Confronting harassment within medicine head on

Barbara L. McAneny, MD , Former President
Jack Resneck Jr., MD , Immediate Past President

The American Medical Association’s commitments to equity, fairness and respect for human dignity are cornerstones of the Code of Medical Ethics we introduced to medicine more than 170 years ago. So, when issues arise that threaten these longstanding tenets of our profession, we work purposefully within the House of Medicine to resolve them and uphold the principles that guide our work.     The national movement that unfolded over the last year brought long-overdue attention to the prevalence of sexual harassment in American society at the highest levels of business, politics, and entertainment. We have heard distressing stories of similar behavior in healthcare settings and at medical meetings. Like every other sector, medicine must operate with zero-tolerance for sexual and other forms of harassment.   

Responding to these concerns and a proactive recommendation from the AMA Board of Trustees, the AMA House of Delegates adopted a comprehensive anti-discrimination policy at its 2017 Annual Meeting, extending the AMA’s zero-tolerance employee policy to all attendees of its meetings and functions—even volunteers.

The Board of Trustees implemented this anti-discrimination policy immediately, and our processes continue to evolve. The Board proposed, and the House adopted, more detailed reporting, investigation, and enforcement mechanisms in June 2018—including a phone hotline and website where both employees and meeting attendees may confidentially report witnessing or experiencing harassment.

As AMA president, I (Dr. McAneny) addressed the House of Delegates last Saturday at our 2018 Interim Meeting and called upon leaders in medicine to stamp out discriminatory behavior when they saw it, to create an environment in which harassment will not be tolerated, and where women and men who’ve been victimized by harassment could comfortably come forward and be confident that misconduct would be appropriately addressed. 

When the House of Delegates reconvened this week in Maryland, it demonstrated its ongoing commitment to creating environments free from harassment and discrimination. The delegates unanimously approved a resolution that seeks to strengthen the existing process outlined in our anti-discrimination policy for investigating and adjudicating claims. 

Specifically, this resolution directs the AMA to engage independent, outside consultants to examine and make recommendations that could improve the process for addressing any future claims of harassment. The Board welcomed this idea, and a progress report is due at our 2019 Annual Meeting in Chicago in June.     Adoption of this resolution by the House prompted a standing ovation from the floor and strengthened the measures adopted at the AMA’s 2017 and 2018 Annual Meetings. Taken together, these actions reaffirm the AMA’s commitment to equity, fairness, respect for diversity, and a safe environment at all levels of the profession. Our Board and Officers share this commitment and sense of urgency.

The AMA’s commitment extends beyond our own organization and the meetings we convene—we have a responsibility to continue to address this national issue throughout medical workplaces where we have influence. Harassment takes on many forms, all of which can have devastating consequences for victims. It can range from subtle to overt, from unintended to highly purposed, and from one-off incidents to a systemic, toxic environment that makes it difficult for victims to get through each day.  

In medicine, as with all professions, harassment sometimes exploits inequalities in status and power, such as the relationships between faculty and trainees, or administrators and staff members. This behavior is unacceptable. The AMA Code of Medical Ethics forbids sexual harassment because it abuses the rights and trust of others, creates a hostile or intimidating work environment, and undermines patient care.    Physicians know how much our profession demands: the incredibly long hours, the overwhelming caseloads, the burdensome regulations, and the emotional toll extracted when bad news must be delivered. Stress and burnout in the profession are already too high, and while we work to address these challenges and renew the joy of practicing medicine, we must not compound them with sexual harassment, unwelcome sexual advances, or degrading behavior or remarks.     Harassment simply has no place within the AMA, within our medical community, or anywhere in society. And as a community of healers, we are better than this. Physicians enter this sacred profession because we are driven to help people, and to improve the lives of all in our care. We must similarly safeguard the dignity and safety of those with whom we work and interact. 

Editor’s note: The AMA’s zero-tolerance anti-harassment policy applies to employees and all attendees of our meetings and functions. Multiple reporting options are available to both the targets of any harassment and witnesses to prohibited conduct, including an option to register complaints confidentially to an external vendor online or via a toll-free hotline at (800) 398-1496.