How rampant is sexual harassment in the healthcare industry? I am not talking about inappropriate or illegal behaviors that have occurred in psychiatric facilities or nursing homes, or of psychiatrists entering into relationships with patients, but of within the ranks.
Unfortunately, data is often hard to obtain. Medical students, for example, are intimidated by powerful professors; immigrant workers employed as technicians are afraid to report harassing supervisors and while women undergo more sexual harassment than men, men are embarrassed to report harassing women to authorities.
Impropriety in the U.K.
Medscape just reported on sexual harassment and sexual abuse in the United Kingdom. The 2019 report (based on 2018) data, is the most recent report at our disposal, and reflects patterns in the U.S.
In 2018, there persisted a low-level but steady pattern of abuse in a profession that “prides itself” on the erudition and social awareness of its workers. Again, this report was not about professional to patient interaction, but professional to skilled or semi-skilled professionals.
It was found that about three physicians in one-hundred (3%) experienced actual sexual harassment from other physicians however (and this is a consistent pattern), 4% witnessed sexual abuse. Only one physician in 100 was accused of abuse. The point overall, is that it takes a lot of courage for one physician to turn in another.
As a keynote speaker on ethical behavior and sexual harassment, I can relate that the numbers reported are low.
Interestingly, medical students both male and female, do report higher frequencies. About 5% of medical students report sexual abuse while 15% (which is not an insignificant number) of medical students have observed it happening. Based on other reports, articles and numerous confidential conversations with medical professionals, I would certainly not bet against all of those percentages being higher than reported. Again, many male students confidentially report inappropriate comments and touching, but they were reticent to report the incidents.
Staff workers, ranging from technicians to aides to custodial help, report a frequency of about 8% of actual sexual harassment. They are fearful of reporting abuse.
In terms of all of the reported abuse, the highest frequency of inappropriate behavior was characterized as “infringing on body space.” It could include “harmless” touching or other unwanted behaviors. The body space issue was as high as 46% in the self-report area. However, in the comments by those witnessing such behaviors, it approached 60%.
Inappropriate Power
Men and women who are sexual harassers, often see those they harass as being powerless. They take liberties, in part, because they feel an opportunity to take advantage. For the most part, this pattern is no different with physicians as it is with tradespeople or business people.
The need for healthcare staff members to sexually harass may be sexual, but typically it is based on them feeling powerful when in other aspects of their lives they feel insignificant or inconsequential. The need pushes boundaries ever so slowly going from comments to suggestions to touching and worse. That it is unethical is a given, but ethics is not a consideration. It can often be a kind of game, with the obvious prize leading to abuse.
The rationalization of sexual harassment is often positioned in terms of it being completely harmless. Abusers may feign ignorance, outrage or even mockery of those who are accusing, especially when they are highly educated authority figures.
In the absence of sexual harassment education programs, inappropriate behaviors are perpetuating or even self-perpetuating (“I was harassed, now I will harass.”). In any case, none of it has a place in healthcare and no one in the profession should have to fear its consequences.
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