Medical field no stranger to sexual harassment

Robert A. Dowling, MDIn 2017, a flood of accusations against high-profile men in positions of power in Hollywood, the U.S. government, and the national media have focused the nation’s attention on sexual harassment and its consequences. The medical workplace is not immune from harassment, and the national conversation presents an opportunity for health care businesses to review their risk, policies, and prevention strategies. In a two-part series, I will review some facts about harassment, its relevance to a urology practice, and some resources to gauge your practice’s status in this regard.

Defining harassment

Harassment in the workplace is defined as “employment discrimination that violates Title VII of the Civil Rights Act of 1964, the Age Discrimination in Employment Act of 1967 (ADEA), and the Americans with Disabilities Act of 1990 (ADA),” and it is unlawful (bit.ly/Harassmentdefinition). According to a 2016 report by the U.S. Equal Employment Opportunity Commission (EEOC), sexual harassment is the most common form of harassment alleged in complaints to that agency (45%) (bit.ly/EEOCreport). It is defined by the EEOC as “unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual nature… when submission to or rejection of this conduct explicitly or implicitly affects an individual’s employment, unreasonably interferes with an individual’s work performance or creates an intimidating, hostile or offensive work environment” (bit.ly/Harassmentfacts).

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Sexual harassment is typically categorized as either “quid pro quo” (sex in exchange for favors or avoiding punishment) or a “hostile work environment.” Unwanted behavior in the first category is easy to recognize, but behavior that constitutes a “hostile work environment” may be more subjective. While the true incidence of sexual harassment is not precisely known, survey data suggest between 40% and 75% of women in the workplace have been subject to unwanted sexually based behaviors (bit.ly/EEOCreport).

The EEOC report suggests that most victims of harassment either avoid the harasser, ignore the behavior, or deny the problem; few file a complaint. These statistics suggest harassment based upon sex is common and underreported. Less common types of harassment can be based on race, disability, age, national origin, or religion.

Sexual harassment in the medical workplace is also apparently common. According to one recent article, data suggest harassment rates of 44% in all women, 59.4% of all medical trainees, and 69% of female emergency medicine residents (bit.ly/Harassmentinmedicine). Another survey-based study reports that 84% of physical therapy students and professionals had suffered sexual harassment in the course of their career, and 47% in the last year (Physical Therapy 2017; 97:1084-93). These studies do not profile the “harasser” in detail, but it is worth noting that health care workers may suffer harassment in the workplace from a patient as well as a coworker or superior.

Next: Are urologists at greater risk?

Are urologists at greater risk?

In the course of researching this article, I was unable to locate any firm statistical information on sexual harassment in the urology workplace, yet I have no reason to believe the specialty is less or more likely than others to encounter sexual harassment.

Urology does carry with it “special circumstances” that may bear on the risk of harassment in the workplace. The specialty deals with diseases of a sexual nature, routine examination and photography of genitalia, frank discussions of intimate personal details, and patients and staff who may be uncomfortable with any or all of the above. A urologist’s training and experience may instill a greater awareness of and sensitivity to inappropriate comments or jokes of a sexual nature; on the other hand, an unprofessional remark by a staff member to a coworker, subordinate, or patient could be more likely to occur and be ill received in a setting where sexual behavior is openly and routinely discussed.

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The EEOC notes several risk factors for sexual harassment: workplaces with power disparity, those that rely on customer service, decentralized and isolated workplaces, those with homogenous workforces (lack of diversity), and those with “high-value employees.” Some of these risk factors could apply to a urology office.

Harassment costly in many ways

The EEOC report correctly reminds us that while sexual harassment in the workplace is wrong and often illegal, it is also expensive. Employers have paid over $40 million each year since 2010 to settle allegations of sexual harassment; this does not include benefits obtained through litigation or the costs of litigation. An insurance company estimates that an employment dispute is typically settled for about $125,000 per claim (bit.ly/Harassmentstats).

Indirect costs include decreased productivity, increased turnover, psychological and physical harm to the victim (and attendant costs), and lower psychological well-being of coworkers who observe sexual harassment. A 1994 study estimated that over 2 years, sexual harassment cost the government more than $325 million. Harassment in the workplace is costly.

Bottom line: Sexual harassment is in the news, and reminds us that it may be common, costly, and transcend all professions and trades. In part 2 of this series, I will review some strategies to prevent or lower the risk of sexual harassment in your workplace.

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