Sexual Harassment Resource Manual

Transcription

Association of Women Surgeons (AWS)
Sexual Harassment Resource Manual
AWS has created a compilation of reference information on sexual and gender
harassment issues. The materials include background on the historical development of
sexual harassment law, definitions of legal terms, strategies for handling personal
attacks, and techniques for managing situations that may arise. A bibliography, list of
telephone numbers, the AWS Statement on Sexual Harassment and sample harassment
policies from the AMWA and AAMC are also included.
Copyright 2001 Association of Women Surgeons
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- TABLE OF CONTENTS What is Sexual Harassment … page 3
Where To Go for Help … page 9
AWS Statement on Sexual Harassment … page 11
Additional Statements on Sexual Harassment … page 12
Sexual Harassment Resources … page 14
Facts & Statistics … page 19
Related Articles … page 28
Please note that every institute should have its own policy.
Please refer to each individual institution for more information.
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- WHAT IS SEXUAL HARASSMENT -
American Medical Association
E-3.08 Sexual Harassment and Exploitation Between Medical Supervisors and Trainees
Sexual harassment may be defined as sexual advances, requests for sexual favors, and other verbal or
physical conduct of a sexual nature when (l) such conduct interferes with an individual’s work or
academic performance or creates an intimidating, hostile, or offensive work or academic environment or
(2) accepting or rejecting such conduct affects or may be perceived to affect employment decisions or
academic evaluations concerning the individual. Sexual harassment is unethical.
Sexual relationships between medical supervisors and their medical trainees raise concerns because of
inherent inequalities in the status and power that medical supervisors wield in relation to medical trainees
and may adversely affect patient care. Sexual relationships between a medical trainee and a supervisor
even when consensual are not acceptable regardless of the degree of supervision in any given situation.
The supervisory role should be eliminated if the parties involved wish to pursue their relationship. (II, IV,
VII) Issued March 1992 based on the report "Sexual Harassment and Exploitation Between Medical
Supervisors and Trainees," adopted June 1989; Updated June 1994.
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- WHAT IS SEXUAL HARASSMENTTitle VII of the Civil Rights Act of 1964
GENERAL
Title VII of the Civil Rights Act of 1964, 42 USC 2000e, makes it unlawful for an employer to hire or
discharge any individual, or otherwise to discriminate against any individual with respect to his/her
compensation, terms, conditions or privileges of employment, because of an individual’s race, color,
religion, sex or national origin. This covers hiring, firing, promotions and all workplace conduct.
FILING REQUIREMENTS & LIMITATION PERIOD
In general, an individual must pre-file a charge with the EEOC within 180 days after the alleged unlawful
practice occurred unless he or she has first filed a charge with an appropriate state agency, in which
case the complainant has the earlier of 300 days from the date of the alleged violation or 30 days "after
receiving notice that the State or local agency has terminated the proceedings under the State or local
law." Notwithstanding the above, the EEOC regulations allow 300 days for filing a complaint in a State
where the State or local FEP agency has subject matter jurisdiction over the claims, regardless of
whether the claimant has first filed a claim with the State agency. Unless excused by the court, a action
must be filed within 90 days after receipt of a right-to-sue letter.
JURISDICTION
An employer (a person engaged in an industry affecting commerce) must have fifteen or more
employees for each working day in each of twenty or more calendar weeks (in the current or preceding
calandar year) to be covered by Title VII.
REMEDIES/DAMAGES
1. Back pay is the most common form of relief. Back pay consists of wages , salary and fringe
benefits the employee would have earned during the period of discrimination from the date of
termination (or failure to promote), to the date of trial.
2. Compensatory Damages are allowed for future loss, emotional distress, pain & suffering,
inconvenience, mental anguish & loss of enjoyment of life. Caps are placed on compensatory
damages according to the size of the employer. The limits on damages are as follows:
o Up to 100 employees: $50,000
o 101-200 employees: $100,000
o 201-500 employees: $200,000
o 500+ employees: $300,000
o These caps apply only to individuals. In a class action situation, each plantiff can be
awarded the maximum amount specified for the size of their company.
3. Attorney’s Fees may be awarded to the prevailing party.
4. Punitive Damages are limited to cases where the "employer has engaged in intentional
discrimination and has done so with malice or reckless indifference to the federally protected
rights of an aggrieved individual." Kolstad v. American Dental Association, 119 S.Ct. 2118 (1999).
These damages are capped according to the size of the employer and are the same as those
listed above: Up to 100 employees: $50,000; 101-200 employees: $100,000; 201-500
employees: $200,000; 500+ employees: $300,000
5. Front pay is designed to restore victims to their "rightful place". It compensates the victim for
anticipated future losses due to discrimination.
6. Injunctive relief is available when there is an intentional discriminatory employment practice.
For instance, an employee can be reinstated and an employer can be ordered to prevent future
discrimination.
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If you are seeking legal advice, find a qualified lawyer in your area. If you need help finding a lawyer,
call your local, county or state bar association. For more information, visit the Employment Law
Information Network at www.elinfonet.com.
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- WHAT IS SEXUAL HARASSMENT -
Sexual Harassment FAQ
by Nolo.com
Frequently asked questions about sexual harassment
Sexual harassment on the job took a dramatic leap into public awareness in October 1991, when
Professor Anita Hill made known her charges against Judge Clarence Thomas after his nomination to the
U.S. Supreme Court. Many other incidents have erupted since then, including investigations into the Navy
after the Tailhook incident and into government officials after Senator Bob Packwood was accused of
harassing several female staffers. Paula Jones dominated headlines for months with her claim that
President Clinton harassed her while a conventioneering governor. And more recently, Mitsubishi Motors
agreed to pay a record $34 million settlement to hundreds of women harassed at its auto assembly plant.
Enforcement of the laws prohibiting sexual harassment has been stepped up in the last few years. But in
workplaces across America, the issue is far from settled. Sexual harassment is still a daily problem for
many workers, especially women.
What is sexual harassment?
In legal terms, sexual harassment is any unwelcome sexual advance or conduct on the job that creates
an intimidating, hostile or offensive working environment. In real life, sexually harassing behavior ranges
from repeated offensive or belittling jokes to a workplace full of offensive pornography to an outright
sexual assault.
Are there laws that protect against sexual harassment on the job?
Yes. But surprisingly, those laws are fairly new. In 1980, the Equal Employment Opportunities
Commission (EEOC) issued regulations defining sexual harassment and stating it was a form of sex
discrimination prohibited by the Civil Rights Act, which had been originally passed in 1964. In 1986, the
U.S. Supreme Court first ruled that sexual harassment was a form of job discrimination -- and held it to
be illegal.
Today, there is greater understanding that the Civil Rights Act prohibits sexual harassment at work. In
addition, most states have their own fair employment practices laws that prohibit sexual harassment -many of them more strict than the federal law. To find out the law in your state, call 800-669-4000 and
ask for the federal EEOC office nearest you.
I'm being sexually harassed at work. What should I do?
Tell the harasser to stop. Surprisingly often -- some experts say up to 90% of the time -- this works.
When confronted directly, harassment is especially likely to end if it is at a fairly low level: off-color jokes,
inappropriate comments about your appearance, tacky cartoons tacked onto the office refrigerator or
repeated requests for dates after you have said no.
But clearly saying you want the offensive behavior to stop does more than let the harasser know that the
behavior is unwelcome. It is also a crucial first step if you later decide to take more formal action against
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the harasser, whether through your company's complaint procedure or through the legal system. And
give serious thought to documenting what's going on by keeping a diary or journal; your case will be
stronger if you can later prove that the harassment continued after you confronted the harasser.
What if the harassment doesn't stop even after I've confronted the harasser?
It may be time to get help from either your employer or a state or federal agency. Prepare to do this by
collecting as much detailed evidence as possible about the specifics of your harassment.
Be sure to save any offensive letters, photographs, cards or notes you receive. And if you were made to
feel uncomfortable because of jokes, pin-ups or cartoons posted at work, confiscate them -- or at least
make copies. An anonymous, obnoxious photo or joke posted on a bulletin board is not anyone else's
personal property, so you are free to take it down and keep it as evidence. If that's not possible,
photograph the workplace walls. Note the dates the offensive material was posted -- and whether there
were hostile reactions when you took it down or asked another person to do so.
Also, keep a detailed journal. Write down the specifics of everything that feels like harassment. Include
the names of everyone involved, what happened, where and when it took place. If anyone else saw or
heard the harassment, note that as well. Be as specific as possible about what was said and done -- and
how it affected you, your health or job performance.
If your employer has conducted periodic written evaluations of your work, make sure you have copies. In
fact, you may want to ask for a copy of your entire personnel file -- before you tip your hand that you are
considering taking action against a harassing co-worker. Your records will be particularly persuasive
evidence if your evaluations have been good but after you complain, your employer retaliates by trying to
transfer or fire you, claiming poor job performance.
If the harassment still doesn't stop, what are my options short of filing a lawsuit or a
complaint with a government agency?
If your harasser has ignored your oral requests to stop, or you are uncomfortable making the request,
write a succinct letter demanding an end to the behavior. If that doesn't end the harassment, you may
want to take more forceful action. Consider giving a copy of your letter to the harasser's supervisor -along with a memo explaining that the behavior has become more outrageous.
If the harassment still does not abate -- or if you believe the supervisor is sympathetic to the harassment
or the harasser -- send the letter to the next-ranked worker or official at your workplace. Include a cover
letter in which you offer your own remedy for the situation -- something realistic that might help end the
discomfort, such as transferring the harasser to a more distant worksite. If it's your own supervisor who
has been harassing you, consider asking to be assigned a different supervisor.
These days, most workplaces have specific written policies prohibiting sexual harassment. If you have
followed the steps that seem reasonable to you but the harassment continues, your next option is to
pursue any procedure your company has established for handling harassment.
What legal steps can I take to end the harassment?
If all investigation and settlement attempts fail to produce satisfactory results, one option is to file a civil
lawsuit for damages either under the federal Civil Rights Act or under a state fair employment practices
statute.
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Even if you intend right from the beginning to file such a lawsuit, you sometimes must first file a claim
with a government agency. For example, an employee pursuing a claim under the Civil Rights Act must
first file a claim with the federal EEOC, and a similar complaint procedure is required under some state
laws. The EEOC or state agency may decide to prosecute your case on its own, but that happens only
occasionally.
More commonly, at some point, the agency will issue you a document referred to as a "right-to-sue"
letter that allows you to take your case to court. When filing an action for sexual harassment, you will
almost always need to hire a lawyer for help.
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- WHERE TO GO FOR HELP -
Filing a Charge
The U.S. Equal Employment Opportunity Commission
If you believe you have been discriminated against by an employer, labor union or employment
agency when applying for a job or while on the job because of your race, color, sex, religion,
national origin, age, or disability, or believe that you have been discriminated against
because of opposing a prohibited practice or participating in an equal employment opportunity
matter, you may file a charge of discrimination with the U.S. Equal Employment Opportunity
Commission (EEOC).
Charges may be filed in person, by mail or by telephone by contacting the nearest EEOC office. If
there is not an EEOC office in the immediate area, call toll free 800-669-4000 or 800-669-6820
(TDD) for more information. To avoid delay, call or write beforehand if you need special
assistance, such as an interpreter, to file a charge.
There are strict time frames in which charges of employment discrimination must be filed. To
preserve the ability of EEOC to act on your behalf and to protect your right to file a private
lawsuit, should you ultimately need to, adhere to the following guidelines when filing a charge.
Title VII of the Civil Rights Act (Title VII) charges must be filed with EEOC within 180 days
of the alleged discriminatory act. However, in states or localities where there is an
antidiscrimination law and an agency authorized to grant or seek relief, a charge must be
presented to that state or local agency. Furthermore, in such jurisdictions, you may file charges
with EEOC within 300 days of the discriminatory act, or 30 days after receiving notice that the
state or local agency has terminated its processing of the charge, whichever is earlier. It is best
to contact EEOC promptly when discrimination is suspected. When charges or complaints are
filed beyond these time frames, you may not be able to obtain any remedy.
Americans with Disabilities Act (ADA) - The time requirements for filing a charge are the
same as those for Title VII charges.
Age Discrimination in Employment Act (ADEA) - The time requirements for filing a charge
are the same as those for Title VII and the ADA.
Equal Pay Act (EPA) - Individuals are not required to file an EPA charge with EEOC before filing
a private lawsuit. However, charges may be filed with EEOC and some cases of wage
discrimination also may be violations of Title VII. If an EPA charge is filed with EEOC, the
procedure for filing is the same as for charges brought under Title VII. However, the time limits
for filing in court are different under the EPA, thus, it is advisable to file a charge as soon as you
become aware the EPA may have been violated.
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- WHERE TO GO FOR HELP Most institutions and hospitals have their own policies and statements regarding sexual harassment. File
all complaints with your institution. If taking the complaint to your place of employment is ineffective,
then file with the Equal Employment Opportunity Commission in your state.
Important Phone Numbers
9 to 5 Job Problem Hotline, The National Association of Working Women
800-522-0925
9to5 is a national nonprofit membership organization for working women. It provides counseling,
information and referrals for problems on the job, including family leave, pregnancy disability,
termination, compensation and sexual harassment. 9to5 also offers a newsletter and publications. There
are local chapters throughout the country.
Feminist Majority Foundation
703-522-2214 (East Coast) or 323-651-0495 (West Coast)
The Feminist Majority Foundation (FMF), which was founded in 1987, is a cutting edge organization
dedicated to women's equality, reproductive health, and non-violence. In all spheres, FMF utilizes
research and action to empower women economically, socially, and politically. Our organization believes
that feminists - both women and men, girls and boys - are the majority, but this majority must be
empowered.
FMF engages in research and public policy development, public education programs, grassroots
organizing projects, leadership training and development programs, and participates in and organizes
forums on issues of women's equality and empowerment. Their sister organization, the Feminist Majority,
engages in lobbying and other direct political action, pursuing equality between women and men through
legislative avenues.
Equal Employment Opportunity Commission
800-669-4000 (to be connected to the nearest field office)
The EEOC coordinates all federal equal employment opportunity regulations, practices, and policies. The
Commission interprets employment discrimination laws, monitors the federal sector employment
discrimination program, provides funding and support to state and local Fair Employment Practices
Agencies (FEPAs), and sponsors outreach and technical assistance programs.
Any individual who believes he or she has been discriminated against in employment may file an
administrative charge with the EEOC. After investigating the charge, the EEOC determines if there is
"reasonable cause" to believe discrimination has occurred. If "reasonable cause" is found, the EEOC
attempts to conciliate the charge by reaching a voluntary resolution between the charging party and the
respondent. If conciliation is not successful, the Commission may bring suit in federal court. As part of
the administrative process, the EEOC may also issue a Right-to-Sue-Notice to the charging party, allowing
the charging party to file an individual action in court without the Agency's involvement.
Check the government yellow pages (blue) for your state’s Division of Human Rights
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- AWS STATEMENT ON SEXUAL HARASSMENT -
Association of Women Surgeons
5204 Fairmount Avenue, Downers Grove, IL 60559
WomenSurgeons.org [email protected]
 (630) 655-0392
Fax (630) 493-0798
Sexual Harassment and Gender Discrimination
Surgery has traditionally been viewed as an inhospitable field for women physicians. Women have been
actively discouraged from entering surgery and have had few role models or mentors within the
profession. These factors, as well as the perception that the demands of surgical training and practice are
incompatible with a balanced personal and professional life, have been major deterrents to women
entering surgery. In addition, many women physicians have experienced episodes of physical and verbal
sexual harassment during surgical education and clinical experiences.
Overt sexual harassment should be considered separately from gender discrimination. Sexual harassment
is a specific form of gender discrimination characterized by verbal or physical conduct of a sexual nature,
which creates an intimidating, hostile, or offensive professional environment. The common behaviors and
situations present every day in the surgical workplace, which adversely affect the work of women, are
often the consequence of the differential treatment of women or gender bias, rather than sexual
harassment. Gender inequities present in the professional environment include slights, which are
inappropriate and unfair, and can be painful and destructive to women. The gender bias perceived by
women surgeons within the surgical community is a reflection of the attitudes prevalent within our
society in general.
Gender inequities experienced daily by all women professionals continues to negatively impact the
scientific, academic and political achievements of women surgeons. Women and other minorities are
excluded from professional networks and mentoring relationships, ignored and demeaned professionally,
and exploited in situations with little potential for professional rewards. Until women are completely
integrated in the highest level of governance in surgery and medicine, the achievement of equivalent
opportunity and recognition will continue to require women surgeons to perform at a level above their
peers in order to achieve the recognition their achievements deserve.
The mission of the Association of Women Surgeons is to inspire, encourage and enable women surgeons
to realize their professional and personal goals. We are committed to fostering an environment for the
practice of surgery which is supportive, fair, and in which all individuals are treated with respect and
tolerance. Discrimination or harassment cannot be condoned by the surgical community. The rapid influx
of women physicians into surgery and its subspecialties should have a major positive influence on
attitudes regarding women as surgeons, trainees and patients.
References
1. Lenhart SA, Evans CH: Sexual harassment and gender discrimination: A primer for women
physicians. JAMWA 1991; 46:77-82.
2. Erhart JK, Sand BR: Rx for Success: Improving the Climate for Women in Medical Schools and
Teaching Hospitals. Washington, Association of American Colleges, Project on the Status and
Education of Women, 1990.
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ADDITIONAL STATEMENTS ON SEXUAL HARASSMENT -
POSITION STATEMENT ON GENDER DISCRIMINATION AND SEXUAL HARASSMENT
The American Medical Women's Association is an organization of women physicians and
medical students which values equality for women and equal opportunity for women to
achieve their full professional and personal potential. AMWA maintains as primary
organizational objectives: the promotion of education and training of women physicians,
the encouragement of women to study and practice medicine, and the assurance of
equal opportunity for women to study and practice medicine. Sexual harassment and
gender discrimination fundamentally preclude these key objectives via multiple routes.
Examples are:
•
•
•
•
•
•
•
Interference with the quality of learning.
Interference with both quality of the practice of medicine and the performance of
other professional activities.
Negative impact on morale.
Interference with opportunities for promotion and career development.
Negative impact on women's physical and psychological well-being.
Negative impact on patient care and doctor/patient relationships.
Interference with opportunities to assume leadership positions within medicine.
In light of these considerations, the American Medical Women's Association has adopted
the position to oppose all forms of sexual harassment and gender discrimination against
women in medical academia, organizations, hospitals, clinics, private practices, publishing
endeavors, and any other professional activities.
Gender discrimination shall be defined as any behaviors, actions, or policies which
adversely affect women due to disparate treatment, disparate impact, or the creation of
a hostile or intimidating work or learning environment. Sexual harassment, a form of
gender discrimination, shall be defined as unwelcomed sexual advances, requests for
sexual favors, or other verbal or physical conduct of a sexual nature when: 1.)
submission to such conduct is made either explicitly or implicitly a term or condition of an
individual's training or professional position, 2.) submission to or rejection of such
conduct by an individual is used as a basis for professional decisions affecting such
individual, or 3.) such conduct has the purpose or effect of unreasonably interfering with
an individual's work/learning performance or creating an intimidating, hostile or offensive
work environment. Examples of behavior that the American
Medical Women's Association may consider as gender discrimination or sexual
harassment include, but are not limited to, the following:
•
Any verbal sexual advance or touching that is deemed by the recipient to be
unwelcome.
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•
•
•
•
•
•
•
•
•
•
•
Sexually oriented comments about the body, appearance or lifestyle of a woman.
Offensive non-verbal behavior such as leering or staring which is deemed by the
recipient to be unwelcome.
Showing or displaying sexually explicit graphics, cartoons, pictures, photographs,
or objects in the school or workplace.
Statements or threats which imply a link or could be reasonably construed to
imply a link between a woman's sexual conduct and her work/training status,
advancement potential, salary treatment, or other action affecting her
professional status or development.
Unequal pay for women's medical training, research, academic, administrative,
practice, or organizational activities.
Unequal or limited access to important mentor relationships.
Unequal or limited access to faculty appointments, promotions, and tenure.
Diminished recognition for clinical work or research due to gender.
Failure to recognize authorship or original material.
Punitive behaviors, actions, or limitations in opportunities for training and career
advancement due to pregnancy or parenting status.
Failure to establish reasonable parental leave policies that allow at least thirteen
weeks leave of absence without jeopardy to job security or rank.
The American Medical Women's Association will support medical institutions,
organizations, and individuals who:
•
•
•
•
Actively monitor the status of women and maintain equity in salary and
promotions.
Provide flexible residencies or job opportunities that provide for parenting status.
Maintain reasonable parental leaves that protect job status and rank as indicated
above.
Have established discrimination and sexual harassment policies and complaint
procedures that specify reporting procedures that are protective of the
complainant's privacy, that provide security against retaliation, and that result in
effective punishment of offenders.
AMWA is committed to the opposition of gender discrimination through, but not limited
to:
1. Educational workshops that enhance the understanding of discrimination and its
prevention.
2. Publication of articles in JAMWA relevant to the identification, prevention, and
resolution of gender discrimination.
3. Resource packets that assist women in preventing, recognizing and dealing with
discrimination.
4. A Gender Equity Subcommittee to monitor the impact of and recommend
organizational responses.
5. Networking of women professionals and organizations active in preventing
discrimination.
6. Support of legislators and bills which promote gender equity.
7. Provision of resource material to women encountering discrimination
Adopted by the House of Delegates
November 1990
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- SEXUAL HARASSMENT RESOURCES Books
1995 Women’s Information Exchange Directory (2nd Ed.). Gayle Research, 1996.
2002 Employers Reasonable Care Pack: Sexual Harassment Prevention in the Workplace. Employer
Publications, 1999.
A Costly Proposition: Sexual Harassment at Work. BNA Communications, Inc., 1986.
Encyclopedia of Women Association Worldwide. Gayle Research, 1993.
Intent vs. Impact: A Sexual Harassment Training Program. BNA Communications, Inc., 1988.
Myths vs. Facts, Trainer's Manual: A Program for the Prevention and Resolution of Sexual Harassment.
BNA Communications. Inc., 1992.
Myths vs. Facts: How to Manage Sexual Harassment Situations. BNA Communications, Inc., 1992.
Myths vs. Facts: How to Recognize and Confront Subtle Sexual Harassment. BNA Communications, Inc.,
1992.
Preventing Sexual Harassment: A Management Responsibility, Trainer's Manual. Employers Resource
Group, 1992.
Achampong, Francis. Workplace Sexual Harassment Law: Principles, Landmark Developments, and
Framework for Effective Risk Management. Quorum Books, 1999.
Allen, Bet T. Preventing Sexual Harassment on Campus: Policies and Practices for Higher Education,
1995.
Anderson, Stephen F. How to Effectively Manage Sexual Harassment Investigations, 1992.
Agonito, Rosemary. No More “Nice Girl”: Power, Sexuality & Success in the Workplace. Holbrook, MA:
Bob Adams, Inc., 1993.
Barickman, Richard B. and Michele Antoinette Paludi. Academic and Workplace Sexual Harassment: A
Resource Manual. New York: State University of New York Press, 1991.
Bingham, Clara and Laura Leedy Gansler. Class Action: The Story of Lois Jenson and the Landmark Case
That Changed Sexual Harassment Law. Doubleday, 2002.
Black, Beryl and Ruth C. Rosen. Coping With Sexual Harassment. Rosen Publishing Group, 1990.
Bouchard, Elizabeth. Everything You Need to Know About Sexual Harassment. Rosen Publishing Group,
1997.
Bradbery, Angela and Rosemarie Lally. Investigating Sexual Harassment Complaints: A Practical Guide.
Thompson Publishing Group, 1998.
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Bravo, Ellen and Ellen Cassedy. The 9 to 5 Guide to Combating Sexual Harassment: Candid Advice from 9
to 5. The National Association of Working Women, 1999.
Chan, Anja Angelica. Women and Sexual Harassment: A Practical Guide to the Legal Protections of Title
VII and the Hostile Environment Claim. Haworth, 1994.
Constantinides, Kathy, Challenging Professional Sexual Exploitation: A Handbook for Survivors, 1993.
Demars, Nan. You Want Me to Do What?: When, Where, and How to Draw the Line at Work. Fireside,
1998.
Dimona, Lisa and Constance Herndon. 1995 Information Please: Women’s Source Book. Houghton Mifflin,
1995.
Eberhardt, Louise Yolton and L. Tobin. Confronting Sexual Harassment (Working With Groups in the
Workplace). Whole Person Associates, 1997.
Eisaguirre, Lynne. Sexual Harassment: A Reference Handbook (2nd Ed.). ABC-CLIO, 1997.
Engelberg-Moston, Estella and Stephen Moston. Sexual Harassment: The Employer's Guide to Causes,
Consequences and Remedies. Business & Professional Publishing, 1999.
Eskenazi, Martin and David Gallen. Sexual Harassment: Know Your Rights. New York: Carroll & Graf,
1992.
Fick, Barbara J. and the American Bar Association. The American Bar Association Guide to Workplace
Law: Everything You Need to Know About Your Rights As an Employee or Employer. Times Books, 1997.
Fitzwater, Terry. The Manager's Pocket Guide to Preventing Sexual Harassment. Human Resources
Development Press, 1999.
Florence, Mari and Ed Fortson. Sex at Work: Attraction, Harassment, Flirtation and Discrimination. Silver
Lake, 2001.
Friedman, Joel, Marcia Mobilia Boumil and Barbara Ewert Taylor. Sexual Harassment: What it Is, What It
Isn't, What It Does to You, and What You Can Do About It. Health Communications, 1992.
Gomez-Preston, Cheryl and Randi Reisfeld. When No Means No: A Guide to Sexual Harassment by a
Woman Who Won a Million Dollar Verdict. Secaucus, NJ: Carol Publishing Group, 1992.
Langelan, Martha J., Hugh Garner and Catharine A. MacKinnon. Back Off: How to Confront and Stop
Sexual Harassment and Harassers. Fireside, 1993.
Lemoncheck, Linda and James P. Sterba. Sexual Harassment: Issues and Answers. Oxford University
Press, 2001.
Lemoncheck, Linda and Mane Hajdin. Sexual Harassment. Rowman & Littlefield Publishing, 1997.
Levy, Anne C. and Michelle Antoinette Paludi. Workplace Sexual Harassment (2nd Ed.). Prentice Hall,
2001.
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Lindemann, Barbara and David D. Kadue. Primer on Sexual Harassment. Washington DC: Bureau of
National Affairs, 1992.
Lynch, Frances and Kathleen Doyle. Draw the Line: A Sexual Harassment Free Workplace. PSI Research,
1995.
McFarland, Rhoda. Working Together Against Sexual Harassment. Rosen Publishing Group, 1996.
Miramontes, David J. How to Deal with Sexual Harassment. San Diego: Network Communications, 1984.
Nicarthy Ginny, Naomi Gottlieb and Sandra Coffman. You Don’t Have to Take It!: A Woman’s Guide to
Confronting Emotional Abuse at Work. Seattle: Seal Press, 1993.
O’Shea, Tracy and Jane Lalonde. Sexual Harassment: A Practical Guide to the Law, Your Rights, and Your
Options for Taking Action. Griffin Trade Paperback, 1998.
Petrocelli, William and Barbara Kate Repa. Sexual Harassment on the Job:What It Is and How to Stop It
(4th Ed.). Berkely: Nolo Press, 2000.
Pruett, Kimberly. Sexual Harassment in the Workplace: A Legal Research Guide (Legal Research Guides,
Vol. 42). William S. Hein & Co., 2001.
Sandler, Bernice R. and Michele A. Paludi. Educator's Guide to Controlling Sexual Harassment. Thompson
Publishing Group, 1993.
Segrave, Kerry. The Sexual Harassment of Women in the Workplace 1600-1993. Jefferson NC:
McFarland, 1994.
Shaw, Ph.D., Victoria. Coping With Sexual Harassment and Gender Bias. Rosen Publishing Group, 2000.
Swisher, Karin. What is Sexual Harassment? San Diego: Greenhaven Press, 1995.
Taylor, Joan Kennedy. What to Do When You Don't Want to Call the Cops: A Non-Adversarial Approach to
Sexual Harassment. New York: New York University Press, 1999.
Webb, Susan L. Sexual Harassment: Investigator's Manual. Pacific Resource Development Group, 1999.
Webb, Susan L. Sexual Harassment, Shades of Gray : Guidelines for Managers, Supervisors & Employees.
Pacific Resource Development Group, 1999.
Webb, Susan L. Shock Waves: The Global Impact of Sexual Harassment, 1994.
Webb, Susan L. Step Forward: Sexual Harassment in the Workplace: What You Need to Know! Master
Media.
Webb, Susan L. The Webb Report Newsletter, beginning 1992.
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- SEXUAL HARASSMENT RESROUCES Online
Discrimination Attorney.com
www.discriminationattorney.com/
Employer-employee.com
www.employer-employee.com/sexhar1.htm
Free Advice – Sexual Harassment Law: Free Legal Information
http://employment-law.freeadvice.com/sexual_harassment/
LawGuru.com – Sexual Harassment Law FAQ
www.lawguru.com/faq/16.html
National Women’s Law Center
www.nwlc.org/index.cfm
Prevent Claims.com – Sexual Harassment & Employment Law Resource Center
www.preventclaims.com/federal.htm
Washington Education Association
www.wa.nea.org/publicat/legal/sexhar.htm
Organizations
American Bar Association
- 312-988-5522
- www.abanet.org
- [email protected]
- http://www.abanet.org/barserv/22-3sexhar.html
American College of Surgeons
- 312-202-5000
- www.facs.org
- [email protected]
American Medical Association
- 312-464-5000 Headquarters
- www.ama-assn.org
Equal Employment Opportunity Commission
- 202-663-4900 Headquarters
- 800-669-4000 To be connected to nearest field office
- www.eeoc.gov
Feminist Majority Foundation
- 703-522-2214 Virginia office
- 323-651-0495 California office
- www.feminist.org/911/1_supprt.html
- [email protected]
17
National Association of Working Women
- 800-522-0925
- www.9to5.org
- [email protected]
The National Organization for Women (NOW)
- 202-628-8669
- www.now.org
o www.now.org/issues/harass/
o www.now.org/issues/harass/issuerep.html
o www.now.org/issues/wfw/index.html
- [email protected]
Videos
Business Know-How – Harassment/Sexual Harassment Awareness Training Manual & CD For Supervisory
and Non-Supervisory Staff
- 631-467-6826
- www.businessknowhow.com/store/aboutharasstrain.htm
Capstone Communications – Sexual harassment prevention training videos
- 530-343-9932
- www.capstn.com/index.html
Enterprise Media – Sexual harassment training videos
- 800-423-6021
- www.enterprisemedia.com/Personnel.html
Pacific Resource Development Group, Inc.
- 800-767-3062
- See tab 8 of binder for a catalog of products
TrainingABC.com – Sexual harassment prevention videos
- 888-281-8038
- www.trainingabc.com/sexualharassment.htm
18
- FACTS & STATISTICS-
Sexual Harassment Statistics
Information from Capstone Communications
•
•
•
Legal Fees for defending a civil case in court average about $250,000.
Judgments in sexual harassment cases routinely exceed $1 million.
The U.S. Department of Labor has estimated that American business loses about $1 billion annually
in absenteeism, low morale and new employee training and replacement costs as a result of sexual
harassment. This figure does not include judgments in civil court cases.
Workplace Statistics:
A telephone poll conducted by Louis Harris and Associates and released March 28, 1994 found that of the
782 workers polled:
-
31% female workers claimed to have been harassed at work
7% male workers claimed to have been harassed at work
62% of targets took no action
Of the women who had been harassed:
-
43% harassed by supervisor
27% by an employee senior to them
19% by a coworker at their level
8% by a junior employee
Of the women who claimed they had been harassed:
-
100% of women = harasser was a man
59% of men = harasser was a woman
41% of men = harasser was another man
19
- FACTS & STATISTICS -
Sex-Based Charges FY 1992 - FY 2001
The following chart represents the total number of charge receipts filed and resolved under Title VII
alleging sex-based discrimination. The data are compiled by the Office of Research, Information, and
Planning from EEOC's Charge Data System - national data base.
FY
1992
FY
1993
FY
1994
FY
1995
FY
1996
FY
1997
FY
1998
FY
1999
FY
2000
FY
2001
Receipts
21,796 23,919 25,860 26,181 23,813 24,728 24,454 23,907 25,194 25,140
Resolutions
20,102 21,606 21,545 26,726 30,965 32,836 31,818 30,643 29,631 28,602
Resolutions By
Type
Settlements
Withdrawals
w/Benefits
Administrative
Closures
1,496
1,399
1,231
1,235
1,070
1,355
1,460
1,988
2,644
2,404
7.4%
6.5%
5.7%
4.6%
3.5%
4.1%
4.6%
6.5%
8.9%
8.4%
1,391
1,693
1,644
1,695
1,318
1,205
1,148
1,269
1,332
1,321
6.9%
7.8%
7.6%
6.3%
4.3%
3.7%
3.6%
4.1%
4.5%
4.6%
5,709
7,416
9,169 11,328 11,001 11,127 10,056
8,747
6,897
6,391
28.4% 34.3% 42.6% 42.4% 35.5% 33.9% 31.6% 28.5% 23.3% 22.3%
No Reasonable
Cause
10,823 10,472
8,801 11,837 16,723 17,832 17,493 16,689 15,980 15,654
53.8% 48.5% 40.8% 44.3% 54.0% 54.3% 55.0% 54.5% 53.9% 54.7%
Reasonable Cause
Successful
Conciliations
Unsuccessful
Conciliations
Merit Resolutions
683
626
700
621
852
1,317
1,661
1,950
2,778
2,832
3.4%
2.9%
3.2%
2.3%
2.8%
4.0%
5.2%
6.4%
9.4%
9.9%
247
259
250
199
254
332
454
535
707
739
1.2%
1.2%
1.2%
0.7%
0.8%
1.0%
1.4%
1.7%
2.4%
2.6%
436
367
450
422
598
985
1,207
1,415
2,071
2,093
2.2%
1.7%
2.1%
1.6%
1.9%
3.0%
3.8%
4.6% 7.0%
3,570
3,718
3,575
3,551
3,240
3,877
4,269
5,207
6,754
7.3%
6,557
17.8% 17.2% 16.6% 13.3% 10.5% 11.8% 13.4% 17.0% 22.8% 22.9%
20
Monetary Benefits
(Millions)*
$30.7
$44.0
$44.1
$23.6
$47.1
$72.5
$58.7
$81.7 $109.0
$94.4
* Does not include monetary benefits obtained through litigation.
The total of individual percentages may not always sum to 100% due to rounding.
EEOC total workload includes charges carried over from previous fiscal years, new charge receipts and
charges transferred to EEOC from Fair Employment Practice Agencies (FEPAs). Resolution of charges
each year may therefore exceed receipts for that year because workload being resolved is drawn from
a combination of pending, new receipts and FEPA transfer charges rather than from new charges only.
21
Sexual Harassment Charges EEOC & FEPAs Combined:
FY 1992 - FY 2001
alleging sexual harassment discrimination as an issue. The data in the sexual harassment table reflect
charges filed with EEOC and the state and local Fair Employment Practices agencies around the
country that have a work sharing agreement with the Commission. The data are compiled by the
Office of Research, Information, and Planning from EEOC's Charge Data System - national data base.
FY
1992
Receipts
FY
1993
FY
1994
FY
1995
FY
1996
FY
1997
FY
1998
FY
1999
FY
2000
FY
2001
10,532 11,908 14,420 15,549 15,342 15,889 15,618 15,222 15,836 15,475
% of Charges
Filed by Males
9.1%
9.1%
9.9%
9.9% 10.0% 11.6% 12.9% 12.1% 13.6% 13.7%
Resolutions
7,484
9,971 11,478 13,802 15,861 17,333 17,115 16,524 16,726 16,383
1,029
1,132
1,075
978
1,082
1,178
1,218
1,361
1,676
1,568
13.7% 11.4%
9.4%
7.1%
6.8%
6.8%
7.1%
8.2% 10.0%
9.6%
1,026
1,118
1,280
1,223
1,267
1,311
1,299
1,389
1,454
9.4% 10.3%
9.7%
9.3%
7.7%
7.3%
7.7%
7.9%
8.3%
8.9%
2,997
5,221
6,884
6,806
6,887
6,292
5,401
4,628
4,293
Resolutions By
Type
Settlements
Withdrawals
w/Benefits
Administrative
Closures
705
4,106
40.0% 41.2% 45.5% 49.9% 42.9% 39.7% 36.8% 32.7% 27.7% 26.2%
No Reasonable
Cause
2,458
3,326
3,525
4,195
6,153
7,172
7,243
7,272
7,370
7,309
32.8% 33.4% 30.7% 30.4% 38.8% 41.4% 42.3% 44.0% 44.1% 44.6%
Reasonable Cause
Successful
Conciliations
Unsuccessful
Conciliations
285
366
520
451
577
808
1,047
1,180
1,659
3.8%
3.7%
4.5%
3.3%
3.6%
4.7%
6.1%
7.1%
9.9% 10.7%
152
180
220
174
232
298
357
383
524
551
2.0%
1.8%
1.9%
1.3%
1.5%
1.7%
2.1%
2.3%
3.1%
3.4%
133
186
300
277
345
510
690
797
1,135
1,195
1.8%
1.9%
2.6%
2.0%
2.2%
2.9%
4.0%
22
4.8% 6.8%
1,746
7.3%
Merit Resolutions
2,019
2,524
2,713
2,709
2,882
3,253
3,576
3,840
4,724
4,768
27.0% 25.3% 23.6% 19.6% 18.2% 18.8% 20.9% 23.2% 28.2% 29.1%
Monetary Benefits
(Millions)*
$12.7
$25.1
$22.5
$24.3
$27.8
$49.5
$34.3
$50.3
$54.6
$53.0
each year may therefore exceed receipts for that year because workload being resolved is drawn from a
combination of pending, new receipts and FEPA transfer charges rather than from new charges only.
23
Pregnancy Discrimination Charges EEOC & FEPAs
Combined: FY 1992 - FY 2001
alleging pregnancy discrimination as an issue. The data in the pregnancy discrimination table reflect
charges filed with EEOC and the state and local Fair Employment Practices Agencies around the
country that have a work sharing agreement with the commission. The data are compiled by the
Office of Research, Information, and Planning from EEOC's Charge Data System - national data base.
FY
1992
FY
1993
FY
1994
FY
1995
FY
1996
FY
1997
FY
1998
FY
1999
FY
2000
FY
2001
Receipts
3,385
3,577
4,170
4,191
3,743
3,977
4,219
4,166
4,160
4,287
Resolutions
3,045
3,145
3,181
3,908
4,186
4,595
4,467
4,343
4,480
4,280
457
420
373
440
388
395
424
505
602
518
15.0% 13.4% 11.7% 11.3%
9.3%
8.6%
Resolutions By
Type
Settlements
Withdrawals
w/Benefits
237
7.8%
Administrative
Closures
762
311
9.5% 11.6% 13.4% 12.1%
341
362
323
379
328
359
322
327
9.9% 10.7%
9.3%
7.7%
8.2%
7.3%
8.3%
7.2%
7.6%
1,155
1,098
1,103
1,026
897
821
761
756
920
25.0% 24.0% 28.9% 29.6% 26.2% 24.0% 23.0% 20.7% 18.3% 17.8%
No Reasonable
Cause
1,497
1,552
1,435
1,851
2,276
2,432
2,534
2,389
2,452
2,373
49.2% 49.3% 45.1% 47.4% 54.4% 52.9% 56.7% 55.0% 54.7% 55.4%
Reasonable
Cause
Successful
Conciliations
Unsuccessful
Conciliations
Merit Resolutions
87
104
104
96
97
279
154
188
280
298
2.9%
3.3%
3.3%
2.5%
2.3%
6.1%
3.4%
4.3%
6.3%
7.0%
56
62
60
51
55
71
66
81
110
123
1.8%
2.0%
1.9%
1.3%
1.3%
1.5%
1.5%
1.9%
2.5%
2.9%
31
42
44
45
42
208
88
107
170
175
1.0%
1.3%
1.4%
1.2%
1.0%
4.5%
2.0%
2.5%
3.8%
4.1%
781
835
818
898
808
1,053
906
1,052
1,204
1,143
24
25.6% 26.6% 25.7% 23.0% 19.3% 22.9% 20.3% 24.2% 26.9% 26.7%
Monetary
Benefits
(Millions)*
$3.7
$3.9
$4.0
$4.7
$4.1
$5.6
$5.3
$6.7
$20.6
$7.5
each year may therefore exceed receipts for that year because workload being resolved is drawn from a
combination of pending, new receipts and FEPA transfer charges rather than from new charges only.
25
Definitions of Terms
Administrative Closure
Charge closed for administrative reasons, which include: failure to locate charging party, charging party
failed to respond to EEOC communications, charging party refused to accept full relief, closed due to the
outcome of related litigation which establishes a precedent that makes further processing of the charge
futile, charging party requests withdrawal of a charge without receiving benefits or having resolved the
issue, no statutory jurisdiction.
Merit Resolutions
Charges with outcomes favorable to charging parties and/or charges with meritorious allegations. These
include negotiated settlements, withdrawals with benefits, successful conciliations, and unsuccessful
conciliations.
No Reasonable Cause
EEOC's determination of no reasonable cause to believe that discrimination occurred based upon
evidence obtained in investigation. The charging party may exercise the right to bring private court
action.
Reasonable Cause
EEOC's determination of reasonable cause to believe that discrimination occurred based upon evidence
obtained in investigation. Reasonable cause determinations are generally followed by efforts to conciliate
the discriminatory issues which gave rise to the initial charge. NOTE: Some reasonable cause findings are
resolved through negotiated settlements, withdrawals with benefits, and other types of resolutions, which
are not characterized as either successful or unsuccessful conciliations.
Settlements (Negotiated)
Charges settled with benefits to the charging party as warranted by evidence of record. In such cases,
EEOC and/or a FEPA is a party to the settlement agreement between the charging party and the
respondent (an employer, union, or other entity covered by EEOC-enforced statutes).
Successful Conciliation
Charge with reasonable cause determination closed after successful conciliation. Successful conciliations
result in substantial relief to the charging party and all others adversely affected by the discrimination.
Unsuccessful Conciliation
Charge with reasonable cause determination closed after efforts to conciliate the charge are unsuccessful.
Pursuant to Commission policy, the field office will close the charge and review it for litigation
consideration. NOTE: Because "reasonable cause" has been found, this is considered a merit resolution.
Withdrawal with Benefits
Charge is withdrawn by charging party upon receipt of desired benefits. The withdrawal may take place
after a settlement or after the respondent grants the appropriate benefit to the charging party.
26
Facts About Sexual Harassment
Sexual harassment is a form of sex discrimination that violates Title VII of the Civil Rights Act of 1964.
Unwelcome sexual advances, requests for sexual favors, and other verbal or physical conduct of a sexual
nature constitutes sexual harassment when submission to or rejection of this conduct explicitly or
implicitly affects an individual's employment, unreasonably interferes with an individual's work
performance or creates an intimidating, hostile or offensive work environment.
Sexual harassment can occur in a variety of circumstances, including but not limited to the following:
-
The victim as well as the harasser may be a woman or a man. The victim does not have to be of
the opposite sex.
The harasser can be the victim's supervisor, an agent of the employer, a supervisor in another
area, a co-worker, or a non-employee.
The victim does not have to be the person harassed but could be anyone affected by the
offensive conduct.
Unlawful sexual harassment may occur without economic injury to or discharge of the victim.
The harasser's conduct must be unwelcome.
It is helpful for the victim to directly inform the harasser that the conduct is unwelcome and must stop.
The victim should use any employer complaint mechanism or grievance system available.
When investigating allegations of sexual harassment, EEOC looks at the whole record: the circumstances,
such as the nature of the sexual advances, and the context in which the alleged incidents occurred. A
determination on the allegations is made from the facts on a case-by-case basis.
Prevention is the best tool to eliminate sexual harassment in the workplace. Employers are encouraged to
take steps necessary to prevent sexual harassment from occurring. They should clearly communicate to
employees that sexual harassment will not be tolerated. They can do so by establishing an effective
complaint or grievance process and taking immediate and appropriate action when an employee
complains.
27
- RELATED ARTICLES -
Vol. 158, pp. 352-358, Feb. 23, 1998
Prevalence and Correlates of Harassment Among US Women Physicians
Erica Frank, MD, MPH; Donna Brogan, PhD; Melissa Schiffman, MD
Background: Despite concerns about its prevalence and ramifications, harassment has not been well
quantified among physicians. Previous published studies have been small, have surveyed only 1 site or a
convenience sample, and have suffered from selection bias.
Methods: Our database is the Women Physicians' Health Study, a large (4501 respondents; response rate,
59%), nationally distributed questionnaire study. We analyzed responses concerning gender-based and
sexual harassment.
Results: Overall, 47.7% of women physicians reported ever experiencing gender-based harassment, and
36.9% reported sexual harassment. Harassment was more common while in medical school (31% for
gender-based and 20% for sexual harassment) or during internship, residency, or fellowship (29% for
gender-based and 19% for sexual harassment) than in practice (25% for gender-based and 11% for sexual
harassment). Respondents more likely to report gender-based harassment were physicians who were now
divorced or separated and those specializing in historically male specialties, whereas those of Asian and
other (nonwhite, nonblack, non-Asian, non-Hispanic) ethnicity, those living in the East, and those selfcharacterized as politically very conservative were less likely to report gender-based harassment. Being
younger, born in the United States, or divorced or separated were correlated with reporting ever
experiencing sexual harassment; those who were Asian or who were currently working in group or
government settings were less likely to report it. Those who felt in control of their work environments, were
satisfied with their careers, and would choose again to become physicians reported lower prevalences of
ever experiencing harassment. Those with histories of depression or suicide attempts were more likely to
report ever having been harassed.
Conclusions: Women physicians commonly perceive that they have been harassed. Experiences of and
sensitivity to harassment differ among individuals, and there may be substantial professional and personal
consequences of harassment. Since reported rates of sexual harassment are higher among younger
physicians, the situation may not be improving.
Arch Intern Med. 1998;158:352-358
EVEN AS WOMEN enter medicine in larger numbers, they may still encounter impediments, including
harassment. It may occur in forms that are shared with men, harassment based on ethnicity or lifestyle. Or,
it may take forms that are more frequently experienced by women,[1] such as gender-based or sexual
harassment.
28
It is acknowledged in thought, policy, and statute that harassment is an exercise of power that may produce
a variety of ill effects, including reduced productivity, morale, and job satisfaction.[1] However, despite these
serious negative potential outcomes, harassment prevalence has never been well studied among physicians.
The few published studies[2,3,4,5,6,7,8,9,10] have been small (N<250) and have surveyed only 1 site,[36,8,10] a convenience sample,[7] or only medical students.[2,3,8-10] Previous studies also have suffered
from potential response bias because the survey only asked about harassment and abuse[2-4,8,10] or sexrelated issues,[5-7] and may therefore have encouraged preferential response by the harassed.
We intended to portray more representatively the prevalence and correlates of harassment experiences
among US women physicians. Specifically, we explored self-characterized gender-based and sexual
harassment. This distinction between harassment types was drawn after pilot testing indicated that, whereas
some women physicians denied being harassed in a manner they characterized as sexual, they nonetheless
may have felt harassed simply because of events specific to being female in a male-dominated culture. Our
database is the Women Physicians' Health Study, a large (4501 respondents), nationally distributed
questionnaire study. The harassment question was placed on an inside page of a 716-item questionnaire,
thereby reducing preferential response by those most concerned with harassment.
SUBJECTS AND METHODS
The design of the Women Physicians' Health Study has been more fully described elsewhere.[11] The study
surveyed a stratified random sample of US women MDs; its sampling frame is based on the Physician
Masterfile of the American Medical Association, a database intended to record all MDs residing in the United
States and its possessions. Using a sampling scheme stratified by decade of graduation from medical school,
we randomly selected 2500 women from each graduating class of the last 4 decades (1950 through 1989).
We oversampled older physicians, a population that would otherwise have been sparsely represented by
proportional allocation because of the recent increase in numbers of women physicians. We included active,
part-time, professionally inactive, and retired physicians, aged from 30 to 70 years, who were not in
residency training programs in September 1993, when the sampling frame was constructed. In that month,
the first of 4 mailings was sent out; each mailing contained a cover letter and a self-administered, 4-page
questionnaire. Enrollment was closed in October 1994 (final N=4501).
Of the potential respondents, an estimated 23% were ineligible to participate because their addresses were
wrong or they were men, deceased, living out of the country, interns, or residents. Our response rate was
59% of physicians eligible to participate. We compared outcomes of respondents and nonrespondents for a
large number of key variables in the following 3 ways: a telephone survey (comparing our telephonesurveyed random sample of 200 nonrespondents with all the written survey respondents), the Physician
Masterfile (contrasting all respondents with all nonrespondents), and an examination of survey mailing
waves (all respondents, from wave 1 through 4) to contrast respondents' and nonrespondents' outcomes for
a large number of key variables. From these 3 investigations, we found that nonrespondents were less likely
than respondents to be board certified. However, respondents and nonrespondents did not consistently or
substantively differ on other tested measures, including age, ethnicity, marital status, number of children,
alcohol consumption, fat intake, exercise, smoking status, hours worked per week, frequency of being a
primary care practitioner, personal income, or percentage actively practicing medicine.
Based on these findings, we weighted the data by decade of graduation (to adjust for our stratified sampling
scheme) and by decade-specific response rate and board-certification status (to adjust for our identified
response bias). The analysis weights (within decade) are 3.4 and 5.5 (1950s), 9.3 and 17.7 (1960s), 17.9
and 36.5 (1970s), and 28.3 and 63.9 (1980s), for board-certified and non-board-certified respondents,
respectively. Using these weights allows us to infer to the entire population of women physicians who
graduated from medical school from 1950 to 1989.
Harassment was queried using an abridged version of the definition of the American Medical Association.[12]
Specifically, we asked the following:
29
Have you ever been harassed in a medical setting (ie, received unwanted physical or verbal attention,
propositions, hostilities, or threats)? If yes, mark all situations that apply .... This occurred: before medical
school; during medical school; while an intern/resident/fellow; while in practice. This harassment was: (mark
all that apply) gender-based but non-sexual; sexual; lifestyle based; ethnically-based.
Gender-based and sexual harassment were not further defined after pilot and focus-group testing indicated
differences between these categories in prevalence and qualitative interpretation. In focus-group testing,
sexual harassment was generally interpreted as meaning harassment with a sexual or physical component.
Gender-based harassment was generally interpreted as related to being female in a traditionally male
environment, without having a sexual or physical component. Severity was queried with the following:
"Would you characterize the worst episode of this harassment as mild, moderate, or severe?" This response
also could have pertained to the worst episode of lifestyle-based or ethnically based harassment, but
prevalences of ever experiencing these conditions were low in this predominantly white, heterosexual
population (2%-7% prevalence of lifestyle-based or ethnically based harassment in any setting queried).
Commercially available software (SUDAAN, Research Triangle Institute, Research Triangle Park, NC) was
used to estimate prevalence of harassment stratified by personal and professional characteristics and to
perform chi2tests to determine if harassment was related to these characteristics. Logistic regression was
used to model harassment at different periods (ever; before medical school; during medical school; during
internship, residency, or fellowship; and during medical practice) as a function of several personal and
professional characteristics. A modified method of backwards selection for logistic regression was used,
including goodness of fit tests for the final models with a modification of the Hosmer and Lemeshow
technique.[13]
All analyses were weighted to infer to the entire population, and SEs and significance testing were
performed using SUDAAN analyses that recognized the sample design. A significance level of P<.01 was
used for assessing relationships of harassment with individual characteristics. To determine which variables
remained in the final logistics regression model, the criterion was P<.10 for the multiple df variable or P<.05
for at least 1 of the regression coefficients for that variable. A 95% confidence interval (CI) on the odds ratio
(OR) is given for any regression coefficient that has P<.05.
RESULTS
Table 2 indicates that surgeons reported the highest prevalences of both types of harassment during
internship, residency, or fellowship. Emergency physicians reported more gender-based harassment, and
emergency physicians and radiologists reported more sexual harassment while in medical practice.
Prevalence in a medical setting before medical school (not shown) was only 14.6% for gender-based
harassment, and 11.2% for sexual harassment. We found (not shown) that both gender-based and sexual
harassment were significantly (P<.001) more common in training (medical school, internship, residency, and
fellowship) than in practice (40.2% vs 20.5% for gender-based and 29.8% vs 11.4% for sexual harassment
in training vs practice, respectively). This was true even in analyses excluding those graduating after 1979
(ie, those with limited potential time for exposure to harassment in practice). Findings in Table 3 did not
achieve statistical significance.
Our logistic regression models (Table 4) simultaneously considered multiple harassment correlates.
Physicians who were Asian or nonwhite, nonblack, non-Asian, and non-Hispanic (hereafter referred to as
other) ethnicity or politically very conservative, or resided in the East were less likely to report ever having
been harassed on the basis of gender; divorced or separated physicians and physicians in historically
predominantly male specialties were more likely to report gender-based harassment. Physicians who were
older, Asian, currently employed in groups or by the government, or politically conservative were less likely,
whereas those who were divorced or separated or born in the United States were more likely to report
sexual harassment. The only significant correlate of experiencing gender-based harassment before medical
school (not shown) was being born in the United States (OR, 1.81; 95% CI, 1.31-2.52; P<.001). Reporting
30
sexual harassment before medical school was correlated significantly with being born in the United States
(OR, 1.96; 95% CI, 1.29-2.96; P=.002), divorced or separated vs married (OR, 1.70; 95% CI, 1.12-2.58;
P<.01), or politically conservative vs liberal (OR, 0.27; 95% CI, 0.11-0.69; P=.007).
As shown in Table 4, the most consistent significant correlates of reporting gender-based harassment in
training or in practice were ethnicity (Asian and other ethnicity less likely), marital status (separated or
divorced more likely), and being in a historically male specialty. The most consistent significant correlates of
reporting sexual harassment in these settings were ethnicity (Asian or Hispanic less likely), marital status
(divorced or separated more likely), and age (older less likely). Other variables were less consistently
predictive, but some (such as the effect of current region on perceived harassment while in medical school)
still had very strong relationships with harassment at particular stages in professional development. All final
models provided a good fit for the data, with Hosmer and Lemeshow goodness-of-fit P values ranging from
.10 to .90.
Figure 1 and Figure 2 display relationships between harassment prevalence and the following 2 domains:
career status and mental health indicators. Figure 1 shows significant (P<.01 using chi2 tests) relationships
between reporting gender-based or sexual harassment and feeling less control of one's work environment,
feeling less satisfaction with one's career, and not wanting again to become a physician if reliving one's life.
Physicians were also significantly more likely to report gender-based harassment if they were less inclined to
choose the same specialty if reliving their lives. Figure 2 shows a strong relationship between histories of
depression or suicide attempts and harassment of both types; there was no significant (P>.10) relationship
between a history of alcohol abuse and harassment of either type.
We also found (not shown) that those reporting more severe harassment of any type also reported having
less work control (P=.001 for a chi2 test of the overall effect of harassment severity), less current career
satisfaction (P<.001), less desire to become a physician again (P<.001), and less desire to choose their
same specialty again (P<.001). Harassment severity of any type was also related to a history of depression
(P<.001) and of suicide attempts (P=.002). Those reporting severe harassment were 2 times as likely to
report a history of depression and 4 times as likely to report a history of suicide attempts as those reporting
only mild harassment.
COMMENT
Nearly half of women physicians reported having been harassed on the basis of gender, and more than one
third reported having been sexually harassed. Reported prevalences of harassment differed considerably
between groups, and there may be substantial professional and personal consequences of harassment.
Women physicians are significantly more likely to report being harassed while in training (medical school,
internship, residency, or fellowship) than in practice. This is true although far more person-years are spent in
practice than in training, with therefore theoretically far more opportunities for harassment. Sexual
harassment is most commonly reported by the most recent medical school graduates (ie, the youngest
women). Some may believe that problems of harassment will disappear in time, that they are simply a
function of older, sexist physicians still being in practice. However, our data suggest that this is not the
problem's only source, and that attrition is unlikely to solve it. Whereas our data may reflect younger
women's greater sensitivity to harassment, they certainly do not suggest that the training milieu is
improving; in fact, it may be getting worse, and we may be continuing to train physicians in an environment
where harassment is common. Our concern about medical schools is echoed by findings that other forms of
harassment and abuse are frequently experienced by medical students of both sexes.[2,3,8,10] Our findings
suggest that much of the harassment problem resides in an area theoretically immediately available for
improvement: the training environment.
Our specialty-stratified data, especially those for women surgeons, may be of particular interest. Previous
31
data[7] and plentiful anecdotes support our finding that surgeons and other specialists in historically
predominantly male specialties are more likely to be harassed in training. However, once surgeons are out of
residency and in practice and therefore more independent, they are not markedly more likely to be harassed
than are other women physicians.
Present thought characterizes sexual harassment as primarily a manifestation of power, rather than sexual
attraction. The profession of medicine, particularly in academic settings, may be especially prone to
harassment because of the importance of hierarchy. This may account for the higher prevalence of
harassment found in training environments in our data and the somewhat lower prevalence experienced
among women physicians once they are in practice, in a typically higher place in the hierarchy. This also
may be a reason that women in surgery and emergency medicine reported a higher prevalence of
harassment, as these fields may particularly tolerate or even value hierarchy and authority. Such historically
more male-dominated and prestigious fields also have fewer women to demonstrate that being female is
compatible with success in these fields.
Other authors have suggested that harassment may have serious physical and psychological sequelae, such
as fatigue, depression, and feelings of anger, fear, alienation, and vulnerability.[4,16,17,18,19] Our data
show that women who were less satisfied with their careers and who felt less in control of their work
environments were also more likely to report having experienced harassment, especially gender-based
harassment. Like depression, harassment causes feelings of helplessness, worthlessness, and guilt in its
recipients.[16,20,21] Perhaps then it is not surprising that our physicians who reported a history of
depression or suicide attempts were more likely to report having experienced sexual or gender-based
harassment. The relationship between harassment and suicide attempts is especially concerning, given
previously reported elevated suicide rates of US women physicians vs other US women (ORs<4 have been
reported).[22,23,24] Such reports, although based on small numbers and the subject of considerable
controversy, are distinct from the minimal risk elevation that has been noted in US male physicians vs other
US men (ORs <1.0-1.2).[22,24,25,26] If these professional and personal dissatisfactions are at all causally
related to harassment experiences (a relationship we cannot determine), this has serious implications for
improving the well-being and satisfaction of physicians.
Some caveats are needed to help interpret our data. First, these problems are not unique to women
physicians. Thirty percent of women registered nurses (n=164) in a California county reported sexual
propositions, sexual insults, or suggestive touching by physicians at least once every 2 to 3 months.[27] A
1981 study of more than 20,000 government employees reported that 42% of women and 15% of men had
received "some form of uninvited and unwanted sexual attention" at work in the past 2 years[21]; the study
was repeated in 1987 with nearly identical results.[28]
There are other caveats. As is the case with most studies of harassment, these are self-defined, selfreported, and therefore subjective experiences. Some of our differential results, such as our finding that
specialists in historically more male-dominated specialties are more likely to have experienced gender-based
harassment, may be most logically attributed to differences in actual frequency of exposure to harassment.
Others, such as the influence of political self-characterization, may be primarily attributable to differences in
perception or sensitivity (however, even politically very conservative women reported a 26.0% prevalence of
sexual harassment and a 33.6% prevalence of gender-based harassment). However, other differentials, such
as higher harassment rates reported by physicians who are now divorced or separated, and lower rates by
Asians and those not born in the United States are more difficult to interpret. Such differences arguably
could be attributed to differences in frequency of perpetration or in perception, and the fluidity of some of
these variables further confounds interpretation. For example, it is difficult to know exactly why women who
are currently divorced or separated would report having had more sexual harassment while in medical school
than would women who are now married. Problems with obtaining objective measures are inherent to
studies of this type; by examining differences among rates reported by different types of women, we do not
mean to imply that some individuals overestimate or underestimate harassment. Alternatively, behaviors that
are acceptable to some women may not, at least in retrospect, be to others.
32
Some of our data raise questions for future study. Our differentiation between sexual and gender-based
harassment is a relatively new approach to examining harassment, and our differential prevalence rates for
both harassment types reinforce that these categories elicit different types of responses. Previous literature
may be interpreted and subsequent studies structured somewhat differently in light of these findings. We
also do not know the exact character of the harassment reported herein. Whereas our data show that most
of it is self-categorized as mild to moderate, further explorations could be fruitful. Finally, our findings of
higher prevalences in training could simply reflect a more negative recall of the more distant past. However,
our data showing the lowest rates in the time before medical school suggest that this is not so, but this
would also be interesting to explore in more narrative assessments.
Despite large and increasing numbers of women physicians in practice, experiences of sexual and genderbased harassment remain widespread. Much remains to be learned about the psychological, emotional, and
physical effects of harassment; however, these effects may be substantial. Also difficult to measure, but
found in our data and acknowledged in theory and in law, are the detrimental effects that harassment can
have on the ability of women to focus their energies on education or work.[21] Perhaps most troubling is our
evidence that harassment rates are not decreasing. Despite strong statements against harassment and
gender discrimination in the medical literature,[29] harassment experiences are still common in the training
sites where the medical community's values are instilled. As physicians must update their understanding of
appropriate practice for patient care, they must also update appropriate practice for professional
interactions. Our data suggest that there has been and remains a substantial divide between what many
women and some men consider acceptable professional interactions, and this could have considerable
professional and human consequences.[12,28,29]
From the Schools of Medicine (Drs Frank and Schiffman) and Public Health (Drs Frank and Brogan), Emory
University, Atlanta, Ga.
Accepted for publication June 3, 1997.
Supported by the Education and Research Foundation, American Medical Association, Chicago, Ill;
Institutional National Research Service award 5T32-HL-07034, National Heart, Lung, and Blood Institute,
National Institutes of Health, Bethesda, Md; and the Emory Medical Care Foundation, Emory University
School of Medicine, Atlanta, Ga.
We thank Randall White, MD; Richard Rothenberg, MD; Robert Green, MD; Sally McNagny, MD; Lawrence
Lutz, MD; Tricia Kunovich-Frieze, MD; Ruth Frank, EdD; Fred Levit,MD; and Mss Dorothy Fitzmaurice, Brooke
Fielding, Lisa Carter, Hilda Maibach, Gargi Patel, and Kelly Hartline for their thoughtful comments and
guidance.
Corresponding author: Erica Frank, MD, MPH, The Women Physicians' Health Study, Department of Family
and Preventive Medicine, and the Department of Medicine, Emory University School of Medicine, 69 Butler
St, Atlanta, GA 30303-3219 (e-mail: [email protected]).
References
1. Schiffman M, Frank E. Harassment of women physicians. J Am Med Womens Assoc. 1995;50:207-211.
2. Baldwin DC Jr, Daugherty SR, Eckenfels EJ. Student perceptions of mistreatment and harassment during
medical school: a survey of ten United States schools. West J Med. 1991;155:140-145.
3. Wolf TM, Randall HM, von Almen K, Tynes LL. Perceived mistreatment and attitude change by graduating
33
medical students: a retrospective study. Med Educ. 1991;25:182-190.
4. Lenhart SA, Evans CH. Sexual harassment and gender discrimination: a primer for women physicians. J
Am Med Womens Assoc. 1991;46:77-82.
5. Equal Employment Opportunity Commission. Guidelines on discrimination because of sex. Fed Register.
1980;45:74,676-74,677.
6. Charney DA, Russell RC. An overview of sexual harassment. Am J Psychiatry. 1994;151:10-17.
7. McCann ND, McGinn TA. Harassed: 100 Women Define Inappropriate Behavior in the Workplace.
Homewood, Ill: Business One Irwin; 1992.
8. Richman JA, Flaherty JA, Rospenda KM, Christensen ML. Mental health consequences and correlates of
reported medical student abuse. JAMA. 1992;267:692-694.
9. Bickel J, Ruffin A. Gender-associated differences in matriculating and graduating medical students. Acad
Med. 1995;70:552-559.
10. Lubitz RM, Dguyen DD. Medical students abuse during third-year clerkships. JAMA. 1996;275:414-416.
11. Frank E. The Women Physicians' Health Study: background, objectives, and methods. J Am Med
Womens Assoc. 1995;50:64-66.
12. American Medical Association. Guidelines for Establishing Sexual Harassment Prevention and Grievance
Procedures. Chicago, Ill: American Medical Association; 1990:3.
13. Hosmer DW Jr, Lemeshow S. Applied Logistic Regression. New York, NY: John Wiley & Sons Inc; 1989.
[Note: References 14 and 15 appear in Table 1.]
14. American Medical Association. Women in Medicine: 1995 Data Source. Chicago, Ill: American Medical
Association; 1995.
15. American Medical Association. Women in Medicine in America: In the Mainstream. Chicago, Ill: American
Medical Association; 1991.
16. Dziech BW, Weiner L. Sexual Harassment on Campus. Boston, Mass: Beacon Press; 1984:16-17.
17. Phillips SP, Schneider MS. Sexual harassment of female doctors by patients. N Engl J Med.
1993;329:1936-1939.
18. Shrier DK. Sexual harassment and discrimination: impact on physical and mental health. N J Med.
1990;87:105-107.
19. Gutek BA, Koss MP. Occupational Medicine: State of the Art Reviews. Philadelphia, Pa: Hanley & Belfus
Inc; 1993:807-819.
20. Komaromy M, Bindman AB, Haber RJ, Sande MA. Sexual harassment in medical training. N Engl J Med.
1993;328:322-326.
21. US Merit Systems Protection Board. Sexual Harassment in the Federal Workplace: Is It a Problem?
34
Washington, DC: US Government Printing Office; 1981.
22. Steppacher R, Mausner JS. Suicide in male and female physicians. JAMA. 1974;228:323-328.
23. Pitts FN Jr, Schuller AB, Rich CL, Pitts AF. Suicide among US women physicians, 1967-1972. Am J
Psychiatry. 1979;136:694-696.
24. Roy A. Suicide in doctors. Psychiatr Clin North Am. 1985;8:377-387.
25. Rose KD, Rosow I. Physicians who kill themselves. Arch Gen Psychiatry. 1973;29:800-805.
26. Rich CL, Pitts FN Jr. Suicide by male physicians during a five-year period. Am J Psychiatry.
1979;136:1089-1090.
27. Diaz AL. A definition and description of nurse abuse. West J Nurs Res. 1991;13:97-109.
28. US Merit Systems Protection Board. Sexual Harassment in the Federal Workplace: An Update.
Washington, DC: US Government Printing Office; 1988.
29. Cotton P. Harassment hinders women's care and careers. JAMA. 1992;267:778-783.
Figure 2. Prevalence of reported previous
harassment by history of mental health indicators.
Figure 1. Prevalence of reported previous
harassment by aspects of career satisfaction.
35
Table 1. Prevalence of Previous Harassment by
Personal and Professional Characteristics*
36
Table 2. Prevalence of Harassment at Different Professional Stages by Specialty Type*
Table 3. Prevalence of Ever Having Been Harassed in Practice by Current Practice Site*
37
Table 4. Part A. Final Multiple Logistic Regressions: Factors That Affect Likelihood of a History of
Harassment*
38
PREVENTING AND RESPONDING TO SEXUAL
HARASSMENT
Family Practice Management
Oct 99, Vol. 6 Issue 9, p32
Protect yourself and your practice by creating an effective sexual harassment policy and by investigating
incidents promptly.
The number of sexual harassment claims filed with the Equal Employment Opportunity Commission
(EEOC) is rapidly increasing. Since 1991, there has been nearly a 50 percent increase in the number of
claims filed, bringing the total in 1998 to just over 15,500 claims. Claims like these aren't limited to the
corporate world or to interactions between supervisors and their employees. Medical practices also need
to be vigilant in preventing harassment of anyone who works there by anyone who works there.
According to the EEOC, sexual harassment consists of "unwelcome sexual advances, requests for sexual
favors, and other verbal or physical conduct" that can affect a person's employment or work performance
and create a hostile work environment. Based on this definition, many things that may have been
acceptable in the past could be considered harassment today. And sometimes the harassment isn't easy
to spot. [See "Is this sexual harassment?" for some examples.]
Not just individuals at risk
For physicians in the role of employer, personally avoiding sexual harassment is not enough; they must
ensure that the whole practice does, too. Two recent U.S. Supreme Court rulings have made it easier to
sue an employer for sexual harassment when the employer isn't directly involved in the incident. In
Faragher v Boca Raton (111 F3d 1530 [11th Cir 1998]), the Supreme Court ruled that an employer can
be held responsible for a manager's or supervisor's sexual harassment even if the employer knew nothing
about the objectionable behavior.
In Burlington Industries, Inc. v Ellerth (123 F3d 490 [7th Cir 1998]), the Supreme Court ruled that an
employee who quit her job after being subjected to constant sexual harassment from a supervisor was
entitled to take her case against the employer to trial even though the employer had a policy banning
sexual harassment, the employee had never suffered a negative employment action and the employee
had never complained to anyone about the supervisor's behavior.
In these rulings, the Supreme Court made dear that the best way to protect yourself and your practice is
to institute a firm written policy against sexual harassment and then communicate and enforce the policy
effectively. The ruling showed that employers can avoid liability by meeting the following criteria: They
must show that they "exercised reasonable care to prevent or correct promptly any sexually harassing
behavior" and that the harassed employee "unreasonably failed to take advantage of any preventive or
corrective opportunities provided by the employer or to avoid harm otherwise."
High costs
Failing to follow the Supreme Court's advice can be an expensive mistake. In one four-partner practice, a
physician and a nurse were in a relationship, which the whole staff knew. But when the physician resisted
the nurse's repeated attempts to end the relationship, it cost the practice dearly. To avoid going to court
39
and having the physician's actions exposed, the practice agreed to a six-figure settlement --substantially
less than it might have paid had the case gone to trial.
A romantic relationship between an employer and an employee is risky in itself, and this one quickly
moved into the sexual harassment arena when the physician ignored the nurse's wishes. In this case, the
practice failed to meet the Supreme Court's first criterion for avoiding liability because it didn't take
prompt corrective action against sexual harassment. The other physicians should have informed the
harassing physician of the inappropriateness of his activity, asked him to stop and informed him of the
possible consequences of his actions --litigation, bad press for the practice, loss of goodwill, low
employee morale leading to poor customer service, the possibility that the liability insurance carrier might
not provide legal counsel to defend the suit, and the fact that he would be making not only himself but
the entire practice liable. When advised of these consequences, many physicians will immediately put an
end to the inappropriate activity.
Creating a sexual harassment policy
Of course, the best way to shield your practice from liability is to prevent harassment in the first place, as
the Supreme Court's ruling implies. You can do that by creating and enforcing a written policy against
sexual harassment. [See page 34 for information about accessing sample harassment policies.] An
effective policy should do the following things:
Define what constitutes . The definition should include physical, verbal and visual forms of . Remember
that harassers and their victims can be of either gender and any orientation.
Encourage employees to come forward with complaints. The policy should assure employees that the
practice will make every effort to preserve confidentiality while being fair to both parties.
Provide alternative avenues for reporting . Employees should not be required to report complaints to a
particular individual or position.
Stipulate that investigations of complaints will be prompt and that the practice will discipline offenders
appropriately. However, the policy should not spell out what the appropriate action should be since it will
depend on numerous factors, such as the harasser's overall performance record, his or her length of time
with the practice, whether it is a first-time offense, whether there are mitigating circumstances, and the
severity of the offense.
Stipulate that the practice will not retaliate against complainants. Some examples of employer retaliation
are firing or demoting an employee who complains of, denying that employee a deserved promotion or
raise, or hazing, ostracizing or criticizing the employee because of the complaint.
The policy should be printed in the employee handbook, posted around the office and distributed to every
employee with an acknowledgment form that each must read and sign. In addition, to illustrate and
explain the policy, your practice should conduct sexual harassment training for supervisors, managers
and their subordinates. Practices can receive this type of training from attorneys or from workplace
consultants.
Once you have a policy in place, you must follow it precisely for each complaint. Any deviation in
application or enforcement of your policy may subject you to liability.
40
Handling an investigation
Although many employers do have written sexual harassment policies, they're often unprepared for an
investigation when a complaint is made against people in their practices. Knowing how to conduct a
thorough investigation will reduce your chances of being taken to court and increase your chances of
winning if you are. A properly conducted investigation shows that your practice takes such charges
seriously and will not tolerate any form of harassment.
When you conduct an investigation, protect the rights of the complainant as well as those of the alleged
harasser, and (in fairness to both parties) proceed quickly. Although each investigation is unique, most
charges can be investigated within 10 days.
The investigation itself should take place in four stages: Make an initial contact, conduct interviews,
report findings and take disciplinary action if it's warranted.
Make the initial contact. Meet with the alleged harasser and tell him or her that a complaint has been
filed. Emphasize that you're not making an accusation of any wrongdoing but that you feel an
investigation is warranted. Tell the alleged harasser that all future discussions are confidential and not to
contact the complainant until the investigation is completed. While it's important to let the alleged
harasser know who made the complaint, it is equally as important to prevent him or her from retaliating
against the complainant. Also, stress that failure to observe the rules may result in disciplinary action up
to and including discharge from the practice.
Meet with the complainant and assure him or her that the investigation will be prompt and that the
practice will take appropriate action if the investigation reveals that harassment did occur. Emphasize the
need for confidentiality. Also, ask how the practice can help the complainant work comfortably during the
investigation. Consider options such as providing paid administrative leave or changing working locations
or hours for both parties.
Conduct interviews. It's best to have an objective party, such as a human resources representative or
an outside consultant, conduct the investigation. Begin by interviewing the complainant and writing a
detailed record of the charges, alleged specific incidents and whether there were witnesses or people
who could offer corroboration. Ask how often the alleged conduct occurred, whether other employees
complained of similar incidents, how the alleged conduct affected the complainant's work, and how much
time elapsed between the conduct and the report. Try to find out whether the complainant has reason to
lie (e.g., job-performance problems related to the accused or a past personal relationship with the
accused).
When talking to witnesses, avoid leading questions such as, "Did you see Mr. Smith fondle the
complainant?" Instead, ask whether they have seen anyone touch the complainant in a way that made
him or her uncomfortable.
Finally, ask the accused whether he or she agrees with the statements you've collected and whether the
accused can offer an explanation or motive for the allegations.
Report findings. Prepare a written report of the facts. The report should not include your opinions or
conclusions. Brief top managers about these sensitive issues orally to avoid including them in a document
that might be discoverable in litigation. It's best to leave top management out of the actual investigation
as much as possible, especially if the alleged harasser is a manager. Sometimes management will try to
"spin" the investigation's facts to create a more favorable conclusion. Instead, do not involve them until
the facts are in place, they show that harassment has occurred and it is time to determine corrective
action.
41
If the investigation doesn't produce sufficient evidence to support the claim, communicate that finding
clearly to all parties.
Discipline the harasser. If the investigation shows that harassment did occur and that discipline is
warranted, choose discipline that is proportional to the seriousness of the offense and the strength of the
evidence. Sanctions can include anything from a written warning to demotion, suspension or discharge.
Before taking any action, meet with the harasser to describe what will happen and why. If the
harassment wasn't aggravated (i.e., if it was a one-time request for sexual favors or a one-time joke
rather than continuous, mean-spirited and threatening comments) treat the conduct as a job-related
issue. While sexual harassment is always harassment, there are degrees of harassment, and the
punishment should reflect this fact. Institute discipline and give the employee a chance to modify the
inappropriate behavior. In addition, warn the harasser against any retaliatory behavior, closely monitor
the harasser's conduct, and schedule more frequent performance reviews to document any improvement
in or complaints about the harasser's behavior.
If the chosen discipline is termination, the reason for the termination should be performance problems,
since sexual harassment is a performance-based issue. Employers don't usually give a public reason for
an employee's termination, and there is no reason to treat this lack of performance differently from any
others.
Review the outcome of the investigation with the complainant, and tell him or her whether, but not what,
corrective action was taken. The complainant need only know that corrective action has been taken.
Finally, avoid discussing the matter in the workplace to reduce the possibility that the harasser will bring
legal action against you for defamation, invasion of privacy or wrongful termination.
High costs all around
A potentially large judgment isn't the only cost of failing to prevent sexual harassment or of dealing with
it poorly when it happens. If left unresolved and allowed to go to court, mishandled sexual harassment
incidents can damage staff morale, harm your relations with patients and the general public, and cut into
your practice's revenue.
Complaints of sexual harassment are emotionally charged and difficult for everyone involved. But by
instituting effective policies and procedures, and by enforcing them consistently, you'll limit your
practice's potential liability as well as protect the rights of all parties involved.
42
Sources of sample policies
For examples of sexual harassment policies that you can tailor to fit the needs of your practice, visit this
article on our Web site, www.aafp.org/fpm . The article includes a link to a sample policy developed by
the authors as well as a policy from a family practice.
By T. Hensley Williams, JD and Nancy M. Williams, JD
Ted and Nancy Williams are co-principals of The Williams Group, a Des Moines, Iowa-based human
resources management consulting firm. Ted Williams is also a speaker on employee and labor-relations
issues.
Employers can now be held responsible for in their practice even if they knew nothing about it.
Creating and implementing a policy in your practice can help you avoid liability.
Investigations should include meeting with both parties, interviewing them and any witnesses,
reporting findings and taking disciplinary action, if necessary.
Sometimes it’s difficult to tell whether certain situations are considered sexual harassment. Here are five
examples you may encounter in your practice. Would you recognize these as incidents of sexual
harassment?
Female employees are laughing and joking at the water cooler as they discuss the shortcomings
of their male friends with earshot of one of the male employees. This may constitute a “hostile
environment” for that male employee.
In the same scenario, male employees are discussing the shortcomings of their female friends
within earshot of the male employee. This may also constitute a hostile environment if the male
employee does not want to be confronted in the workplace with unwanted conversations.
A female employee has a lesbian roommate. Although the female employee is not gay, the
physicians in the practice are constantly making jokes to the female employee about the
preferences of her roommate and insinuating that the employee is also gay. This is “hazing”. The
actions of the physicians can be construed as an intentional infliction of emotional stress.
A young, attractive office worker has an affair with one of the older physicians in the practice.
She is promoted to office manager over more experiences and qualified female employees. The
more qualified employees could have a case against the employer because they believe the
physician and the office worker have a “quid pro quo” relationship. Arguably, favors were traded
for advancement in the workplace, and the other workers have been sexually harassed by these
activities.
An employee regularly uses the office computer to download pornographic movies. A coworker,
who has to pass by this employee’s desk to get to her own, can see the movies. The coworker
complains to the office manager and the physicians, but they think it’s funny, do nothing about
the complaint and ostracize the complaining coworker. Again, this constitutes a “hostile
environment” because viewing pornographic movies in the workplace is not an acceptable
condition of employment. If the office were a pornographic store or movie house, the outcome
would be different.
43
Since 1991, the number of claims files with the EEOC has increased by nearly 50 percent.
It’s “unwelcome advances, requests for favors, and other verbal or physical conduct” that can
create a hostile work environment.
Even if just one physician in your practice is involved, the whole practice could be liable.
Prevent in your practice by creating and implementing a policy.
Ensure that no employer retaliation, such as firing or demoting the employee, will be taken
against the complainant.
Include your policy in the employee handbook, post it around the office and give a copy to each
employee.
Your practice should also provide training for employees.
Most charges can be investigate within 10 days.
The four stages of an investigation are making the initial contact, conducting interviews,
reporting findings and taking disciplinary action.
During the investigation, consider providing paid administrative leave or changing work locations
for both parties.
Have a human resources representative or an outside consultant conduct the investigation.
Disciplinary action can include anything from a written warning to demotion, suspension or
discharge.
44
- RELATED ARTICLES EDITORIAL: A PROFESSIONAL DISGRACE
Lancet
09/11/93, Vol. 342 Issue 8872, p627
"'You've lost a lot of weight. Especially here.' And with both hands he clutched my buttocks and
squeezed. And then walked away to talk to someone else."(n1) That was not inebriated foolery between
acquaintances at a party, but an account of the treatment of a woman doctor at a medical gathering by a
senior male colleague ("a sensible older clinician"). The issue of sexual harassment of women in medicine
has surfaced recently because women doctors have spoken out--and been believed.
Sexual innuendoes are common in medical training--eg, "pin-ups" featuring as slides during anatomy
lectures. After qualification, women doctors remain fair game, as Berrien(n2) described. "At an office
Christmas party I received a present: a sepia photograph of a bare-breasted woman on a do-not-disturb
sign, purportedly for my examining room door." Men who find these examples trivial or barely offensive
may care to note a recent appellate-court ruling in the United States, which held that sexual harassment
must be judged from the perspective of a "reasonable woman", since "conduct that many men may
consider unobjectionable may offend many women." (n3) The defense that the victim lacked a sense of
humor is unlikely to carry much weight.
There are graver harassments that would tax the most flexible sense of humor. Consider, for example,
the senior resident on a surgical rotation who had instructed his female colleague on several occasions to
stand next to him in the operating room and had repeatedly rubbed his groin against her during the
surgical procedure. (n4) Although perpetrators may claim that such events, albeit offensive, do no real
harm, victims' reactions suggest otherwise.(n5) Moreover, emotional upset may be the least of the
damage done by sexual harassment. Advancement in medicine is competitive and dependent on
favorable assessments from seniors. Women doctors have been sexually blackmailed by invitations to
dates by senior male colleagues before letters of recommendation or evaluations were completed.(n4) An
even more blatant example was the doctor whose refusal to grant sexual favors ultimately led her
supervisor to relinquish responsibility for her course work, to humiliate her in front of others, and finally
(in his own words) to kick her out of the department.(n6)
Within the professional "monopoly of middle-aged men"(n7) discrimination against women because they
are women, or because they have declined sexual favors, has received scant attention.(n8) Ever since the
issue has been open to debate, the profession's response has been limp. To the demands of women
doctors that "they should be sacked immediately"(n6) or "the General Medical Council [should] be asked
to make sexual harassment by doctors an offence that could lead to erasure from the Medical
Register",(n9) the profession has responded by evoking the European Commission's code of practice,
which recommends that employers should (in part) "Issue a policy statement which expressly states that
all employees have a right to be treated with dignity...",(n10) or the American Medical Association's
equally mealy-mouthed recommendation that "all training programs develop and implement a sexual
harassment policy that includes a grievance procedure mechanism".(n11) A more vigorous response is
required.
In the UK there is a procedure for the prevention of harm to patients resulting from physical or mental
disability of hospital medical staff, (n12) generally known as the "three wise men". Each health authority
appoints a special professional panel of senior medical staff to whom confidential notifications of a
doctor's disability can be made. Should the disability be independently verified, an appropriate three
members of the panel (not necessarily male) decide what actions should be taken. As the procedures are
"specifically designed to encourage a sick doctor to accept treatment", (n12) the approach to the doctor
concerned is usually informal. The procedure deals mainly with doctors who are mentally ill or addicted
45
and who lack the insight to seek help themselves. The intention is not to cover up mishaps to patients
but to prevent them, and is an alternative to formal disciplinary proceedings which may not be in the best
interests of the doctor or patients.
An extension of this procedure to include notification of sexual harassment would safeguard the victim
from retaliation and encourage the perpetrator to accept guidance without the necessity of a
confrontation. This suggestion is open to the criticism that a sexual harasser is neither mentally ill nor
addicted; and his conduct does not put patients at risk. Victims of sexual harassment would not agree: "If
doctors cannot pick up subtle clues about what is fun and what is unwanted they are in serious trouble
with regard to their social and communication skills".(n1) The authors of a survey in the USA observed:
"Physicians whose trainees feel intimidated or offended may inadvertently affect their own patients the
same way, creating barriers to communication and good medical care".(n4)
Formal recognition that sexual harassment of women doctors in medicine is a deviant behavior potentially
damaging to patients may deter would-be harassers. The effects might be more far-reaching: a
transgressor whose behavior merits advice from his peers that harassment is not merely impolite but
professionally disgraceful is less likely to join the conspiracy poignantly described by Jensvold and
colleagues: "Currently, many documented harassers receive promotions and awards and are taken care
of by the old-boy network which rallies to protect them".(n13) To advise employees subjected to
harassment to "seek advice, support, and counseling in confidence and without obligation to take the
complaint further"(n14) is clearly not enough. The notification scheme will not do away with sexual
harassment overnight, but it would represent a more determined attempt to rid the profession of this
disgrace.
(n1) Anon. Unprofessional behavior. BMJ 1992; 305: 962.
(n2) Berrien R. Outside in. JAMA 1992; 268: 2616.
(n3) Ellison v Brady 9th Cir 924F. 2d 1991.
(n4) Komaromy M, Bindron AB, Hober RJ, Sande MA. Sexual harassment in medical training. N Engl J
Med 1993; 328: 322-26.
(n5) Anon. Unprofessional behavior. BMJ 1992; 305: 1161-62.
(n6) Anon. Sexual harassment. BMJ 1992; 305: 1361.
(n7) Editorial. Monopoly of middle-aged men. Lancet 1991; 557: 1007-08.
(n8) Conley FK. Sexual harassment in medical training. N Engl J Med 1993; 329: 663.
(n9) Tomlin PJ. Sexual harassment. BMJ 1992; 305: 1361.
(n10) Rubenstein M. The dignity of women at work: a report on the problems of sexual harassment in
the member states of the EC. Brussels: Office for Official Publications of the European Communities 1988
(Com V/412/1087).
(n11) Anon. Guidelines for establishing sexual harassment prevention and grievance procedures. JAMA
1992; 268: 273.
46
(n12) Health Services Management. Prevention of harm to patients resulting from physical or mental
disability by hospital or community medical or dental staff. 1982. DHSS HC(82)13.
(n13) Jensvold MF, Mackey B, Young-Horvath V. Sexual harassment in medical training. N Engl J Med
1993; 329: 661-62.
(n14) Forster P. Sexual harassment at work. BMJ 1992; 305: 944-46.
47
Sexual harassment and bar association policy:
Tightening the gaps is key for management
By Anna Marie Kukec
Professional associations should have a written sexual harassment policy that is enforced. But what if the
policy's enforcement is left to the person against whom a complaint is filed?
These policies should list alternative sources for reporting, a provision needed as both a safeguard and a
defense, but many just list the chief executive officer or the executive director, according to Gerard
Panaro, a Washington, D.C., lawyer and advisor with the firm Wilkes Artis Hedrick & Lane and author of
Employment Law Manual.
"If the alleged harasser is the chief executive, then you have a real dilemma," adds Panaro, who
represents trade and professional associations, including those in the security, bakery and police fields.
He has handled harassment lawsuits for 15 of his 20 years in practice.
This dilemma hit the State Bar of Arizona in Phoenix when its executive director was accused of sexual
harassment of two employees reportedly in 1991 and 1994. Ironically, the bar's sexual harassment policy
listed the executive director as the only source for reporting such incidents. After reviews of the incidents
were handled by staff internally, the bar's voluntary leadership stepped in by instigating an investigation
last November and, ultimately, terminating the executive director for "inappropriate conduct which
impaired his ability to manage the bar." The board did not reach a finding of sexual harassment,
according to state bar President Robert Van Wyck of Flagstaff.
"There wasn't an adequate mechanism in place for reporting inappropriate behavior. That was a link that
was missed and contributed to the difficulties," Van Wyck says.
In April, the board approved a new policy which calls for complaints to be filed with the executive director
and the president-elect. If those individuals are the targets, then complaints can be made to the
president of the Board of Governors or his or her designee. In addition, the bar plans to pursue more
education and sensitivity training for the staff and provide greater opportunities for suggesting
improvements in employer-employee work relations.
"We wanted to reaffirm to our staff our commitment to provide a work environment that is comfortable
and productive and free of gender bias and sexual harassment," Van Wyck says.
A name for the issue
The term sexual harassment evolved in 1978 when the federal Equal Employment Opportunity
Commission issued guidelines covering such discrimination under the federal law, Title 7. Sexual
harassment was also recognized as a form of discrimination under Title 7 in the 1986 U.S. Supreme Court
case, Vinson v. Meritor Savings Bank. In this case, a female bank employee charged that the male branch
manager forced her to have sex about 50 times during a three-year period. She claims she submitted out
of fear of losing her job.
In Martin v. Cavalier Hotel Corp., a federal appeals court held an employer liable for sexual harassment
when a male supervisor harassed and assaulted a female worker in 1992 even though the employee
never reported it. (See "Employer found liable despite lack of knowledge," Dollars & Cents, American
Society of Association Executives, February 1996.)
48
Although the boss denied the harassment, the woman resigned, then filed and won a lawsuit. On appeal,
the court said the company was responsible for the boss' actions. The case also sent a shock wave
through business circles and associations, according to the article, because liability was found to be
greater when the harasser is the CEO.
All states, and the District of Columbia, have anti-discrimination laws that include sexual harassment.
However, all state statutes do not necessarily require businesses, associations or other entities in their
jurisdiction to have their own individual policies, according to Teresa Chaw of San Francisco, executive
director of the National Employment Lawyers Association.
Adding elements from these state and federal guidelines and court rulings can be useful to bar
associations when they develop policies, says Panaro. That's because bar associations are public
representatives of the legal community and should be role models that address all forms of employment
discrimination, adds Laurel Bellows of Chicago, chair of the ABA's Commission on Women in the
Profession.
"Sexual harassment has been a serious problem in the workplace long before Anita Hill brought it to light.
It comes as no surprise that perpetrators are at Fortune 500 companies and law firms, and we'll find
them in the ranks of bar associations as well," says Bellows.
In 1995, 39 state and 54 local bar associations (or about 44 percent of the 208 responding bars) had
sexual harassment policies, according to the 1995 Bar Activities Inventory compiled by the American Bar
Association Division for Bar Services.
In comparison, about 51 percent of 1,540 responding general associations around the country have a
sexual harassment policy in place, according to the Policies and Procedures in Association Management, a
1996 survey by the American Society of Association Executives in Washington, D.C.
Many associations realize that a written policy is a vital tool for both management and the employees. In
his experience, Panaro says text of the policy is rarely an issue. But not having a policy or not taking
action when complaints arise can be major thorns if a case escalates, Panaro says.
"If complaints arise, the association must take (them) seriously and investigate. They just cannot say,
Deal with it yourself,' or Boys will be boys,'" he says.
Oregon a leader
The Oregon State Bar adopted its sexual harassment policy in 1989, which states that complaints can be
reported to a supervisor or to the human resources manager.
"We were ahead of the curve on this one," says George Riemer of Lake Oswego, the bar's deputy
executive director and general counsel, about adopting the policy earlier than most bars. Shortly after the
policy was enacted, it was put into practice when a situation occurred within the bar staff that same year.
Although Riemer declined to discuss specific details, he says that an employee complained about another
employee. After an internal investigation, the alleged harasser was warned verbally and in writing not to
repeat the offense. When the situation reoccurred in 1992, the alleged harasser was fired. No lawsuit
resulted by the complainant or the harasser, he notes.
"This situation demonstrated that the policy was effective and the process was a good one," Riemer
adds. North Carolina's plan
49
About four years ago, the North Carolina Bar Association's Commission on the Status of Women in the
Profession recommended both a sexual harassment policy for the bar and a model policy for law firms.
The bar took the policy a step further for its own employees by including other forms of potential
harassment, such as religious, racial and ethnic.
The policy states that an employee can report alleged harassment to the director of administration, the
assistant executive director, the executive director or the personnel committee.
"How could we recommend something to others when we didn't have it ourselves?" says Executive
Director Allan Head of Cary, adding that the bar needed to set an example for the legal community. Such
policies should be used as a safety alarm, not as a hammer, he says.
Recently, a female employee told Head that a vendor was exhibiting inappropriate behavior. Head told
her to read the bar's policy carefully, and put her complaint in writing. In the meantime, Head wrote a
follow-up memo to the employee in order to reassure her that appropriate action will be taken, if
necessary.
"I used the policy as a manager to help protect myself as well," he explains about the need to keep
records. Although the situation did not reach a formal complaint stage, Head is grateful for the policy and
its protection for staff and management.
"These policies are a sign of the times," Head notes. "We're not like we used to be. Families are not.
Society is not. We need to protect people, and everyone has a right to work in a safe, dignified work
environment."
Vermont bar follows state law
About three years ago, the Vermont Bar Association included elements of the state anti-discrimination
statute in its own employee harassment policy. Besides the bar association's executive director, state
agencies such as the Vermont Attorney General's Office, the Equal Employment Opportunity Commission,
and the Vermont Human Rights Commission are listed as sources for reporting complaints.
Since the bar adopted its policy, there have been no complaints of harassment, says Executive Director
Robert Paolini of Montpelier.
"This policy is a recognition of the diversity in the workplace which didn't exist five or 10 years ago. It's a
matter of respect for people who staff the bar association," Paolini says.
Boston promotes professionalism
Like North Carolina, the Boston Bar Association instituted both a sexual harassment policy for its
employees and adopted a model policy for law firms. Both policies were developed by the bar's Gender
and Justice Committee in 1993.
The policy allows an employee to discuss an alleged incident confidentially with one of two harassment
counselors who have been appointed by the executive director. The counselors, both lawyers and bar
employees, have knowledge of and training in harassment issues. They will advise the complainant of the
bar's policy and provide advice and assistance on how the complainant may proceed with the matter.
"The complainant has complete control and (the policy) tends to encourage counseling without
committing to a formal complaint. It is then up to the complainant to decide how to take it," explains
Executive Director Frank Moran, who adds that the policy has so far remained unused and unchallenged.
50
Although the policy does not state specific action or reprimands if a complaint is deemed valid, Moran
says that the discipline should fit the seriousness of the offense. In his annual briefing to the staff on this
subject, Moran states that sexual harassment is grounds for termination of employment. The policy puts
employees on notice regarding actions that are unacceptable and establishes standards of behavior.
"My experience, both in the military and in management, is that sexual harassment policies act as a
deterrent to sexual harassment. They have the tendency of sensitizing people to the concept to provide a
better understanding of the offensiveness of certain actions," Moran says. "Having a policy increased the
professionalism of the organization."
New York trains staff
The New York State Bar Association began educational seminars and sensitivity training for its employees
in 1994, nearly a year before a sexual harassment policy was adopted by its Executive Committee.
"This was not prompted by Oh, my gosh, we have a problem employee' and had to do something about
it. No. In fact, sexual harassment is a socially and legally prominent issue, and it was just time to put a
plan into place," says John Williamson of Albany, the bar's associate executive director.
In early 1994, a staff committee began to examine the issue for the workplace and recommended that
the bar's 100 employees undergo special training so they would fully understand what constitutes sexual
harassment and how to deal with potential problems.
With that suggestion, the bar hired the Connecticut Women's Education and Legal Fund, a Hartfordbased consulting group, to provide three days of seminars for the 8-member committee and another
round of two half-day seminars for the general staff later that year. Instructional materials and guidelines
were offered on how to identify sexual harassment and how to report and deal with a potential situation,
Williamson says.
"It's better to put this together before there's a problem," he says, noting that no complaints have yet
been reported.
The bar's Executive Committee adopted the Sexual Harassment Procedures in 1995, which designates a
Sexual Harassment Response Committee, composed of staffers appointed by the executive director.
Complaints or problems are also reported to the executive director.
"We're operating on a basis to be fully compliant, and feel this issue is important enough to have the
training for our people," notes Williamson.
(Kukec is a reporter for Bar Leader)
Found online at www.abanet.org/barserv/22-3sexhar.html
51

Sexual Harassment Resource Manual

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