Editor’s Memo

#Metoo and American Health Care

Peter Wehrwein

As we went to press, the first of what may be up to 100 women were giving their victims statements against Larry Nassar, the former team doctor for the USA Gymnastics team. Nassar had already pleaded guilty to 10 counts of sexually assaulting young girls, and prosecutors had recommended a stiff sentence on top of the 60 years he is already serving on child pornography charges. Simone Biles, Aly Raisman, and other Olympic stars have come out and said #metoo. We watched all their amazing handsprings, dismounts, landings, and big smiles. But awful stuff was going on behind the scenes.

As the #Metoo movement crested, some criticized the notion of there being a spectrum of bad behavior because it seemed to muffle criticism of some men. Clearly, though, Nassar and abusers like him belong in a special category of heinousness. And as Susan Ladika reports in this issue, sexual harassment in American health care occurs in a variety of forms and degrees, ranging from sexual remarks to unwanted advances to coercion.

Some of health care’s problem stems from the gender structure of its workforce. Most of the people working in the sector are women while men hold most of the positions of power. As that changes (or maybe that should be “if that changes”) so might the incidence of sexual harassment. Susan spoke with a number of women who recalled when women were a small minority of medical students. Now the ratio of women to men is close to even. That bodes well.

In the meantime, health care organizations can respond constructively. Sexual harassment policies should be updated so they are clear, simple, and confidential for people filing complaints. Training can help. So can managers, by setting a tone and expectations for how people should behave.

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