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January 3, 2018

#MeToo: A doctor reflects on what keeps women in medicine from reporting harassment—and her own story

Daily Briefing

    Writing in the New England Journal of Medicine, Reshma Jagsi, director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan, draws attention to the factors that discourage women—particularly those in medicine—from reporting sexual harassment.

    An error sheds light

    Jagsi explains that she decided to write the piece after an assistant confused her for a survivor of sexual assault rather than "a scholarly expert" on the topic—a mistake that Jagsi said she "leapt to correct."

    Jagsi realized she "rushed to correct the [individual] partly because I worried that she might tell others that I'd been victimized and also that victims do not fare well in our society." She explains that while the #MeToo movement has helped bring attention to the prevalence of sexual assault, "reporting such behavior is far from straightforward," and women who do decide to report harassment are often met with "marginalization, retaliation, stigmatization, and worse."

    A larger problem—and the professional ramifications

    Jagsi shares messages sent to her from strangers since she published her research that "reinforce these intuitions." Several of those who reached out to her said they'd experienced "unwanted touching," while one described a "'tormentor'" during training. According to Jagsi, "others noted remarkably consistent experiences in the operating room that ironically they thought were unique" and one woman disclosed a rape by a supervisor that she had not reported.

    None of the women who reached out to Jagsi reported their experiences, she notes. Doing so involves confronting "challenging institutional cultures, with workplaces dominated by men who openly engage in lewd 'locker-room conversation' or exclude them from all-male social events," Jagsi writes. As such, women are "without allies."

    Meanwhile, women who bring sexual harassment complaints to HR could see their own career damaged in the process, Jagsi writes. A lawyer told one woman whose experience had come to HR's attention indirectly that "'making this an HR issue' could hurt her own career," Jagsi writes. As such the woman "deflected the inquiry" but "felt guilty over not protecting younger women from the man who'd harassed her."

    Jagsi continues, "Standing up to harassment is clearly hard." For instance, she notes that two department chairs each "were trying to recruit" a "talented physician researcher" even though the individual's current institution was in the process of carrying out "sexual misconduct proceedings" after it was brought to light that the individual "had engaged in a witnessed act of unwanted sexual contact with a trainee." According to Jagsi, the department chairs "worried about fallout if the behavior were to recur, but neither wanted to forgo the opportunity to steal away a superstar."

    Her personal experience

    In the piece, Jagsi also discusses her "sole personal experience with workplace-related sexual harassment." She writes, "Because it was a more minor transgression than some other women have faced, until very recently I hadn't thought of it as harassment, although it meets the criteria outlined by experts—a disconnect that's remarkably common."

    In the incident, which took place at a professional society dinner, a prominent surgeon made "sexual advances" toward Jagsi and later "accosted [her] in the cloakroom." The surgeon continued to pursue Jagsi, "intent on walking [her] to [her] room," when a female colleague appeared at just the right time, "rescuing [Jagsi] from what was rapidly evolving from an uncomfortable situation into something potentially worse."

    Overall, according to Jagsi, "My intuition is that the [sexual harassment] problem is at least as bad in medicine as elsewhere, especially if one adds harassment by patients to that by colleagues and superiors." If nothing else, she adds, "the data show that the problem for female physicians is certainly bad enough that the profession must work together to correct it" (Jagsi, New England Journal of Medicine, 12/13; Samuel, STAT News, 12/15; Finnegan, FierceHealthcare, 12/14).

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