EC and DK: The report makes clear that organizations with less gender diversity in the workforce, and particularly in the leadership team, are at greater risk for tolerance of sexual harassment. The same forces that create a gender salary gap and limit opportunities for women also foster sexual harassment. You can’t peel these issues apart and address them in isolation; they are absolutely connected.

KK: What were the most important take­away points from the study?

EC and DK: We need better measurement of the problem and more ownership by health care leaders. We need to do much more beyond trying not to get sued. We need the gatekeepers and sources of funding, like accreditation organizations and major scientific funding institutions, to provide strong incentives for health care institutions to create safe environments for their scientists. In addition, we need to change the steep hierarchies that reinforce a culture where no one can speak up about harassment. Ultimately, health care needs to make a serious investment in improving this problem, but it is one that will pay back with huge dividends.

KK: Are there actions or steps that should be taken from the study to move the needle in the right direction, or will this serve only to raise awareness?

EC and DK: The report has many levels of recommendations. There are global recommendations and immediately-actionable ones. Long-term culture change is an important goal, but that will take time. What can we do now? We can measure the occurrence of sexual harassment using standardized instruments and improve the transparency and accountability of existing policies and practices for responding to sexual harassment. It is difficult to read this report and simply feel satisfied with more awareness. This report paints a grim picture of the culture of permissiveness in medicine with regard to harassment. Our hope is that this information and this conversation will lead to meaningful action.

References

1. National Academies of Sciences, Engineering, and Medicine. Sexual harassment of women: climate, culture, and consequences in academic sciences, engineering, and medicine. Washington, DC: National Academies Press, August 2018.
2. Choo EK, van Dis J, Kass D. Time’s up for medicine? only time will tell. N Engl J Med. 2018;379(17):1592-1593.