45.13% of 18,803 physicians had experienced sexual harassment by patients in their workplace in the UK, Canada, Australia, the US, Israel, Germany, and Malaysia.
The horrific incident in RG Kar Hospital, Kolkata has highlighted the vulnerability of healthcare workers, especially women alone on night duty. A video of the sexual harassment of a nurse in an Indian hospital by an international patient went viral on social media earlier this year. The very nature of healthcare exposes doctors, nurses, and paramedics, often alone on duty, to strangers in vulnerable circumstances ideal for sexual predators. This is in addition to sexual harassment from seniors and co-workers in any workplace. Despite fundamental rights of equality and constitutional protection from gender discrimination and multiple legislations including the Sexual Harassment of Women at Workplace Act, 2013 (PoSH Act), and National Medical Commission (NMC) directives to all healthcare institutions in India, there are daily reports of incidents in different parts of India. Many go unreported due to inadequate complaint mechanisms and lack of any action against perpetrators leading to further harassment and assault against the complainant. Frequent and serious assaults are causing doctors to be formal, defensive, or migrate abroad, or to safer institutions, or other health-related professions like medical software causing a further shortage of personnel.
As per a recently published meta-analysis of 12 studies from the UK, Canada, Australia, the US, Israel, Germany, and Malaysia on occupational hazards in healthcare, a shocking 45.13% of 18,803 physicians had experienced sexual harassment by patients in their workplace. Female doctors (52.2%) were more affected than male doctors (34.4%). The report suggested the provision of panic alarms for night shifts and isolated wards, CCTV without affecting patients’ privacy, and adequate security. Patients had proper channels to report harassment but doctors had inadequate support to raise concerns about patient and family behaviour. Many hospitals with crumbling old buildings, long dark quiet corridors, and distant unlit parking are a doctor’s nightmare.
In a survey of thousands of doctors in the USA, published earlier this year in the JAMA Health Forum, nearly three-quarters of all new female doctors and a third of males faced some form of sexual harassment. These included gender-biased comments or jokes, persistent unwanted romantic overtures, unnecessary exposure of body parts, or pressure to engage in sexual activity. Interns training in surgery and emergency medicine were 20% more likely than those training in paediatrics or neurology to have experienced sexual harassment. In a random sample survey of 599 of the 1,064 licensed female family physicians in Ontario, Canada, reported in the New England Journal of Medicine, “75% of respondents reported some sexual harassment by a patient at some time during their careers. Physicians had been harassed most often in their own offices and by their patients. However, in settings such as emergency rooms and clinics, unknown patients presented a proportionately higher risk”.
Employers should provide safety to health workers and meet their basic human needs. Background scrutiny of all employees, trainees, volunteers, security staff, logistics, and maintenance crew is indispensable. Biometric verification at secured entry-exit points, electronic access control systems and CCTV monitoring is crucial. All vehicles, goods, and personal belongings should be checked. Duress alarms for staff members, effective communication systems, and adequate lighting of the entire premises are vital. The doctors’ demands for better working conditions and airport-like security for hospitals should be accepted and implemented. Respecting and protecting health workers and providing a safe and congenial workplace is a prerequisite to efficient health care.
Dr P.S. Venkatesh Rao is Consultant Endocrine, Breast & Laparoscopic Surgeon, Bengaluru.