COMMENTARY

Docs Ignore Sexual Harassment: What Happened to Do No Harm?

Alok S. Patel, MD; Natalie M. Crawford, MD; Pamela Mehta, MD

Disclosures

March 26, 2021

This transcript has been edited for clarity.

Alok S. Patel, MD: Doctors take an oath, and there's a phrase we use to keep one another in check: "First, do no harm." Yes, sometimes harm is done to our colleagues and it goes unreported, or it's swept under the rug when it is reported. Many healthcare professionals have experienced this harm, and it's sickening how commonplace it's become. I'm talking about sexual harassment.

Recently, there have been a lot of headlines about sexual harassment because of a lawsuit at Oregon Health & Science University (OHSU). Some people are shocked by this. Sadly, others aren't. The inspiration for this video actually came from what I heard from Dr Natalie Crawford, a reproductive endocrinologist and host of the As a Woman podcast.

Natalie M. Crawford, MD: When the news of the "TikTok Doc" scandal broke, everybody said they were surprised, but I wasn't. I knew this was the reality for women in medicine.


 

I posted on Instagram and asked my followers to share their stories. That way, everybody could read the words from women who've been objectified, sexually harassed, and abused, all while they were told to be quiet, cover it up, and not report it or their future career would be on the line. I had hundreds of messages — so many that I couldn't even get to share them all.

Patel: I saw several of these messages and they're horrific. We're at a point where awareness and even a clear process for victims to report incidences aren't enough. Take a look at the allegations against the "TikTok Doc." The $45 million lawsuit alleges that OHSU didn't even report the incident, and it implicates several faculty members who were supposed to be advocates. This all really riled up the medical community, and for good reason. Here again is Dr Crawford.

Crawford: It's so hard to read how this culture of medicine is letting down our women; how bystanders are standing by, doing nothing; how silence is acceptance; and how other women in power — reporters who are supposed to stand up for those victims — let them down time and time again. It's time for things to change.

Patel: There was a clear violation of Title IX. A victim reported the harassment to the right people. According to the affidavit, "OHSU's ongoing violations of the mandatory reporting rules paved the way for the plaintiff to be sexually harassed and assaulted by Jason Campbell the following year." And, according to the lawsuit, the mandatory reporters didn't report it.

Here's a comment a registered nurse posted on a Medscape article: "OHSU does not condone behavior as described in the lawsuit...Yes, actually they do."

If institutions don't hold perpetrators accountable and stop burying these harassment cases, what's the point of reporting?


 

According to data presented at the Women in Medicine Summit, among those who were sexually harassed and didn't report it, 40% said they didn't because they didn't think there'd be any impact. Twenty-one percent said they felt too embarrassed or ashamed. According to Dr Pamela Mehta, an orthopedic surgeon, victims aren't always reassured when they report harassment cases.

Pamela Mehta, MD: One of the most disheartening aspects of our culture of medicine is that when a woman is courageous enough to report her sexual harassment or discrimination, she often isn't heard. Not only is she not heard, but she's also blamed, and sometimes there is retaliation. This culture has got to change. There is no way that women can feel safe if they don't feel that they can report and be heard and actions will take place.

Patel: Dr Arghavan Salles wrote an article titled "Sexual Harassment Is Still the Norm in Health Care" a couple of years after the #MeToo movement went viral. As a female surgeon, she outlined the pay gap, sexual abuse, and the toll it takes on a healthcare professional as they're trying to take care of patients while simultaneously dealing with harassment. She hoped the healthcare industry would catch up to the #MeToo movement. She wrote this article in 2019 — it's been 2 years.

I don't think we made the progress we all envisioned and hoped we would. There are plenty of polls, surveys, studies, and personal stories demonstrating that sexual harassment by another healthcare professional is still shockingly widespread — or as Dr Salles puts it, the norm.

Dr Mehta feels that the "grin and bear it" culture of medicine plays a part, and I think many would agree with her.

Mehta: As medical students and residency trainees, we're taught, both females and males, to put your head down, make no noise, cause no waves, and make no demands. This is a terrible setup if you're faced with sexual harassment and discrimination. Oftentimes, females in medicine and surgery are facing these challenges. As an orthopedic surgeon, I make up only 6% of women in that field. So, when I was training, there were definitely encounters that I faced like this.

Patel: Clearly, we have work to do, and there needs to be some type of massive reckoning beyond what's currently happening. TIME'S UP Healthcare was founded to support survivors when they come forward about any type of sexual assault, abuse, or harassment.

Well, a founder of TIMES UP Healthcare is named in this lawsuit against OHSU. Several other prominent women physicians resigned from the organization. They took to social media and, using the hashtag #Istandwithsurvivors, many of them voiced concern about how the organization handled these recent events and said they wanted to support victims and change the culture, but by other means.

We can't let this be a mainstay in the culture of medicine. A zero-tolerance policy needs to mean exactly that. Here are some final thoughts from Drs Crawford and Mehta.

Crawford: The first thing that has to happen is victims need to feel empowered to share their stories without fear of retaliation in their career. There need to be clear guidelines for what gets reported to whom and the action steps that are going to be taken. There should be a written trail. Nobody should ever be able to say, "My program director told me to let it go or not report it." Every incident that gets reported needs to be investigated. There should be zero tolerance because what happens is that this abuse only magnifies. It gets worse throughout a person's career and leaves lasting trauma on the victim.

If the perpetrator is allowed to continue on in medicine, are we to think that this will not get worse as more victims start to come forward?

Mehta: The key to this is going to be launching investigations for every claim made and protecting the person that makes the claim. We need to be less concerned about the person the claim is made against and more for the person that makes the claim. It takes a great deal of courage, especially in healthcare, to make those claims. If we can dismantle the system and start there, I believe there will be a lot less sexual harassment and discrimination because people will know that they can't do that and they have to be held accountable for it.

Patel: And with that, I'm going to turn it over to all of you to share your thoughts, stories, frustrations, and ideas for how we can finally fix this wretched dark side of healthcare we let exist for far too long.

Alok S. Patel, MD, is a pediatric hospitalist, television producer, media contributor, and digital health enthusiast. He splits his time between New York City and San Francisco, as he is on faculty at Columbia University/Morgan Stanley Children's Hospital and UCSF Benioff Children's Hospital. He hosts The Hospitalist Retort video blog on Medscape. Follow Alok Patel on Twitter.

Natalie M. Crawford, MD, is an assistant clinical professor in the department of women's health at the University of Texas Dell Medical School. She is director of patient experience and outreach, and co-founder of Fora Fertility, a boutique fertility practice in Austin, Texas. She also hosts the As a Woman podcast and her YouTube channel, "Natalie Crawford, MD," with the goal of empowering women through education. Follow Dr Crawford on Instagram, TikTok, and Twitter, and visit her blog.

Pamela Mehta, MD, is a board-certified orthopedic surgeon who specializes in the diagnosis and treatment of all orthopedic conditions. Her compassionate manner and excellent surgical skills have earned her multiple accolades, including being named the chief of orthopedics and national orthopedic director for Surgical Affiliates Management Group. She founded Resilience Orthopedics to allow her to take care of patients on a more individual and personal level. Follow her on Instagram and TikTok.

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