The Toxic Culture for Female Doctors
When obstetricians are harassed, how do they treat patients?
In 1984, when my Aunt Sharon entered her OB/GYN at the residency at the University of Pennsylvania, the profession was changing. More than 60 percent of residents in the class ahead of her were women, and the American College of Obstetricians and Gynecologists had just elected its first female president. Today, 85 percent of OB residents are female. Progress, right? Most of the people charged with delivering babies are now women.
Yet research suggests that even in this field, women are routinely sexually harassed.
Roughly 69 percent of female OB-GYN trainees experience some kind of sexual harassment, along with 70 precent of female gynecologic oncologists, according to an analysis published on the JAMA Open Network in May.
The article’s authors reviewed 10 studies that included 5,800 survey participants, all discussing harassment among health care workers. The article concluded: “There is high prevalence of harassment in OB-GYN despite the field being female dominant for the last decade.”
This will not surprise anyone familiar with the “ACOG slap,” an incident that took place at the American College of Obstetrics and Gynecology’s annual meeting last year. A visibly angry man confronted an older doctor who was presenting onstage. He grabbed the doctor by the collar, and slapped him. “This moth****cker sexually assaulted my wife seven years ago,” the man told the audience. The video of the incident (warning: it’s violent and cathartic) went viral.
Writing about the slap in Bioethics Today, Dr. Alyssa Burgart of Stanford University decried the “culture of silence” in medicine, which discourages sexual assault victims from reporting such crimes.
Reporting may sabotage a career into which they’ve already invested countless hours and dollars. Physicians and physicians-in-training face a terrible bind – we need these organizations to advance our careers.
As authors of the JAMA study note, there’s a major power differential between women who work in obstetrics and the men who supervise them. Although 61 percent of obstetricians are women, they make up only 34 percent of departmental chairs—those in charge of OB-GYN divisions at teaching hospitals.
All of which makes me wonder: For those of us who experienced misogyny and mistreatment during childbirth, perhaps we need to look at the larger picture. The culture of the profession is tainted by sexual harassment and an imbalance of power. If that’s the environment in which doctors are trained, how can we expect them to treat us any differently?
And if this is the prevalent culture where this is how peers are treated, how can we expect its leaders to create empowering, positive, equitable structures of care that uphold safety, quality, and patient autonomy? You are on to something big here, Lisa!