome Medscape's comprehensive and detailed study of healthcare providers' harassment experiences in the sense that it allows us a greater understanding of the larger environment we currently work in and what, perhaps, we can do to better protect ourselves and our colleagues.

Of course, sexual harassment, abuse, and misconduct have existed within human interactions since time beyond measure. However, the range of such behaviors, the perceptions and degree of acceptance of them, and a victim's recourses have varied greatly, even throughout my own lifetime. This significant change in awareness may, in and of itself, be cause for hope in seeking fundamental changes in the rates of such unwanted encounters in the future.

As an example, in my past lectures on domestic violence I would refer to statistics which reflected that rates of violence against women in Mexico have long been at high levels. But even there, things are now beginning to change, as thousands of men and women have recently marched through the streets of Mexico City to protest violence against women.[3]

Given the pace of change of discourse over the past couple of years, it was wise to focus on instances that have occurred over the past 3 years. Because of this, the study adeptly focuses a bright beam of scrutiny on the current experiences of abuse, harassment, and misconduct among healthcare professionals, experiences which have for so long been obscured by long shadows of shame, fear, and inaction.

Certainly, just because we are looking at the current climate, it shouldn't be perceived as diminishing the lifelong impact of sexual misconduct or abuse suffered at any age and no matter how long ago. In my internal medicine practice, the frequency with which patients confide or admit to me that they've experienced—or are currently experiencing—sexual abuse is sobering. The reverberations or scars from such experiences may affect the victim's health, and the costs of medical care, for decades to come.

Unwanted actions such as those detailed in the report are unacceptable when the interaction is between strangers, acquaintances, or coworkers, but keep in mind that this aberrant behavior is also being regularly forced upon spouses, significant others, and/or romantic partners. The line for what constitutes abuse, unwelcome harassment, or misconduct isn't erased just because someone consents to be with someone else. Whether the unwanted contact is a comment, pressure to have sex, or the use of threats in return for sex, the nature of the personal and ethical violation is the same. In addition, gaslighting, ambient abuse, and other forms of relationship abuse, sometimes culminating in rape, remain all too common.[4]

Both Sexes Are Reluctant to Report Harassment

It comes as no surprise, in the Medscape survey and in other reports on sexual harassment, that women have been predominantly the victims. But although the percentage of physicians harassed was small, it was found that some 25% of those who said they had been harassed by other physicians were men. And that number could actually be higher, because many men are embarrassed to report unwanted advances. Anecdotally, I know of plenty of cases of same-sex physician harassment, so this statistic doesn't surprise me.

The reluctance to report sexual harassment cuts across both sexes. Overall, only 40% of the physicians who responded to the Medscape survey and said they had been harassed actually reported the incident. In my experience, it seems that the rates of reporting don't appear to be trending much lower among current house staff, but some of this could be related to changing mores in the interpretation of what qualifies as abuse, harassment, or misconduct, as well as intergenerational differences in perception.

However, while so many physicians who responded to the survey reported that they were victims of sexual abuse, very few doctors—even in this confidential, anonymous survey—agreed with their accuser that they had crossed a line. Yes, some of these accusations turned out to be false or fabricated, but it's hard for me to believe that in this day and age so many doctors remain tone-deaf to their own actions and in denial about how these transgressions ultimately affect the people who are brave enough to speak out against them.

Unfortunately, despite this generation's willingness to talk about sexual harassment issues, many inappropriate actions continue, and the lack of empowerment to respond to the alleged perpetrators persists for a wide variety of reasons.

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