Abstract
IntroductionGender-based discrimination and sexual harassment of female physicians are well documented. The #MeToo movement has brought renewed attention to these problems. This study examined academic emergency physicians’ experiences with workplace gender discrimination and sexual harassment.MethodsWe conducted a cross-sectional survey of a convenience sample of emergency medicine (EM) faculty across six programs. Survey items included the following: the Overt Gender Discrimination at Work (OGDW) Scale; the frequency and source of experienced and observed discrimination; and whether subjects had encountered unwanted sexual behaviors by a work superior or colleague in their careers. For the latter question, we asked subjects to characterize the behaviors and whether those experiences had a negative effect on their self-confidence and career advancement. We made group comparisons using t-tests or chi-square analyses, and evaluated relationships between gender and physicians’ experiences using correlation analyses.ResultsA total of 141 out of 352 (40.1%) subjects completed at least a portion of the survey. Women reported higher mean OGDW scores than men (15.4 vs 10.2; 95% confidence interval [CI], 3.6–6.8). Female faculty were also more likely to report having experienced gender-based discriminatory treatment than male faculty (62.7% vs 12.5%; 95% CI, 35.1%–65.4%), although male and female faculty were equally likely to report having observed gender-based discriminatory treatment of another physician (64.7% vs 56.3%; 95% CI, 8.6%–25.5%). The three most frequent sources of experienced or observed gender-based discriminatory treatment were patients, consulting or admitting physicians, and nursing staff. The majority of women reported having encountered unwanted sexual behaviors in their careers, with a significantly greater proportion of women reporting them compared to men (52.9% vs 26.2%, 95% CI, 9.9%–43.4%). The majority of unwanted behaviors were sexist remarks and sexual advances. Of those respondents who encountered these unwanted behaviors, 22.9% and 12.5% reported at least somewhat negative effects on their self-confidence and career advancement.ConclusionFemale EM faculty perceived more gender-based discrimination in their workplaces than their male counterparts. The majority of female and approximately a quarter of male EM faculty encountered unwanted sexual behaviors in their careers.
Highlights
Gender-based discrimination and sexual harassment of female physicians are well documented
The majority of women reported having encountered unwanted sexual behaviors in their careers, with a significantly greater proportion of women reporting them compared to men (52.9% vs 26.2%, 95% confidence intervals (CI), 9.9%-43.4%)
Having experienced discriminatory treatment based on gender was significantly associated with higher Overt Gender Discrimination at Work (OGDW) scores
Summary
Gender-based discrimination and sexual harassment of female physicians are well documented. This study examined academic emergency physicians’ experiences with workplace gender discrimination and sexual harassment. Women represented 49.5% of United States (US) medical students in 2018-2019.1 Despite near parity in the number of men and women entering medicine, female physicians continue to experience disparities in salary,[2,3] leadership,[4,5] and career advancement.[6,7,8] For example, while 80% of the overall medical workforce is comprised of women, women hold only 13% of the healthcare industry’s executive positions.[9] Data suggest inequity and harassment are intertwined, and harassment is often fostered in workplace environments that perpetuate these gender disparities.[10] For instance, discrimination and harassment by gender are more prevalent in industries in which women make up a majority of the workforce but hold a minority of the positions of power.[11] Many studies have documented gender discrimination and sexual harassment of female medical students and physicians.[5,12,13,14,15,16,17,18,19] The recently released National Academies of Science, Engineering, and Medicine report on sexual harassment of women in medicine revealed troubling results. Inappropriate encounters were consistently reported, ranging from sexist comments and sexual innuendo to inappropriate touching and solicitation.[2]
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