Professor and chair of the UAB Department of Health Services Administration Christy Harris Lemak, Ph.D.,FACHE sat down with the UAB Department of Surgery to talk about her recent article in Modern Healthcare: "Why the Weinstein Case Matters in Healthcare." The interview is followed by remarks from UAB Department of Surgery Chair Herbert Chen, M.D., FACS.

You cite that 58% of women surgeons report being sexually harassed in the last year, 25% of nurses are sexually harassed on the job, and half of female medical students will experience sexual harassment before they graduate. Do you feel the field of surgery experiences this problem more than others?

“It's hard to say for sure. The simple answer is probably yes. What we know for sure is that of all fields in medicine, surgery remains one of the most male-dominated – which is associated with dynamics that may lead to more gender and sexual harassment. It also makes it more difficult to change norms of behavior and organizational culture when most of the folks involved may be unaware of the issues experienced by a few.

As well, surgical scholars – both men and women – have been leaders in what I consider a ‘movement’ – they have begun to study gender issues empirically. Some of the best research we have right now regarding issues of gender harassment, sexual harassment, gender equity, etc. in health care are coming out of academic surgery departments. So, we probably know more about it in surgery than any other places.”

Have you seen or felt a decrease in the number of sexual harassment stories that women bravely share, and how would you advise a woman who is scared to report because of professional backlash?

“I don’t think the stories- or the reporting- have decreased. It seems to me that the #MeToo movement has given women a bit more courage to come forward. The recent work done by several associations and even the National Institutes of Health to shed light on pervasive sexual harassment has made it somewhat easier to tell your story. I am not sure, however, that women believe that their careers will be okay, that is, they won’t suffer for coming forward. I think some of them are just ready to suffer those consequences today, perhaps more than before.

In terms of advice– each situation is different. I don’t have a set answer. The first step is to believe the person. The second step is to get the person some help, be that counseling, human resources or legal. A support team can help the person make the right decision from there. Sadly, many people simply brush off the person or try to explain it away. That’s where we go wrong.”

What responsibility do our leaders have to combat this issue?

“At the heart of all of this is leadership. Leaders have the responsibility to address issues of gender harassment and sexual harassment throughout their organizations – from structural things like compensation, work schedules, leave policies and opportunities to cultural and behavioral things like the differences in the words we use to evaluate men and women, the way we talk about men and women and uncovering biases in all we do. I just heard someone say we must seek to be 'consciously aware' in our leadership. I love that.”

At an institutional level, what programs or policies have you seen be effective for keeping young women in healthcare?

• “A demonstrated commitment from the top that diversity (all kinds) matters.
• Flexibility in work and things that support families and family life– schedules, time off for family and personal reasons, paid paternity/maternity leave, on-site childcare (and sick childcare options).
• Culture that does not have room for bias of any kind (so training, behavior and accountability around this)”

What can women do to support other women? What can men do to support women?

“People need to start with themselves and understand that we all have bias. How can we root those out and be sure they do not guide our behaviors? Next, we need to listen more, pay attention to those around us – bystanders observe a lot and often say very little. How can we begin to be allies and active supporters for what we know and believe in, that is, respecting people.

Above all – don’t harass anyone. Believe people if they come to you and say they have been or are being harassed. Change the culture where you work; start with your own words and actions. It’s really the best we can do.”

A note from the UAB Department of Surgery Chair Herbert Chen, M.D., FACS:

“Leadership can bring unlimited opportunity but that comes with an ultimate responsibility. As leaders, our role is to recruit, mentor, sponsor, advise and nurture our team members. We must provide an environment that allows everyone the opportunity to succeed and be the best they can be. And, without saying, everyone must feel safe in this environment.

My hope is that you thought about your role as a leader in our own department of surgery as you read the article and our interview with Christy Harris Lemak, Ph.D., FACHE. A leader must recognize that they are not always perfect. We must surround ourselves with other leaders who are not afraid to provide feedback and sometimes critical advice. We must be careful not to misuse the trust that we have been bestowed by the people that we lead.

In my fifth year as your chair, I feel extremely fortunate to have a fantastic group of leaders within the department who have contributed to a culture which promotes achievement, teamwork, diversity and inclusion. I am also very appreciative for all of the opinions, feedback, support and pushback that I have received from all members of the department. By expressing your views and advocating for others, we make the whole team better.”