Sexual harassment is making big news with the #MeToo movement. It’s also making news in medicine. And often patients are the perpetrators.
Medscape reported in its Sexual Harassment of Physicians Report 2018 that more than one-quarter (27%) of physicians indicated they had been sexually harassed by patients.
Nearly half (46%) of dermatologists say they’re sexual harassed by patients, making it the most harassed specialty in the Medscape survey. Emergency physicians (43%), plastic surgeons (41%) and aesthetic medicine physicians (41%) round out the top three specialties.
“Traditional perspectives on patient-initiated sexual harassment have generally dismissed the effects on physicians as simply a hazard of the job that should be handled by physician resilience,” according to a commentary published August 4, 2018, in The Lancet.
The perception needs to change so physicians and systems can address sexual harassment by patients directly and proactively, the authors write.
For many physicians, it’s a daunting task to deal with sexual harassment, which the American Medical Association defines as unwelcome sexual advances, requests for sexual favors and other verbal or physical conduct of a sexual nature.
“Physicians are well trained in medicine, but lack training in how to respond to inappropriate behavior and sexual advances from patients,” commentary author Elizabeth M. Viglianti, M.D., M.P.H., M.Sc., research fellow and clinical lecturer, in the department of internal medicine, division of pulmonary and critical care medicine at the University of Michigan writes in an email to The Aesthetic Channel. “With no formal training, they rely on social modeling to learn the unwritten norms for response. Social modeling is highly dependent on individual behavior and not a reliable source for responding appropriately.”
A total of 62% of female physicians and 39% of males respond to patients’ inappropriate behavior by telling those patients to stop. Only 11% of female and 6% of male doctors dismissed the patients from their practices, according to Medscape.
Dr. Viglianti and coauthors are calling for physicians to be empowered in such situations in a systematic and standardized way — one that’s supported by the institutions or systems in which they work, their practice policies and medicine as a whole. They offer a decision-guiding algorithm for physicians experiencing sexual harassment by patients.
The idea, according to Dr. Viglianti, is to develop a standardized response to sexual harassment and practice it, so that it comes naturally when the event occurs.
“Understand that safety comes first. Always feel empowered to leave a situation that feels unsafe,” she says.
Physicians who feel safe in these situations should try to clearly and firmly address the patient’s behavior and continue with care if the patient stops. If the physician doesn’t feel safe or the patient doesn’t stop, the doctor should get out of the room and consider transferring the patient to another provider. Physicians who work at hospitals, health systems or other facilities should report the behavior to leadership if the patient doesn’t stop or if the doctor feels unsafe, according to The Lancet commentary.
“As it exists in every profession, often sexual harassment flows under the radar. Dermatology is no exception,” Pearl E. Grimes, M.D., FAAD, president of Women's Dermatologic Society writes in an email to The Aesthetic Channel. “In dermatology, harassment may originate from various directions — from patient to physician as the recent Medscape study shows, physician to patient, physician to physician, physician to administrative/support staff or some other permutation. In any form, coming from anyone, sexual harassment must never be tolerated to any degree, in any profession — from the subtle to the overt and outright.”
Dr. Grimes writes that she hopes the #MeToo movement helps change the short-term and long-term landscape, so that men and women feel comfortable and empowered to call out inappropriate and unacceptable behaviors at the first instance, directly to the perpetrators, and also to the authorities within any institution, business and practice where this misconduct takes place.