Women Doctors Tell Of Improper Behavior By Their Male Patients
Kay Petersen, a Boston physician, recalls when she first encountered undeniable sexual harassment from a male patient - a man she had been treating without incident for several years.
"I was saying goodbye at the end of an office visit. He grabbed my hand, then grabbed me around the waist and kissed me on the lips," Petersen said. "It was a terribly painful moment."
Such overt sexual aggression by patients is apparently relatively unusual. But a unique study published yesterday, along with anecdotal evidence from women doctors, suggests that most female physicians suffer sexual harassment by male patients and that it comes in many forms.
"Our results suggest that sexual harassment of female physicians is widespread and troublesome," concluded Dr. Susan Phillips of Queen's University in Kingston, Ontario, and Margaret Schneider of the Ontario Institute for Studies in Education. Their study appears in this week's New England Journal of Medicine.
More than three-quarters of 417 female family practitioners in the Ontario study reported experience with sexual harassment by male patients. The offensive behavior spanned a wide range: sexual remarks and gestures, lewd genital exposure, pressure for dates and unwelcome gifts, brushing or fondling the doctor's body, "grossly inappropriate touching" such as Petersen's patient displayed, and rape or attempted rape.
The researchers asked study subjects whether they had had first-hand experience with these behaviors. The study drew on definitions of sexual harassment used by the U.S. Equal Employment Opportunity Commission and other studies.
Female physicians told researchers they had experienced such patient behavior anywhere from once a year to once a month or more, except for grossly improper behavior, which occurred from less than once a year to three times a year.
The most common setting for such sexual harassment was the doctor's office, but proportionately the risk was higher in emergency rooms or community clinics.
Researchers and physicians in the United States and Canada say female physicians are in a unique position simply because the doctor's traditionally powerful role and the patient's vulnerability can be threatening for some men when the doctor is a woman.
"The traditional male provider-female patient situation keeps the powers lined up," said Dr. Lucy Candib, a family practitioner in Worcester on the faculty of the University of Massachusetts Medical School.
"When you have a female provider and male patient, I think it's confusing for the man to know what is his relationship to this particular female," Candib said. "There are two ways they handle it. One is to work out some kind of egalitarian and mutually sympathetic way of thinking about each other, and the other is for him to try to assert power in the ways that he knows, which often are sexual."
Phillips subscribes to this view. "I've concluded that this behavior is all about power relationships and abuse of power," she said in an interview. "Though doctors traditionally hold power in our society, in this relationship that power seems to be overridden or undermined."
Or, as Phillips and Schneider put it in their article, "female doctors are treated primarily as women, not as physicians, by many of their male patients."
The researchers solicited and received numerous specific examples of untoward behavior by male patients. The most common involved men who refused to be gowned or draped, requested genital examinations for no apparent reason, and displayed erections before or during physical examinations.
The problem has been as hidden as it is common, according to the Canadian researchers and U.S. physicians who were asked to read and comment on the study.
Many female doctors say they thought this was only their own problem, not a wider social phenomenon. They have rarely mentioned it to colleagues or anyone else, and they often asked themselves if they somehow provoked the improper behavior.
"I found this a very thought-provoking article," Petersen said. "It made me reflect on a number of uncomfortable situations that I have dealt with very subliminally over the years. No one ever discusses this in my professional life."
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