By Amanda Sheppeard - Medical Republic - 18.07.2024 - [International] - [Prevention] Professor Louise Stone’s mission to keep the spotlight burning brightly on sexual assault and harassment in medicine.
The Canberra GP has co-authored papers, organised the nation’s first summit on the topic last year, spoken at countless conferences, and written hundreds of thousands of words on the subject. And she has no plans to stop there.
Her latest project is ambitious on a global scale, but she needs support to make it happen. Professor Stone has led a team of 75 authors from 23 countries to put together a book on sexual harassment between doctors.
The book – Sexual harassment of doctors by doctors: International perspectives, experiences, and responses – is the culmination of 10 years of work which began with a consultation at her clinic 10 years ago.
“In 2014, I looked after a young intern who was sexually assaulted by her supervising consultant while on the way to the car park after a night shift,” Professor Stone details in the book’s preface.
“As a general practitioner with a long-standing interest in mental health, I had seen hundreds of survivors of sexual trauma in my clinic, but this consultation felt profoundly different.
“The therapeutic relationship felt fragile, trust was hard-won and the shame in the room was deep. In retrospect, these difficulties were unsurprising.
“After all, the intern was a doctor, the consultant was a doctor, and I was a doctor, so there were complexities in the therapeutic relationship. I was part of a community that had been complicit in the abuse.”
With little literature around at the time to guide her in understanding the nature of sexual trauma in the medical workplace, she embarked on a quest to find out more.
An international meta-analysis on harassment and discrimination in medical training, published in 2014 in Academic Medicine, a journal of the Association of American Medical Colleges, showed that 57% of medical trainees experienced bullying and harassment, and 33% experienced sexual harassment.
Professor Stone teamed up with Professor Kirsty Douglas and Professor Christine Phillips to undertake a qualitative study to better understand the lived experience of young doctors who had survived sexual abuse within the medical profession. Their findings were published in the journal Medical Education in 2019.
“We found that the experience of abuse and its management was complex, and caused long-lasting harm,” Professor Stone wrote in the new book’s preface.
“In keeping with the existing research around workplace sexual trauma, we found that the culture of bullying and harassment within medicine made junior doctors vulnerable to more serious sexual trauma.”
Even before that, they knew they were opening a can of worms.
“We also knew that the medical workplace was toxic, and despite considerable efforts within and outside of the profession, occupational trauma remained high,” wrote Professor Stone.
“Medical workplaces are hierarchical, and junior doctors depend on their seniors for career progression, making them particularly vulnerable to abuse. There are high rates of depression and alcohol use among doctors, and high levels of vicarious trauma. Doctors are reluctant to seek help, and tend to believe that mental illness is a sign of weakness. Racism and sexism are common. Suicide risk is high, particularly among junior doctors.”
Professor Stone told The Medical Republic that in the months and years following this paper’s publication, it was clear that the problem was international.
Researchers came from all over the world to share their own experiences, thoughts and frustrations. And so, the idea for the book was born.
It is far more than a catalogue of personal stories and case studies – although there are harrowing accounts – and aims to provide an international picture on incidence and solutions for meaningful change.
The book is split into four main sections: context, interdisciplinary perspectives, international perspectives and looking to the future. Countries explored include Australia, Austria, Egypt, Germany, Iran, Japan, Malaysia, Mexico, Nigeria, Pakistan, the UK, the US and Zambia.
Professor Stone told TMR it was not a comfortable book to read, or write, but it was necessary to bring the subject out of the shadows and acknowledge that it remains a problem in medicine – not just in Australia but around the world.
It was also a practical book that looked at solutions and practical steps that could be taken to improve the problem, while acknowledging that sexual assault and harassment in medicine would likely never be completely eradicated.
“If you’re a predator, you’re going to pick a position of power. We’re always going to have predators in medicine, in law, in politics, in the military, because if you’re a predator, you’re going to pick a profession where there is power,” she said.
The book also includes a chapter on the role of men. Although sexual harassment is often seen as a problem limited to women, men play critical roles as leaders, bystanders, champions, advocates, colleagues and survivors. The book has outstanding authors of all genders.
“While perpetrators are commonly male, survivors are from all genders,” she said.
If you have been affected by any of the issues raised in this article, you can contact Dignity4Patients, whose helpline is open Monday to Thursday 10am to 4pm.
https://ofdoctorsbydoctors.com/the-observatory/ Dignity4Patients Commentary - Shedding light on the issue of sexual abuse in the medical field and recognizing that it continues to be a global problem is crucial for prioritizing patient safety. It is vital to acknowledge that while efforts to address sexual assault in medicine are important, it may not be entirely eliminated. #StopSexualAbuse #PatientFirst #PatientProtection
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