Patient-to-provider sexual harassment, assault common, especially for female physicians

Sexual harassment and sexual assault by patients are common in many specialties, most often toward female practitioners, and can significantly increase rates of physician burnout, according to a study.

“Sexual harassment (SH) includes unwelcome sexual advances, requests for sexual favors, and hostile verbal or physical conduct that targets someone based on gender, whether or not sexual overtures are involved. Sexual assault (SA) is defined by the Centers for Disease Control and Prevention as ‘a sexual act that is committed or attempted by another person without freely given consent of the victim or against someone who is unable to consent or refuse,’” Eliza Notaro, MD, of the division of dermatology at University of Washington, Seattle, and colleagues wrote. “Most studies about SH in medicine focus on SH perpetrated by one health care provider against another, with very few studies examining SH from patient to provider. Heightened awareness of SH in general has highlighted the potential role of the patient as the perpetrator of SH.”

Using professional listservs and an online forum, an anonymous survey was distributed to medical professionals in multiple institutions, targeting dermatologists and trainees specifically. The survey asked about experiences of SH or SA by patients, including unwelcome sexual advances, requests for sexual favors, verbal or physical conduct of a sexual nature, unwanted and intentional exposure of patient genitals, unwanted exposure to pornography or sexual content, and unwanted and intentional touching of a provider’s genitals, groin or breasts.

STATA and R were used to complete statistical analyses of the data gathered.

Of 330 respondents, 274 (83%) reported experiencing SH from a patient, while 213 (65%) reported experiencing SH in the past year. Of these, 135 (63%) reported SH one to three times in the past year, while 17 (8%) reported experiencing harassment more than once a month.

Women were significantly more affected by SH, with 231 of 247 (94%) reporting SH compared with 41 of 79 men (52%) (P < .001).

Of those who experienced unwanted sexual behavior from a patient, 218 of 300 (73%) did not officially report incidents. Most cited not believing a report would have productive consequences (67%) or not being sure the incident was serious enough (63%) as reasons not to report.

SH’s impact on burnout was reported by 76 of 252 respondents (30%), with 72 of 216 women affected over three of 34 men (33% vs. 9%; P = .002).

SA was reported by 98 of 320 subjects (31%), with 85 of 241 women reporting these incidents compared with 11 of 75 men (35% vs. 15%; P = .001).

“Our data highlight the very real problem of patient-perpetrated SH and SA occurring toward physicians, particularly women. Trainees in particular are on the front line of patient interactions and potential SH/SA exposure,” the authors wrote. “Our findings highlight a critical need to educate all of those involved, but particularly those who work with trainees, about the frequency of patient-to-provide SH/SA, provide training on SH/SA from patients and provide training on how to support providers when SH/SA from patients occurs.”