AAP updates policy on sexual, gender-based harassment in offices, schools
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The AAP updated a policy statement to address sexual and gender-based harassment in the pediatric work and learning environments.
The policy statement, published online in Pediatrics, is an update of a 2006 statement.
“One of the activities we're thinking a lot about these days is how to recruit, retain and support an appropriate pediatric workforce,” Julie S. Byerley, MD, MPH, president and dean of the Geisinger Commonwealth School of Medicine in Scranton, Pennsylvania, and a member of the AAP’s Committee on the Pediatric Workforce told Healio.
“We know that one of the things most important to wellness and doctoring is the prevention of burnout, and we also know that clinicians who feel that they're discriminated against or harassed or in environments that are not inclusive, they're less likely to be well, they're more likely to burn out, and it compromises the care of children and families,” Byerley said.
Byerley and colleagues conducted a literature review in preparation for the updates, and said that some of their findings were “troublesome.”
“One of the things that is troublesome is the concern about discrimination or even harassment toward providers from patients and families,” Byerley said. “We need to ensure that our clinical workspaces are always ones where respectful care is encouraged. It's most unfortunate that some health care providers of all different professions — not just pediatricians or physicians but all different providers in the clinical setting — are at risk of concerning behavior on the part of patients and families.”
Among the new issues addressed or elaborated upon in the statement are microaggressions, intersectionality and bystander training.
“What we have done since the 2006 statement is broaden our understanding of intersectionality and the way different factors come together to make some individuals at increased risk of harassment,” Byerley said. “We also understand gender in a broader way, and recognize concerns about mistreatment based on gender for individuals who don't fit typical gender norms.”
The statement also notes that because women now make up most pediatricians graduating from residency training in the years after 2006, men are in the minority of that population and are also at risk for gender-based harassment.
“Although attention to gender-based harassment typically focuses on men as perpetrators and women as victims, it is important to take a holistic approach to the issue, especially as a recognition for the workforce within the field of pediatrics,” the committee wrote.
Also newly discussed in the policy are setting expectations on patient behavior.
“Although patient expectations are often stated about timeliness to the visit, payments for services rendered, and other activities involved in the clinical interaction, it is less common to see statements of patient expectations regarding respectful treatment of clinical staff,” they wrote.
“In many settings, this culture is changing in recognition that stating expectations for patient behavior helps to establish a healing-oriented culture. Furthermore, naming respectful treatment and nondiscrimination as expectations for patient and family behaviors supports clinicians’ wellness and sustainability.”
“We all want simply to improve health and well-being in the lives of children,” Byerley said. “It's so much easier to do that effectively in an environment where you don't feel threatened or harassed, and it's the responsibility for each of us to create environments where everyone is safe and able to thrive.”
In addition to recommending a zero-tolerance policy toward overt sexual harassment, the committee recommends that practices establish a list of expected patient behaviors to protect all medical staff and develop an accompanying protocol, sharing data regarding harassment transparently among staff, among other advice.
“Our clinicians go into this kind of work because they want to serve others and help improve health and well-being,” Byerley said. “I think it is worth paying attention to what the environment is like for the work that one tries to do to that end.”
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