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You will likely have an issue with sexual harassment at your practice, here are six ways to deal with the problem and ensure it gets resolved.
There has been a lot of coverage in the news lately regarding sexual harassment, largely by celebrities and politicians. Sexual harassment and inappropriate sexual behavior happens everywhere in this country, including in physician practices. Over the past 20 years, I have been involved in countless cases involving sexual misconduct and assault by physicians. More likely than not, it has happened or will happen, at some point in your practice as well.
While the sexual harassment we hear about in the news has been fairly blatant, involving rape and physical assault, inappropriate behavior can be far more subtle. Rubbing a nurse's breasts in the hallway when nobody can see, discussing details of your swinger sex life with someone of the opposite sex who has requested you stop, or even off-color jokes intended to make someone feel uncomfortable, are all arguably sexual harassment and can lead to a claim.
A colleague of mine was a fairly tough cookie yet even she, on multiple occasions, felt uncomfortable with the conduct of her male superiors. She once went to sit in a partner's office and by mistake bumped the desk when she went to sit down, knocking some papers onto the floor. She apologized and said, "I'm so sorry for knocking those over. I must have rubbed against the desk." His response: "I'd rather you rubbed against me." She didn't say anything, and bent over to pick up the papers. He then stated, "I'd really enjoy seeing you pick those up again."
Was this sexual harassment? Is this tolerable? What should she have done? She brushed this off, but was still uncomfortable and her husband was appalled when she told him. As a young lawyer, she felt she could say nothing. How do the people in your office feel about what goes on in the workplace? Are you losing good people who work for you because they feel uncomfortable and/or harassed?
In my opinion, the best way to minimize risk of any allegation of sexual misconduct in a physician practice is by taking preventative measures. The following are recommendations I make to my clients:
1. In meetings, particularly one involving any reprimand, discipline, termination or similar interaction, there should always be a witness present who is the same sex as the employee. For example, having a male physician or office manager meet alone with a nurse who is being disciplined, is a bad idea as it can turn into accusation of misconduct by the supervisor.
2. Having a female nurse present in the room when a male physician performs an exam should be required to minimize exposure. This is especially true of ob-gyns and those performing exams where there is contact with breasts or genitals (male or female). Explain to the patient what is being done and why. A patient might not expect their ob-gyn to perform a breast exam and if the doctor (assume a male) suddenly reaches into their gown without explanation, this might raise cause a patient to feel exposed or assaulted. The vast majority of patients are uninformed and unsophisticated, and assumptions should never be made about what they understand or expect. Where a patient has specifically asked for a male/female physician, I always advise that the request be honored when possible as it may minimize some possible risks and may be an alert to the practice of a particular sensitivity. I find physicians who have been in practice a long time are particularly indifferent to such concerns.
3. Take every accusation, allegation or comment suggesting inappropriate behavior seriously. I have blogged many times regarding how to conduct investigations and this applies to allegations regarding sexual misconduct.
4. Create a culture in the practice where inappropriate behavior and comments are simply unacceptable. The practice should not have to rely on a complaint before action is taken. What is going on in the lunch room or during surgical procedures? What type of emails are being shared? What type of suggestive innuendo is occurring? I am often shocked at the stories I hear about the practice that does not come to light until someone finally makes a complaint, even though everyone was aware. Who speaks up in your practice for those that may not feel they have a voice or fear losing their job?
5. Allegations of sexual misconduct are also frequently untrue. This is the reason that an investigation must be performed and documented. I have had patients make allegations for attention, to disparage physicians, avoid paying bills and, worst of all, in order to blackmail then and medical practices into settlements. This problem is exacerbated by the ability of patients to use social media (Yelp, Healthgrades) to further his or her own agenda. While every claim needs to be fully examined, remember that your staff and physicians are innocent until proven otherwise-something we often forget!
6. Get rid of bad characters in your practice. It may be a surgeon who bring in lots of money and has been in the practice for years, but at the same time he harasses and intimidates the staff and laughs off efforts to address his behavior. He often gets away with it because the practice does not want to lose the income and professional reputation he provides. Ultimately, there is a high price to pay for having the wrong priorities.
Concerns about inappropriate conduct can be quickly corrected with everyone feeling satisfied about the outcome. There does not need to be a termination in all instances and a practice can successfully reform its culture and attitude. However, practices must take sexual harassment in the workplace seriously and not assume it only happens elsewhere. The first step is to carefully look to see what is really going on behind your practice's doors.