sexual harassment Archives

QUESTION: Not to be political, but as I hear the reports of alleged sexual harassment by Governor Cuomo, I’m reminded of the allegations that have repeatedly been made about one of our interventional cardiologists, who also happens to be the department chief and former chief of staff. While there are calls for the Governor’s resignation, our offender in chief continues to practice unrestrained. Is there a different standard applied to, or more tolerance for, sexual harassment in medicine?

ANSWER: The short answer is no. State and federal law require employers to provide employees with a work environment that is free from harassment. The legal standard for sexual harassment does not vary by industry or profession. Health care doesn’t get a pass because it’s stressful, the hours are long, or because “it’s the way it’s always been.” Sexual harassment, in health care or elsewhere, is unacceptable and should not be tolerated. When an organization learns of alleged sexual harassment, they should investigate it promptly and thoroughly.

All too often sexual harassment goes unreported. Under certain circumstances, this is because many employees and staff are reluctant to report sexual harassment for fear of being ignored or being retaliated against and because the harasser may be a big admitter and/or a leader. As a result, sexual harassment, like other forms of disruptive behavior, threatens the integrity of team-based care and undermines the culture of safety by chilling channels of communication. Therefore, to remedy this problem, organizations should implement mechanisms through which early intervention, bystander reporting, and prompt investigation becomes the norm and not the hesitation.

If the behavior is going to change, leaders in the organization need to stand up and get involved. In an AMA Moving Medicine Podcast, Reshma Jagsi, MD, PhD, director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan, talked about the importance of bystander intervention and bystander empowerment and training. According to Dr. Jagsi, “when we see something like this going on, we can speak up. We can distract, we can remove the victim and, if we’re in positions of power, as many of the people in this room are, we can also report or make sure that that situation is addressed more formally.”

Therefore, for these mechanisms to work, sexual harassment must be viewed not only as an institutional responsibility, but as an ethical obligation. It is important to train employees and staff to say something if they see something, and it is equally, if not more important for the organization to provide the effective and responsive channels to do so. In other words, the organization should foster a workplace environment where reporting misconduct is always welcome and where sexual harassment is not.

QUESTION: In our Medical Staff Professionalism Policy, should we have a different process for addressing reports of sexual harassment?

ANSWER: Since there are unique legal implications surrounding sexual harassment, we recommend that a policy addressing inappropriate conduct incorporate a modified process for review of reports involving sexual harassment.

We recommend that a single, confirmed incident of sexual harassment trigger a well-defined process that involves the medical staff and hospital taking immediate and appropriate action to address the conduct and to prevent it from reoccurring. For example, a personal meeting should be held with at least two members of the professionalism committee (or similar committee) to discuss the incident. If the physician acknowledges that the incident occurred and agrees not to repeat the conduct, the physician is sent a formal letter of admonition and warning that is placed in his or her file. The letter should set forth any additional actions or conditions imposed on the physician’s continued practice at the hospital which result from the meeting. If the physician refuses to acknowledge the confirmed incident of sexual harassment or there are confirmed reports of retaliation, the matter should be immediately referred to the Medical Executive Committee to conduct a review consistent with the credentials policy or bylaws. A well-defined process which incorporates these details demonstrates the hospital’s efforts to address any incidents of sexual harassment and attempts to prevent them from occurring again, minimizing the risk of the hospital being held liable in court.