The medical community is plagued by bullying, sexual harassment and discrimination, according to a new editorial in the Canadian Medical Association Journal that says the hierarchical culture that allows silence needs to change.
The editorial, published Monday, questions why medicine hasn’t had its own #MeToo moment and suggests built-in biases and unprofessional workplaces may be the culprit.
“As a profession, we need to stop excusing unprofessional behaviour toward colleagues just because physicians are accomplished in clinical care or academia,” wrote authors Jayna Holroyd-Leduc, deputy department head of medicine at the University of Calgary’s Cumming School of Medicine and Sharon Straus, director of the Knowledge Translation Program at the Li Ka Shing Knowledge Institute in Toronto.
The #MeToo movement, which encourages people to speak out about sexual harassment and violence, has touched numerous industries, from film to journalism and politics, in recent months. The editorial states that even though a prominent male physician hasn’t been in the #MeToo spotlight, the work force faces many problems with harassment, bullying and other forms of abuse and needs to find solutions.
While research has shown women, particularly students and trainees, may be most susceptible to harassment in medicine, Dr. Holroyd-Leduc said men are also affected. Part of the problem is the nature of medicine, which involves years of training, long hours and high stress levels, can contribute to an unhealthy, unprofessional work environment, she said.
“It’s a very hierarchical profession,” said Dr. Holroyd-Leduc, adding that power imbalances feed into some of the troubling behaviours that have long been a problem in medicine, such as sexual harassment or bullying. In addition, hierarchies also help prevent people from speaking up when they experience or observe harassment, she said, because people are afraid of jeopardizing their future careers.
In some cases, the harassment is subtle, making it more difficult to report, she said.
“It’s the small underlying comments or expectations that really are not necessarily appropriate or needed that put people in awkward positions or feel like they’re being bullied or harassed,” Dr. Holroyd-Leduc said.
The long hours and stressful elements of jobs in health care also leads many health-care workers to neglect their own personal health, which can contribute to workplace problems, according to the editorial. The authors note that “unhealthy physicians find it difficult to be professional.”
In June, a report published by the U.S. National Academies of Sciences, Engineering and Medicine found that nearly 60 per cent of female academic staff said they experienced sexual harassment on the job. About 40 per cent of female medicine students reported experiencing sexual harassment from a superior, much higher than the 20 per cent of female science students and 25 per cent of female engineering students who said they experienced sexual harassment.
The CMAJ editorial calls for a series of changes, such as having more women in leadership roles, encouraging people to speak up when they see or experience bullying or harassment and having a system to evaluate on-the-job behaviour when considering someone for a promotion.
It’s not enough to have rules or codes of conduct, Dr. Holroyd-Leduc said. The whole culture of medicine needs to change to get rid of generations of built-in biases, hierarchies and unhealthy environments that lead to harassment and abuse, she said.
“It’s all about having an organizational change,” she said.