The day the article “The Stubborn Culture of Harassment in America’s Medical Schools” was brought to my attention, I had just read thelundreport.org report “Lawsuit Says OHSU Perpetuates ‘Toxic Environment’ Of Sexual Discrimination; University Denies Claims”. The report refers to a female surgeon who filed a gender discrimination lawsuit against Oregon Health and Science University (OHSU) over her pay, career advancement opportunities and a hostile work environment.
I am the founding member of #WoSurgMeToo and I posted the Lund Report article on our Slack platform. There were two immediate responses on Slack and one from a colleague I emailed the article to. They were: “It’s endemic” and “This whole battle is hopeless. It’s the same shit everywhere”.
As an ethicist and idealist, these articles and the responses I received from my colleagues made for a very bad day. Not for the first time, I wondered, is achieving gender equity in surgery really hopeless?
The good news is that more and more high impact outlets are publishing stories of gender inequities. The bad news is the vigor and pace with which mitigation is embraced is pathetic. Even after the National Academies of Sciences, Engineering, and Medicine (NASEM) report gave specific recommendations to effect change, academic institutions, health systems, and professional organizations are still dragging their feet and not demanding no tolerance policies or taking proportional and reasonable action against perpetrators.
I founded the #WoSurgMeToo group because our largest professional organization, the American College of Surgeons, was not acting responsibly to support it’s member who were victims of such injustices. In the aftermath of these articles, I was reminded by the American College of Surgeons (ACS) what the 2017 NASEM report published:
Professional societies have more freedom to develop independent policies and practices for dealing with sexual harassment than federal agencies have, so they are in an ideal position to take action in preventing sexual harassment and affecting cultural change. Several societies have come forward in the past few years to take a strong stand on the issue of sexual harassment among its membership. As such, professional societies have the potential to be a powerful driver of change through their position to help educate, train, codify, and reinforce cultural expectations for their respective scientific, engineering, and medical communities.
It is clear from the published literature in this area that until there is public accountability and serious consequences for such behavior, the behavior will continue. Exchanging one endowed chair title for another after being accused of sexual harassment is not a consequence that carries enough weight to deter such behavior. In my post on the ACS communities, I asked what the ACS is doing in this regard? I asked have fellowship privileges been revoked from any fellow/member found guilty of sexual harassment or perpetuating the inequities outlined in the Lund Report? I also asked what the consequences are for those found guilty besides continuing to promote-up violators of such inequities.
There is some light shining through the shadow of the ACS. Last years president-elect Dr. Ronald Maier has gone on the record during his American Surgical Association (ASA) presidential address at the 138th Annual Meeting identified the inherent good in committing to equity, diversity, and inclusion in medicine. He also confirmed the need for our commitment to move forward and become leaders for this change.
I really hope that achieving gender equity isn’t hopeless because if it is, not only will the women (and men) in medicine and surgery suffer, public health will suffer as well.
I’d like to encourage women surgeons and trainees to join #WoSurgMeToo on Slack to further engage with collaborators on the cause of achieving gender equity in surgery. Join the movement here.
Pringl Miller, MD, FACS