High Stakes

The #MeToo Movement is Coming for Healthcare

#metoo comes to healthcare

Physicians have traditionally been members of a protected class. Now, everything is changing.

The public push to call out abuses of power may have started in Hollywood, but it’s coming for every industry. Healthcare is not immune – last week the world mourned for the young victims of physician Larry Nassar. The healthcare industry should be prepared for a new wave of allegations.

Of course, misconduct – sexual and otherwise – isn’t a healthcare problem any more than it is a Hollywood problem. It’s a larger, all-encompassing societal problem. In almost any facet of society, certain members– typically men, typically powerful – have belonged to a protected class.

When we look at healthcare, the protected class has traditionally included physicians. But the public will hold hospitals and health systems responsible for rooting out improper behavior as the social dynamic that has shielded members of the protected class breaks down.

To be crystal clear: The overwhelming majority of doctors are devoted to providing excellent care to patients, first and foremost. Bad actors are in the minority. But it only takes one person at an institution to create a toxic environment.

Given that, healthcare leaders must take responsibility for dealing with abuses of power, create and support the infrastructure for staff to report problems and be ready to enforce consequences. As our CEO David Jarrard said in a recent Bloomberg BNA article, leadership should absolutely have a crisis plan ready to deal with sexual and other misconduct.

This type of introspective work is more important in healthcare now than ever. Many hospitals are running on thin margins and operating in between fee-for-service and value-based models. As such, doctors who perform lengthy, complicated procedures or see a high volume of patients often bring in a disproportionate amount of money for themselves and the hospital. Losing a star doctor or a high-performer can often directly impact a hospital’s bottom line.

When that lines up with a gender imbalance (the ratio of male to female doctors nationwide is about 2:1, according to the Kaiser Family Foundation and women make up 80 percent of the healthcare workforce, but only 40 percent of healthcare executive leadership, according to the Advisory Board) it’s important to keep potential abuses of power in check.

Allowing misconduct isn’t just wrong, it’s a bad business decision. The cultural climate now, thankfully, supports people who come forward about abuses of power. So while it may hurt a hospital’s bottom line to lose a star physician, we have seen serious allegations bankrupt institutions, especially when there’s evidence that leadership knew about the problem and didn’t act.

Even when misconduct doesn’t escalate to the level of sexual abuse, bullying and other behaviors that foster a negative environment create more problems than any high-earner is worth. Added negativity for staff and caretakers can decrease employee morale when industry uncertainty is already at an all-time high. Frankly, it’s more important than ever for hospitals to have engaged employees.

Here’s what healthcare leaders should consider.

Those who have fostered open, collaborative cultures that value transparency are less likely to face this particular crisis. Even so, they should reinforce a zero-tolerance policy for misconduct of any kind and communicate clearly across the entire system that policy violators will face consequences.

But health care providers with cultures that look the other way when star physicians behave badly need to look inward, take control of the process and get rid of problematic people in power. It’s better to end unacceptable behavior now, before employees begin to feel defeated or a story goes public and threatens the livelihood of the hospital. Because the overarching culture has changed, and it’s no longer a question of whether misconduct will cause a problem, but when.

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Responsible Transparency: How Health Systems Deal with Bad Behavior


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