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Medicine Has to Stop Sweeping Sexual Harassment Under the Rug

Rachel M. Bond, MD

Disclosures

August 13, 2021

Sexual harassment is prevalent in medicine, especially in male-dominated fields, such as cardiology. Despite the attention to this matter through such initiatives as TIME'S UP Healthcare and the JACC Case Report series on sexual harassment led by editor-in-chief, Julia Grapsa, MD, PhD, there has been limited public outcry for accountability.

Many of the accused are shielded or passed to other healthcare systems without major repercussions. This archaic and inappropriate culture of tolerance perpetuates a diffuse power structure that often leaves survivors and repulsed bystanders without support.

Although harassment can affect all, regardless of sex, gender, race and/or ethnicity, a disproportionate number of women in our field must climb over stumbling blocks of discrimination and harassment. Women of color and sexual- and gender-minority women experience more harassment (both gender and racial) than others. And in healthcare, the abusive treatment affects physicians, nurses, and advanced practitioners along with other allied healthcare workers.

While harassment is unacceptable in any setting, in healthcare, this undermining of women may inadvertently affect those they care for. Data suggest that patients taken care of by women have better outcomes than those who are cared for by men. Don't our patients deserve to be cared for by experts who can work autonomously at the top of their game, without being hampered by workplace harassment or discrimination?

Globally, women occupy 70% of the healthcare workforce, despite typically being paid 11% less than men and comprising only 25% of healthcare leadership and decision-making positions.

COVID-19 added insult to injury in terms of equity of women in healthcare, with the burden of frontline care falling to women. Discrimination not only undermines one's clinical integrity but also affects academic promotion and the means of gaining equitable wages. It ultimately reduces the talent pool by harming both survivors and bystanders.

Female-led organizations in healthcare and active leadership within several of our cardiovascular societies have offered solutions through their respective diversity, equity, inclusion, and belonging task forces.

These include tools to self-identify our own implicit biases and changes in how harassment is handled that challenge the victim-blaming culture by first believing the survivors, reporting incidents when they occur, not excusing an abuser's actions, and acknowledging the toll these situations may also take on bystanders.

The lack of acknowledgement, along with lack of accountability for the accused, have made it difficult to overcome these injustices to date. Many women in medicine believe that such negative experiences are the status quo or, worse yet, a rite of passage.

I don't believe that this epidemic can be corrected by one martyr or trailblazer. To be one of a few women who has a seat at the table can be challenging out of fear of being labeled as "abrasive" or "difficult." To create a diverse, inclusive, equitable environment where we can all belong, we need to hold everyone culpable for their actions and promote intolerance of harassing and bullying behaviors.

Such an environment requires a culture of transparency and accountability with strict implementation policies and disciplinary consequences, including appropriate remediation measures. And most important, we need to develop a support system for survivors and bystanders alike to help change the organizational climate and decrease the incidence of harassment in our field.

For us all to excel without fear of retaliation, we must begin to be comfortable with the uncomfortable and exert pressure to remove discrimination and harassment in healthcare. Although this disproportionally affects women, especially women of color and sex- and gender-minority women, we need all hands on deck so that no one has to wonder who will advocate for them.

Our only worry should be how to continue to excel in a safer and less caustic environment.

The opinions expressed in this blog are solely my own and do not necessarily reflect the views and opinions of my affiliations.

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About Dr Rachel Bond
Rachel M. Bond, MD, FACC, is a board-certified attending cardiologist in Arizona who has devoted her career to the treatment of heart disease through early detection, education, and prevention. She is a women's heart health and prevention specialist and the author of several review papers referencing maternal health, sex, and gender differences and cardiovascular conditions that predominantly affect women, along with opinion pieces aimed at addressing health equity, reducing health disparities, and promoting the professional development of women and minorities in the health-science profession. She has a passion for advocacy of education and mentorship and has advised as an expert source through news and media outlets. Her clinical interests include heart health prevention and maternal health. Dr Bond is a Fellow of the American College of Cardiology and a member of the American Society for Preventive Cardiology, the Association of Black Cardiologists, and the American Heart Association, where she is a national spokesperson for the "Go Red for Women" campaign and sits on the board of directors.
Twitter: @drrachelmbond
Instagram: @drrachelmbond
Facebook: @drrachelmbond

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