Gender‐Based Discrimination and Sexual Harassment Among Academic Internal Medicine Hospitalists

Abstract

BACKGROUND: Gender-based discrimination and sexual harassment, both implicit and overt, have been reported in academic medicine. This study examines experiences of academic hospitalists regarding gender-based discrimination and sexual harassment. METHODS: A survey was distributed to Internal Medicine hospitalists at university-based academic institutions in the United States. Questions assessed experiences regarding gender-based discrimination and sexual harassment in their interactions with patients, as well as with other healthcare providers (HCPs). RESULTS: Eighteen institutions participated in the survey, resulting in 336 individual responses. Female hospitalists more frequently reported inappropriate touch, sexual remarks, gestures, and suggestive looks by patients compared with male peers both over their careers (P < .001) and in the last 30 days (P < .001). Similarly, females more frequently reported being referred to with inappropriate terms of endearment (eg, “dear,” “honey,” “sweetheart”) by patients both over their careers (P < .001) and in the last 30 days (P < .001). Almost 100% of females reported being mistaken by patients for nonphysician HCPs over their careers, compared with 29% of males (P < .001) (76% vs 10%, in the last 30 days; P < .001). Similarly, females more frequently reported sexual harassment over their careers (P < .05) and being mistaken for nonphysician HCPs by colleagues both over their careers (P < .001) and in the last 30 days (P < .001). Females rated their sense of respect both by patients (P < .001) and colleagues (P < .001) lower than males (P < .001). More females than males reported that gender negatively impacted their career opportunities (P < .001). CONCLUSION: This survey demonstrates that gender-based discrimination and sexual harassment are commonly encountered by academic hospitalists, with a significantly higher number of females reporting these experiences.

Sexual Harassment and Gender Discrimination in Hospital Medicine: A Call to Action

“…The study by Bhandari et al adds to the increasing body of knowledge documenting high levels of sexual harassment and gender discrimination in medicine and highlights important gender differences in these experiences among hospitalists nationally 1,2 . Among 336 respondents across 18 academic institutions, sexual harassment and gender discrimination were both common and highly problematic within the field of hospital medicine, confirming what prior narratives have only anecdotally shared.…”

“…Among 336 respondents across 18 academic institutions, sexual harassment and gender discrimination were both common and highly problematic within the field of hospital medicine, confirming what prior narratives have only anecdotally shared. Both men and women experienced harassment, from patients and colleagues alike, but women endured higher levels compared with men on all the measures studied 1 …”

“…The field of hospital medicine has claimed numerous successes and the hospitalist model has been embraced by institutions across the country. Yet the lived experiences of hospitalists surveyed by Bhandari et al in this month's issue of JHM suggest a grim undertone 1 . Hospital medicine is a field with high physician burnout rates, stark gender inequities in pay, leadership, and academic opportunities, and an unacceptably high prevalence of sexual harassment and gender discrimination.…”

“…Yet the lived experiences of hospitalists surveyed by Bhandari et al in this month's issue of JHM suggest a grim undertone. 1 Hospital medicine is a field with high physician burnout rates, stark gender inequities in pay, leadership, and academic opportunities, and an unacceptably high prevalence of sexual harassment and gender discrimination. Women hospitalists disproportionately bear the brunt of these inequities.…”

“…Both men and women experienced harassment, from patients and colleagues alike, but women endured higher levels compared with men on all the measures studied. 1 Qualitative comments in this study are noteworthy, including one about a hospitalist's institution allowing potential faculty to be interviewed about plans for pregnancy, childcare, and personal household division of labor. One might argue that this knowledge is necessary for shift-based inpatient work in the context of a worldwide pandemic in which pregnant workers are likely at higher risk of increased morbidity and mortality.…”