Sexual harassment in medicine [PODCAST]

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“I would encourage you to see amazing women on social media for who they are in the future.  Maybe figure out where they have been and what they are working toward.  Maybe even figure out how ways to help each other solve the problems this country faces.  Instead of looking at someone’s appearance, listen to their story. You got unlucky with me; you can’t intimidate someone who has lived through the war.  I’m hoping that you choose to go in a more professional direction with the next woman you message because of these words.  We are not transactions. We are intelligent, determined, passionate, and persistent people.  It’s far better to be our ally than our foe.”

Kellie Lease Stecher is an obstetrician-gynecologist.

She shares her story and discusses her KevinMD article, “When a colleague asks you for nude photos.”

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Kellie Lease Stecher. She is an obstetrician-gynecologist, and she wrote the KevinMD article “When a colleague asks you for nude photos.” Kellie, welcome to the show.

Kellie Lease Stecher: Thanks so much for having me.

Kevin Pho: We’ll get into the article in a little bit, but first off, can you share your story and your journey to where you are today?

Kellie Lease Stecher: Sure, I’d be happy to. So I grew up in Wisconsin. I ended up going to the Medical College of Wisconsin, which is a lovely medical school, and then I did my residency in OB/GYN at Michigan State at Grand Rapids Medical Education Partners. Then I moved back to Minnesota to be near family for raising our two kids. I have a daughter and a son; they’re seven and six.

As I was going through my professional career, I realized that there were so many missed opportunities that we had as a medical community. One of them was really to be a strong advocate for medical students and residents, because I think that so often we have this mentality that just because I went through something, they should go through something, and at times it can really be part of almost a hazing process. So I really started working on some advocacy issues, to see if we could do some structured committees and task forces in terms of counteracting the bullying and the harassment that students go through, because often they’re too scared to speak up and to protect themselves, especially if there is a powerful individual who has the ability to ruin their career, right? So I wanted to put safeguards in place for that.

Then, along those lines, speaking to people across the country, I really realized what a void we had in the mental health care space for physicians, nurses, and other medical staff. There is really a fear that they will be stigmatized, that they won’t be looked at as serious professionals if they seek help for their mental health. And there’s also a fear of retaliation for their licensure, right? Every year, we fill out our license information, and we have to report if we have any sort of medical illness or mental illness, and people are afraid that they will be retaliated against.

So recently, with the COVID pandemic, we’ve seen a lot more issues in terms of mental health, and I know that the data is supporting increased rates of burnout. So I really felt that we were not doing enough to support basically everyone who interacts with patients, and I started an organization called Patient Care Heroes with Naveen Goyal. Our team out of Loud Capital is putting together this program to get resources, financial, mental health, and other things that people need, to really make sure that they’re taking care of themselves.

Kevin Pho: Now, can you share a story of a medical student or a trainee that may have been hazed, or a clinician who is going through a potential mental health issue, and some of the things that you’re doing, or that they can do, to help address that issue?

Kellie Lease Stecher: Again, I talk to 30-plus women a day, right? And most of that is HIPAA-guarded. However, my girlfriends are also struggling, because they feel like they haven’t been really supported, especially in terms of preparation and PPE, and they feel kind of like they were hung out to dry by the governments at large, right? So people feel this sense of moral injury: They’ve been fighting their whole life to protect patients and their colleagues, and then, unfortunately, they’ve gotten into this situation where they haven’t been able to fulfill that need to protect people.

So moral injury is something that I hear really almost across the board from medical providers, especially physicians and nurses. They feel like they can’t do everything that they should be doing, and that increases burnout, depression, and anxiety. Some of our colleagues who have witnessed multiple deaths from the pandemic are really going through PTSD because of everything that they faced, right?

Unfortunately, physician suicide, as you know, is the highest among any profession, and we are still seeing suicides, right? The Dr. Breen Foundation was created, and I know Tim Kaine is doing legislation to kind of address some of these issues, so hopefully that will pass. However, we want to be strong advocates to help our community fulfill its true potential, and if we’re healthy, we’re going to have safer patient care, you know? So I think that really being a structured organization that can supply some of this barrier-free access to mental health care will really help us in the long run.

Kevin Pho: Now, for those clinicians who are struggling with mental health issues, moral injury, or burnout, what are some resources that you suggest?

Kellie Lease Stecher: Yeah, so our organization is going to have a hub of national resources. However, there are advocacy centers, right? So, like, the Minnesota mental health advocacy center is working with us, and Shereen McConnell, and she’s been getting donations, and we have multiple people who are going to be volunteering through that organization. There are national centers for burnout. There are organizations; for example, here in this area, Jennifer Krippner is part of an organization that is really steadfast in making sure that we’re helping to prevent burnout, and they’ve got multiple studies that they’ve launched, which really point to burnout as a risk factor for physician suicide and everything else. So there are many resources. If you reach out to patientcareheroes.com, we can help link you up with resources that may be more pertinent to your needs.

Kevin Pho: All right, so let’s transition now into your KevinMD article that you wrote in January. It’s titled “When a colleague asks you for nude photos.” Now, for those who didn’t read that article, can you share your story and explain why you decided to write it?

Kellie Lease Stecher: Yeah, so I think that, being a professional woman in medicine, I’ve obviously talked to many colleagues, and it’s almost universally known that there’s going to be a level of harassment that’s just a commonplace thing. Usually people go through this in training. As we get older, we do kind of suspect that this is going to die down a little bit. However, there’s always someone older than you, right? So I have heard countless stories of women across the country being harassed, being intimidated, being asked for quid pro quo, right? And I’ve even had multiple interactions on this professional website where people have essentially asked for some sort of picture or something, for maybe connections or getting into some sort of organization that could help promote something that I want to promote, right?

So when I really thought about what I represented, I really want to be a strong advocate for women everywhere, because I’m an OB/GYN, right? That’s what I do all day long. And I also have a six-year-old daughter. So when I think back to when I’ve been intimidated, and when I’ve had my professional career threatened by people in power, I really wanted to show them the women, or men, right? Because I don’t discredit that men also can be harassed, and they can be intimidated, and they can be bullied. So I don’t want this to be like a woman-hating-men thing, because I do realize that it does work both ways. But I want people to feel like they’re not alone in these situations.

And I realize I have had so many things in my life that I could easily brush this off. However, what am I doing to help people from someone like this in the future, right? So I realized that people get power, and people continue to harass people or threaten people or intimidate people, because no one stopped them. Someone has witnessed it, or someone has experienced it, and no one has spoken up. These people don’t typically just get created out of a vacuum. It’s typically a pattern of behavior, and it’s a pattern of behavior that often spans 20, 30, 40 years. So if I can put the brakes on this pathway for even one person, or make someone reconsider their interactions with a female colleague, then I will feel like I did some sort of service for them, to try to protect them from a bullying behavior.

Kevin Pho: Now, can you share some stories and anecdotes, whether it’s from your career or the careers of other physicians that you’ve talked to, where their careers are threatened because of harassment?

Kellie Lease Stecher: You know, I think that students and residents have a particularly vulnerable situation when it comes to this, because you literally are not fully done with training, right? You’re not a board-certified clinician. From the moment I signed my first loan check, or whatever you would call it, I knew I had to graduate medical school, and I knew I had to complete training for me to be able to afford to survive, right? Because I didn’t have the background of a family that could afford to pay for anything. And so my friends and I just kind of grinned and bore it, right?

The vast majority of people are awesome. However, it only takes one person to make the situation a hard thing to deal with. I know that one of my girlfriends dated a clerkship director in medical school, and that ended very poorly, and that became a situation where she felt intimidated. I felt intimidated. It was not a good situation for any of us, because we were the ones that knew what went on. And I think that a man in his 50s dating a medical student who he knows he has power over, to fail out or to give punishment to, I don’t think is appropriate. I don’t think you can really have a truly consensual relationship when there’s a significant power dynamic like that.

I know residents who’ve been assaulted by attending physicians, and there are many studies that have come out that women really feel like they cannot speak up against this because they fear retaliation. So a lot of times, people will report something, right? I’ve tried to get something done with the AMC and ACGME on this. But they’ll report something, and it will be laughed off or belittled, and usually the residency director goes hunting with the person that you’re reporting. And what happens is really pretty much nothing, except now you’re kind of on the blacklist, right?

So we’ve reinforced the thought that women should not come forward because their career will be jeopardized, not the man who’s the perpetrator, right? Because he’s this powerful person, maybe bringing money into the system. There have been a lot of articles out of different university systems where women have united and come back and sued the organization, because they knew that they had this predator all along and they did nothing. So my goal is to eventually have a national governance where we can have safe reporting structures, especially for medical students and residents, committees that can look at the data objectively, and support groups where they have an ability to openly communicate without fear of retaliation.

Kevin Pho: So for these medical students, trainees, and physicians who are the recipients of harassment, is the harassment from other physicians, primarily?

Kellie Lease Stecher: Yes. Yeah, so it’s typically from someone who’s superior to them in rank, right? And, you know, like anyone else knows, medicine is very hierarchical. It’s very patriarchal. We have a lot of the good old boys’ club still, and unfortunately, that really suppresses the ability to fix the medical culture and really sets us back. There are so many people trying to work on this. There’s Time’s Up Healthcare, and unfortunately, for whatever reason, not every health system is backing this. I can’t understand why anyone would say, “Nope, I don’t think that we should promote a culture of anti-bullying, anti-harassment.” So until we get people in leadership who believe in supporting people, we’re going to be in trouble. We’re not going to be able to fix the culture.

Kevin Pho: Now, you tell a story here on KevinMD about your own experience with harassment. What did you learn from this experience, and if there was something that you could have done differently, what would that be?

Kellie Lease Stecher: You know, it’s interesting, because I’m a pretty outgoing person, and I used to kind of find that a strength and a weakness, right? Because people would use that against me in terms of, you know, am I being flirtatious, or am I, you know, whatever. And I feel like we do things to women to discredit their personality and their assets, to try to use them as an excuse to bully them or harass them, right?

So I really have realized, through everything I’ve been through, that there’s no better solution for me than to be fully authentic and fully transparent. I realized that I will tell my truth, whatever that is, regardless of who it is or what power they have or what money they have or what connections they have, because you compromising yourself and your values for some career advancement is not worth it, right? I mean, just because you fear some sort of retaliation, it’s not worth you getting yourself into a situation that you can’t get out of. So really, from my standpoint, it’s walking in your truth, being your authentic self, and when you stand up for yourself, you stand up for people everywhere who are in a similar situation. That’s really kind of what I took from my experiences.

Kevin Pho: We’re talking to Kellie Lease Stecher. She is an obstetrician-gynecologist, and she wrote the KevinMD article “When a colleague asks you for nude photos.” Kellie, if someone is the unfortunate recipient of harassment, what is your advice to that person, and what kind of resources can they turn to?

Kellie Lease Stecher: They could certainly reach out to me personally at patientcareheroes.com. I have an entire team of people who are sensitive to this issue, and we can help get them the advocacy that they need, because I do fully realize that there is fear, right? Even after I wrote that article, I’ve had numerous people reaching out to me on different social media avenues, telling me, “Thank you for sharing this. Thank you for doing this, because I feel more empowered to stand up for myself next time.” And that was really an amazing and heartening thing that I actually didn’t even really expect.

But there are resources out there for you. I would tell you, first and foremost, I mean, sadly, keep the receipts, right? If you’re uncomfortable with the situation, make sure you’re documenting. Make sure you’re saving text messages and emails. Don’t be alone with somebody. Make sure that you are supported in your friend group, so that you have trusted colleagues that you can communicate with, and make sure that you’re reaching out to people who have been through different situations, who can advise you on further progress of what’s going on. Because there are people like me in every organization who are happy to help walk you through whatever situation you’re in, and we will find you the resources that you need. So take a deep breath. Know that there’s us out there. You can reach out to me, and we’ll figure it out together.

Kevin Pho: You mentioned that the reporting system is flawed and often doesn’t lead anywhere. Now, is there a role for hiring an attorney, for instance, if a physician is a recipient of harassment?

Kellie Lease Stecher: You know, it depends on your contract, right? This is another thing that I’d really like to see changed. However, there are legal structures that minimize a woman’s ability to seek legal ramifications for what’s happened to them, right? A lot of times, especially in big health systems, you sign arbitration, right? So you are committing to not take this further, and you’re supposed to kind of hash it out and figure it out in the context of the health system itself. The issue I have with that is that it allows different places across the country to harbor these people and to not give consequences for actions.

So certainly, I think finding an attorney is great. I think finding one that you can be totally honest with. I mean, I know I have an amazing attorney, Luke Thompson, whom I’ve now roped into helping us with Patient Care Heroes. But you need to find someone who can be your ally when you feel at your worst. And if that’s an attorney, great, because there’s the privilege between the two of you. If it’s your sister, and I’m fortunate to have a sister, that’s wonderful too. But you need to find your circle of allies that can help you through whatever situation you’re in.

Kevin Pho: And my final question: What is your take-home message that you want to leave with the KevinMD audience?

Kellie Lease Stecher: You know, I think that in light of the last couple of years, we really need to figure out how to have more empathy for each other. We really need to give each other a little bit of grace and distance, and not assume the worst in people, because I think everyone struggles with that right now. If we can see each other as just human beings who are trying to get through the world, provide for our families, and survive this kind of chaotic couple of years, we can figure everything out together. So, you know, from health care disparities to mental health issues to the stigma and everything else, I think we really need to unite and fix these problems together.

Kevin Pho: Well, thank you so much for sharing your time and insight, and thanks again for being on the show.

Kellie Lease Stecher: Thanks for having me.

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