There has been a lot of talk in the news about sexual harassment in the workplace. Usually, it is done by someone in power, someone who has influence over a person who cannot defend herself because of fear — fear of losing a job, fear of retaliation, fear of physical harm. And, yes, I said "herself" — not to say that men are never harassed in this way, but let's face it, the majority of victims are women, and "himself/herself" is just too cumbersome to write or read.
I'm writing not about physicians who are harassed by senior partners or hospital administration, although this certainly happens, but something a little different. Patients can sometimes act inappropriately towards physicians and it can cause a strain on the physician-patient relationship. Patients are often offered a chaperone especially when a delicate exam, such as a genital or breast exam needs to be done, but physicians don't get to have a chaperone.
Sometimes, it's just a look. A stare. It can be uncomfortable, but it's hard to call someone out on something like that. Sometimes, it's presented as a compliment. "All my doctors are pretty women". OK, not direct. Non-threatening. Still uncomfortable. "You have nice legs," "Can you let your hair down?"
It is important early on to emphasize that the relationship is purely that of physician and patient and that comments undermine the professional nature of that relationship. If the patient says he means nothing by his comments, you can say that you would prefer that the discussion focus on the patient's medical issues and not on yourself. If the patient continues to make such comments, then a discussion about discontinuing the physician-patient relationship may be necessary.
More seriously, patients can be more aggressive, even physical. I believe this is grounds for immediate dismissal from the practice. A physician is alone in the exam room with the patient and needs to feel safe. If the physician works for a group or the hospital, the administration should be informed of any incident of this nature. It's a little trickier if one is in a solo practice. Depending on the case, it may even be necessary to involve the authorities.
Most patients, of course, would never do such things. They are in the office for medical attention and hitting on their doctor is the last thing on their mind. And most people know their boundaries.
But every now and then...I've contemplated carrying mace around, maybe I should.