Time's Up Tackles Gender Bias and Harassment in Health Care
Since launching in January 2018, Time’s Up has worked swiftly to tackle sexual harassment and gender inequity in entertainment, tech, and advertising. Now, the nonprofit is setting its sights on another big industry: health care.
Time’s Up announced Thursday that it’s launching Time’s Up Healthcare, a new affiliate that aims to tackle discrimination, harassment, and inequality across the health care industry. Dozens of health care providers—from surgeons and psychiatrists to nurses and medical students—joined together to found the organization. And they’ve already scored the support of a handful of major medical institutions that signed on to signal their commitment to the effort. Those backers include the Mayo Clinic and the medical schools of Yale, Brown, Drexel, and the University of Wisconsin.
The launch of Time’s Up Healthcare came on the same day that the National Institutes of Health apologized for its past failures to recognize and address the culture of sexual harassment that has impacted scientists for generations. A sweeping report released by the National Academies last year found that sexual harassment takes a significant toll on women in academic science and medicine. In one survey conducted for the report, nearly half of female medical students said they had been harassed by faculty or staff. That report also made one thing clear: Current policies to stem sexual harassment in health care aren’t cutting it.
STAT spoke with Dr. Jane van Dis, an OB-GYN in California, the chief executive of the nonprofit Equity Quotient, and founding member of Time’s Up Healthcare, about the group’s goals. The interview has been edited for length and clarity.
Why is Time’s Up expanding into health care?
It’s not so much why health care, but why do we as a society need to start addressing these problems? Once you have some data, you have no choice to try to fix the problem. It’s so pervasive. We’ve looked at a lot of data around physicians, but physicians are not even the most vulnerable. This affects women of color and low-income health care workers [in particular]. All of us feel an obligation to fix our industry, not only for the health and welfare of women working in it, but also for our patients. Let’s look at it from a patient safety angle. We need to be the best qualified and healthy workforce in order to take the best care of the patients who present at our doorsteps for care.
Discrimination can affect women and other marginalized patients who aren’t always taken seriously by medical providers. Do you see Time’s Up Healthcare addressing that?
As physicians, we’re learning to start asking those difficult questions. I’m in a Facebook group with 3,400 other female OB-GYNs. Someone had a poll the other day, and they asked what people’s opinions are about women who report endometriosis-related pain—are they exaggerating, are they treated appropriately, is their pain ignored. I was absolutely flabbergasted by the number of my colleagues that thought patients were exaggerating their pain. We know it takes an average of nine years for women to be diagnosed and treated for that condition.
As specialists, we necessarily have to ask difficult questions about our history, how we arrived here, how we come to conclusions, how we evaluate patients’ pain. You can’t always separate unconscious bias from your understanding of how you diagnose, treat, and communicate with patients. Another example of this is the horrific number of black women who die in pregnancy [and childbirth] in our country. All indicators point to the fact that systemic racism plays a role. Medicine needs to be—and thank goodness we are—actually asking those questions, so we can be the drivers of the conversations.
What made you want to get involved in launching this effort?
My mother experienced sexual harassment in her workplace. I had my own Me Too moment in medicine as well. … As my daughter’s Girl Scout troop leader, I look at their faces and think about how we emphasize their education and their participation in STEM activities. We should not promise a workplace to them that will honor their abilities and intellect unless that workplace is safe. And we have a lot of work to do in that regard.
What’s first for Time’s Up Healthcare?
One of the first steps is acknowledging the problem. Health care organizations should take qualitative and quantitative assessments of their culture. I think that’s why the [National Academies] report was so important, because it put data and numbers behind it.
When sexual harassment or gender discrimination happens in the workplace, we sort of wall it off. We push it to the side, but we don’t implement institutional changes. We’ve taken a very reactive approach. We need to assess ourselves. We need to improve the manner by which people can come forward with these complaints. We need to put policies in place that actually have teeth. It’s very difficult to change culture. I think this problem is so important that companies and organizations have to do the difficult work. That means no more symbolic compliance. You implement changes, track those changes over time, and see whether your interventions are working. If they aren’t, you change things. [It’s] the same way we solve scientific problems.
What do you see as its long-term goals?
I think we have a good start, but I do think we have a long way to go. I don’t think we have enough diversity at the table today. One year from now, I would like to see even more health care professionals represented in Time’s Up Healthcare so that we can hear their voices, their concerns, and their ideas for improving the health care workplace. I’d love to see us financially viable. I think that one of our key jobs is to let women and men know we exist so they can utilize the organization.
I would like [to see] every academic institution come and sign on to our mission, vision, and values, which is that gender discrimination and sexual harassment have no place in health care. Our goal is to create safe, dignified, and equitable environments for all women in health care. To me, those are achievable goals.
What does it mean to have leaders from so many specialties and areas across health and medicine come together to address this issue?
Inclusivity is absolutely an underlying value of our mission, vision, and values. I don’t think we can accomplish our goal to unite health care workers across all fields without bringing everyone to the table. I think understanding how the workplace is experienced by the scrub tech in the OR, the environmental services worker, the nurse, the medical assistant, the social worker, and the chief nursing officer [is important]. I think everyone working in a culture has an opportunity to have a different set of eyes to look at how we can make our culture better. I don’t think we can get there solely by looking at [what each of us] saw or experienced. My black female physician colleagues tell me they get mistaken for the [janitorial] staff all too often. That doesn’t happen to me as a white doctor, but it has happened to my colleagues who are black doctors. We have to look at how each of us experiences the health care setting. All the voices at the table matter.
Republished with permission from STAT. This article originally appeared on February 28, 2019