By Sherry Blumenthal, MD
The huge amount of publicity about sexism in Hollywood (enough already!) started a train of thought, which led me to think about a discussion I had with medical students in September.
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The presentation I was giving was about the issue of gender inequality in medicine, and the question posed by a female student was how to get her male colleagues to speak up when an Attending makes a sexist remark. I was somewhat surprised that this question was raised in 2017.
I asked the men in the audience to comment about their reaction to their colleague's question and their answer increased my sensitivity to the complexity of the issue. They were genuinely concerned, but felt conflicted about the best way to handle the situation.
As in so many situations where the offensive remark or action comes from a superior, the men were afraid to speak up because they were afraid of repercussions. It is very unfortunate that medical students still feel powerless to address significant remarks because it might affect their grades or professional relationships. It is very encouraging, however, that the male students wished to be sensitive to the concerns of their female colleagues.
At another meeting of female physicians, a man who was there to write an article on the meeting asked for a show of hands by women in the room who had been sexually harassed. Every hand was raised.
I spoke to a woman anesthesia resident who was frustrated that the staff in the OR, many of whom were also women, showed her no respect when she was the only physician administering anesthesia in the room. And her female attendings did not address this issue.
Many women are too concerned with being "liked" to actually engage in a discussion with team members about appropriate behavior and respect regardless of gender. I learned early that, unfortunately, no matter how polite and "nice" I was, I was going to be disliked for acting appropriately as the "captain of the ship" in the OR. It may have been my patient and my job to protect her, but it would have been smoother sailing had I been a man! For me this reinforces the persistence of sexism by men and women.
The "casting couch" in the entertainment industry should not be news to most of us. It has been my observation that some people are unaware that comments that used to be tolerated and were part of the accepted culture are no longer appropriate in a professional or social situation. I'm also not sure whether the publicity helps or hinders the quest to stop this behavior. I worry about the perception of a "witch hunt" and backlash. Changing the cultural acceptance of this behavior should be our goal.
I know of many women, including physicians, who have put up with much of the harassment. In our defense, that often was our only avenue to success or avoiding a "blacklist." But many of us feel guilt and blame ourselves when these incidents occur. I believe an important message is that we cannot believe this is our fault. We just learned to tolerate it.
When scrubbing for a Gyn case as a medical student, with male Attendings, I said nothing when they told a joke that was incredibly crude and demeaning to women! I said nothing when I did my surgery rotation and the cases were discussed in the Doctors' locker room while I had to use the Nurses' locker room. They were telling me clearly that I was unwelcome. Now I feel sorry that I did not speak up, but I had no power.
Perhaps it is beneficial that this issue is currently getting so much press. I continue to believe that women can and should advance based upon our merits, education, and talent, not on our use of sexuality. And my hope is that women will unite in this goal, accepting other women as supervisors in the same way they accept men in that role.
Perhaps the sensationalism in the news about sexual harassment in the world of entertainment and politics will promote more of a dialogue about the persistent sexism in other fields, including medicine. As I mentioned in another blog, many women avoid leadership roles because they are uncomfortable with the way they are treated and perceived when their behavior is quite appropriate to their roles. This may result in changing jobs to avoid hostile environments and losing seniority.
Also, women who actually reported harassment were often doubted, and still are. One attendee at the aforementioned meeting recounted a story of two cases where there were repercussions for the accused harassers, but the subsequent dismissals of the men were "hushed up" by the hospital to prevent bad publicity. This is not empowering to women if they did not know that appropriate action had been taken. Nor does it inform the men that certain behavior is not acceptable.
One comment that I often hear is that we are "long" on defining and exposing the problem, but "short" on helping women handle incidents of harassment. I have a few suggestions, based upon discussions with women and reading about different HR policies. Angry responses to harassers, which may be appropriate, may also be counterproductive in that they may induce defensiveness and subsequent aggression. Calmly and firmly responding that a comment or action is upsetting you may make resolution easier. Reporting to HR about an incident and not being taken seriously could be addressed by "Perhaps I need to pursue this issue at a higher level." Documentation of the incident, and letting friends or colleagues know about the incident, may increase the likelihood that, should the issue resurface, there are others who know about it.
There are many men (and women), including my colleagues on the Board of Trustees of PAMED, who seem very aware of this problem and make a concerted effort to avoid sexism. And I believe that the most effective way to fight gender discrimination is to address it as a unified group as women. I maintain that there has been a "war on women" that is about power more than actual sexuality. This is a fight we cannot afford to lose.
I invite commentary and suggestions about this issue. Women members of PAMED are invited to join our Women Physicians Caucus. Make sure to also join our private Facebook group and get engaged in the conversation.
The views expressed in this Commentary reflect the opinion of the author and do not necessarily represent the view of the Pennsylvania Medical Society.