Workplace Discrimination and Harassment Are Common in Ob/Gyn, Study Finds

Workplace discrimination, along with sexual and nonsexual harassment, are fairly common in the practice of obstetrics and gynecology, according to an article recently published in The Journal of Minimally Invasive Gynecology. Researchers found that more than two-thirds of females and over one-third of males reported experiencing workplace discrimination.

“I think our findings reflect what women, and also men, have experienced professionally,” states Linda Bradley, MD, Vice Chair for Diversity and Inclusion at Cleveland Clinic’s Ob/Gyn & Women’s Health Institute and an author on the study. “As a society, we are paying closer attention to how discrimination and harassment are woven through our cultures.”

Physicians are rethinking their professional relationships in light of the #MeToo movement

The article summarizes the results of a survey sent to more than 7,000 physician members of the American Association of Gynecologic Laparoscopists (AAGL) after the #MeToo movement became part of the national dialogue in 2018. Just over two-thirds of respondents reported spending time considering their professional relationships since the #MeToo movement began; however, fewer than half believe their perceptions about harassment have changed as a result of the movement.

Women were more likely to reflect on their relationships with their colleagues, and more likely to change their perceptions on harassment. Females were markedly more likely to rate the #MeToo movement as “justified and overdue,” independent of respondents’ age or training status.

Dr. Bradley indicated that although she was not surprised by the results of the study, she was surprised that it had taken so long to discuss issues of discrimination and harassment in medicine. “During my residency, we never had a lecture on domestic violence,” Dr. Bradley reflects. “It was years into my practice before we began to have language around domestic violence and female sexuality, which are significant aspects of our day-to-day practice.”

Workplace discrimination and harassment are common

Sixty-seven percent of female respondents experienced workplace discrimination, compared with 39% of male respondents. Workplace discrimination was more common in the United States, and among females under the age of 30. Gender was the most common basis for discrimination among both females (90%) and males (72%). Discrimination was also based on age, race, national origin, religion, appearance and body size.

Basis for discrimination among survey participants (N = 503)

*Total may exceed 503, as some respondents indicated multiple fields

Thirty-nine percent of respondents reported experiencing harassment in the workplace. Of those respondents, 28% reported non-sexual harassment, 35% reported sexual harassment and 37% reported both. Eighty-one percent of the victims were female.

Respondents named the following types of sexual harassment: the habitual telling of suggestive stories or offensive jokes, persistent attempts to establish sexual relationships despite discouragement, the offering of bribes or rewards for sexual activity with a coworker, negative consequences for refusing to engage in sexual activity, unwanted stroking or fondling, and sexual assault. Nonsexual workplace harassment was frequently based on gender, physical appearance, race and age.

Basis for nonsexual workplace harassment (N = 503)

*Total may exceed 503, as some respondents indicated multiple fields

Although respondents were likely to experience harassment at multiple points throughout their training, by multiple people and in multiple settings, the most frequent setting for harassment was in the hospital during work hours. The harasser was a physician in approximately 90% of the cases; female respondents were more likely to be harassed by a physician, and men were more commonly harassed by other healthcare workers or administrators.

Each gender experienced the effects of workplace harassment differently, with women indicating they lost self-confidence and had lower salaries, while men noted lower patient volume and fewer employment opportunities.

Dr. Bradley notes: “Harassment effects self-confidence. It spoils one’s experience of an institution, and can impact the trajectory of one’s career. It might prevent one from applying for leadership roles, limiting one’s sphere of influence.”

Sequelae from discrimination (N = 503)

*Total may exceed 503, as some respondents indicated multiple fields

Most incidences of harassment in medicine go unreported

Thirty-one percent of victims of non-sexual workplace harassment report the incident to authorities, compared to only 8% of sexual harassment victims. More than 60% of the victims who reported harassment felt that their accusations were not taken seriously. More victims of non-sexual harassment felt they were subject to retaliation compared to sexual harassment victims. Several reasons for not reporting harassment were cited, including: fear of retaliation or reputation damage, not wanting to get anyone in trouble and not knowing to whom the incident should be reported.

“When harassment occurs in public, there are witnesses; but it takes a strong person to speak up about a one-on-one situation,” Dr. Bradley comments. “Frequently, victims may not speak out of fear of retaliation or because they do not want to be labeled as a ‘whistle-blower.’

“As institutions, however, I think we have become more intolerant of retaliation,” Dr. Bradley continues. “Harassment in the workplace places additional stress on a workforce that already struggles with burnout. Victims report increased levels of anxiety, more job stress and less commitment to the institution, which can lead to decreased productivity, legal action and increased levels of turnover. We do not want these kinds of people working for us.”

When you know better, do better

“At least in part because of the #MeToo movement, when so many victims shared their truths, there is no denying that harassment and discrimination are widespread – not just in the worlds of business and entertainment,” Dr. Bradley says.

“It’s like that Maya Angelou quote: ‘Do the best you can until you know better. Then, when you know better, do better.’ We’re in the process of educating and implementing policies and structures to protect victims of harassment, ensure anonymity and promote respect, fairness, integrity and inclusiveness in medicine.”

Dr. Bradley serves on the Grievance Committee of the American College of Obstetrics and Gynecology and on the Task Force on Anti-Harassment, Diversity and Incident Report of the AAGL.

“The AAGL defines harassment and publishes a toll-free, confidential, third-party hotline in its meeting brochures. Individuals who are the victims or witnesses of harassment are expected to report it in a timely manner. We take these matters very seriously,” Dr. Bradley notes.

Note: Figures reprinted from Brown J, Drury L, Raub K, et al. The Journal of Minimally Invasive Gynecology, Workplace Harassment and Discrimination in Gynecology: Results of the AAGL Member Survey. 2019 Jul – Aug;26(5)838-846, with permission from Elsevier.