Study Highlights Need for Systemic, Multi-Level Interventions for Patient-Perpetrated Sexual Harassment in VA Healthcare Settings
A recent study found that >60% of women physicians experienced sexual or gender harassment by patients in the past year, and other research shows high prevalence of patient-perpetrated harassment of medical trainees, nurses, and allied health clinicians. In addition, in a previous study 25% of women Veteran primary care users have reported being harassed by male Veterans on VA grounds. Patient-perpetrated harassment creates unique challenges, and recent studies indicate that both men and women providers desire more training in managing this type of harassment. An understanding of the barriers and challenges to addressing this harassment may help guide recommendations for guidelines and training interventions. This study sought to identify challenges and stakeholder recommendations for addressing patient-perpetrated sexual harassment of women staff and patients at VA facilities. Between June and August 2016, investigators interviewed 24 staff, clinicians, and administrators across four VA medical centers located in the West, Midwest, and Northeast regions of the US. Participants were asked to: 1) describe their experiences, observations, or knowledge of harassment by men patients toward women staff and/or women patients; 2) discuss VA’s management of patient-perpetrated harassment; and 3) provide feedback about potential future interventions for harassment within the VA healthcare system.
- Findings highlight the complexity of addressing patient-perpetrated harassment and underscore the need for systemic, multi-level interventions.
- Perceived organizational-level challenges included a climate of tolerance for harassment, lack of formal policies, and insufficient leadership support.
- Perceived staff-level challenges included ambiguity around defining harassment, fear of negatively impacting patient-staff dynamics, and competing priorities.
- Study participants emphasized the need for greater education and training around harassment.
- Participants explained that some patients lack awareness and do not realize that their behaviors may be construed as harassing.
- Findings indicate an urgent need for clear, well-disseminated, action-oriented policies addressing how to report and/or intervene around patient-perpetrated harassment. As study participants noted, leadership must publicly uphold and enforce these policies to ensure their effectiveness.
- Interviews took place before VA’s campaigns against harassment and the popularization of the #MeToo and #TimesUp movements, so stakeholder perceptions may have evolved.
This study was supported by VA’s Office of Women’s Health Services. Dr. Fenwick is funded through an HSR&D fellowship program, and Dr. Yano is supported by an HSR&D Research Career Scientist award. All authors are part of HSR&D’s Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP).
Fenwick K, Luger T, Dyer K, Chrystal J, Hamilton A, Yano E, and Klap R. Challenges to Addressing Patient-Perpetrated Sexual Harassment in Veterans Affairs Healthcare Settings. Journal of General Internal Medicine. February 25, 2021; online ahead of print.