Pediatric offices should develop policies to prevent sexual harassment, address complaints
Laura J.Sigman, M.D., J.D., FAAP
Pediatricians and the Law
Key to preventing sexual harassment in pediatric workplaces are policies supported
by senior leadership that establish effective education and prevention; no tolerance
for inappropriate behavior; clear policies and resources for addressing concerns;
and appropriate responses.
Sexual harassment takes on a variety of forms. The Equal Employment Opportunity Commission
(EEOC) defines it as unwelcome sexual advances; requests for sexual favors; and other
verbal or physical conduct of a sexual nature that explicitly or implicitly affects
an individual's employment, unreasonably interferes with work performance, or creates
an intimidating, hostile or offensive work environment. When perpetrated in office
settings with at least 15 employees, sexual harassment violates Title VII of the Civil
Rights Act of 1964.
With the recent #MeToo movement attesting to the prevalence of sexual mistreatment
in society, the medical field, including pediatrics, is not exempt. Numerous examples
of risks may occur in pediatrics. A practice partner continues to tell jokes of a
sexual nature in the break room despite being told by her employee pediatrician that
these are unwelcome. A physician feels uncomfortable attending events at an annual
society meeting after a colleague continues to approach her despite her repeatedly
declining invitations to have a drink in his hotel room. A doctor brushes against
a staff member while trying to get through a tight office workspace; the staff member
feels uncomfortable or alleges inappropriate contact.
According to the AAP policy Prevention of Sexual Harassment in the Workplace and Educational Settings, more than one-third of female physicians perceive that they’ve been subjected to
sexual harassment. The incidence has been shown to be more common during medical school
and training. And men have filed an increasing percentage — up to 17% — of sexual
harassment charges brought to the EEOC in recent years (http://bit.ly/2LqvnA3). Sexual harassment in the work environment can negatively impact individual well-being
and performance, office morale and organizational effectiveness.
The Academy provides guidelines regarding sexual harassment and appropriate boundaries
with patients (http://bit.ly/2HnPqwi and http://bit.ly/2HlxJO4).The best approaches are proactive and emphasize prevention while also providing well-established
procedures for responding to claims of inappropriate behavior.
5. Regular, interactive training tailored to the audience and organization.
Prevention is most effective if leaders are positive role models who regularly and
unequivocally emphasize that sexual harassment is prohibited. Allocating staff time
and resources to developing policies against sexual harassment and attending routine
trainings are important components to effective prevention and response.
Practices should develop a written policy to delineate acceptable behavior and establish
processes for responding to sexual harassment concerns. The policy should be easy
to understand, comprehensive and regularly communicated to all employees. It should
provide avenues for appeal as well as clear consequences in case of retaliation against
an individual filing a complaint.
An effective system encourages employees to report concerns early; treats all involved
parties respectfully; maintains confidentiality; and, if possible, provides multiple
avenues for reporting complaints. It facilitates timely, neutral and complete investigations;
takes complaints seriously; and avoids prematurely drawing conclusions or implementing
The person alleging inappropriate conduct should be interviewed by a neutral party
either within the organization or, if needed, by an outside investigator or in coordination
with legal counsel. The investigator should have a clean record and be a neutral individual
who can maintain confidence and express sensitivity to uncomfortable details that
may come up. An organization should consider having an investigator of the same gender
as the person reporting the event.
Details of the complaint — including date, time and place of the incident and people
involved — should be put in writing, dated and signed by the filing party, ideally
on a standardized complaint form. Investigators should gather and document factual
information and avoid recording impressions or conclusions (http://bit.ly/2sFkfrb).
Caution should be exercised during the investigation process, as information obtained
may be used in a subsequent legal case. Discuss with an attorney questions on legal
implications of and protections in the investigative process. During the investigation,
a reassignment of the person filing the complaint may be considered if possible and
desired, but not in a way that may be seen as a demotion or punishment. For example,
a medical assistant filing a complaint about a physician may be reassigned to work
with another physician in the practice.
Know your state’s laws regarding reporting and investigating discrimination and disciplinary
procedures; some states may require materials to be maintained confidentially in personnel
files. A local human resources (HR) consultant or employment attorney may be the right
starting point for questions.
Effective prevention and response to sexual harassment in the workplace makes for
a more productive and collegial work environment and can help resolve workplace complaints.
Strong policies and procedures can prevent or reduce liability if lawsuits ensue.
Prevention of sexual harassment is key to creating respectful and productive workplaces
and to avoiding legal claims.
Offices should develop written policies to guide appropriate behavior and address
complaints of sexual harassment. These policies should be communicated regularly to
staff and modeled and supported by leadership.
When a complaint occurs, a thorough investigation should be conducted, and both parties
should be treated with respect and confidentiality. Attempts at retaliation should
be prohibited and addressed in office policies. An outside mediator, HR consultant
and/or employment attorney may be utilized, especially in small practices without
internal HR or legal departments.
Check with medical liability insurance providers to ascertain if your practice is
covered for sexual harassment claims. Obtain separate coverage if needed.
Dr. Sigman is a member of the AAP Committee on Medical Liability and Risk Management.