Advis Vice President, Monica Hon, is featured in Part B News discussing diversity and its potential barriers in the healthcare workplace. Read the full Part B News article below.
Gender Discrimination Cases Suggest Weak Spots in Medical Practice Diligence
By Roy Edroso
Published June 13, 2022
A gender discrimination complaint from a staff physician at a prestigious New York hospital serves as a reminder that the health care sector isn’t immune to such problems, and developing a culture that supports a level playing field is central to management’s responsibilities.
On Dec. 21, 2021, Deborah Keller, M.D., a colorectal surgeon, brought suit against New York Presbyterian Hospital claiming gender discrimination under Title VII and the New York State Human Rights Law as well as retaliation for filing a complaint about it with the U.S. Equal Employment Opportunity Commission (EEOC).
As her complaint alleges, while Keller was employed by New York Presbyterian, she received “lower starting annual compensation than her male colleagues” and was “held to higher performance standards,” despite exemplary performance. She says she was also subjected to “relentless sexism” from her supervisor, Pokala Ravi Kiran, M.D., the hospital’s division chief of colorectal surgery, including “regular remarks about Dr. Keller’s body and physical appearance.” When she complained to HR, the complaint further alleges, Kiran withheld support and increased Keller’s workload.
Eventually, Keller complained via other official channels, including the offices of the ombudsman and the vice dean for academic affairs as well as the EEOC, leading to what her complaint describes as a pattern of retaliation including “diverting her patients, creating an unsustainable work schedule and environment, cutting off communications, sabotaging her career development research grant and, ultimately, refusing to extend her employment contract.”
In a response to that complaint dated March 28, 2022, the defendants denied knowledge or information sufficient to form a belief on nearly all of Keller’s material assertions.
The latest in a string of cases
Keller’s are far from the only recent gender discrimination charges made against a medical workplace. For example, Jacqueline Lappin, M.D., a transplant surgeon, currently has before the Western District Court in Texas an Application to Confirm and Render Judgment on Arbitration against her former employer, the Baylor Scott & White Clinic in Temple, Texas.
An arbitrator awarded Lappin $337,866 in 2021 on charges including discrimination after the Clinic fired Lappin for, allegedly, “unbecoming conduct” related to work outbursts. Lappin argued that other male physicians who had been similarly accused had been disciplined or given anger management classes rather than fired, which the arbitrator accepted as evidence of “wrongful termination based on gender/sex discrimination.”
A separate suit filed in April 2019 alleging age and gender discrimination against Mt. Sinai Hospital in New York City — in part because a supervisor allegedly fired older and female employees and replaced them mostly with young men — is ongoing, albeit with some original defendants severed from the case per a January 14, 2022 judge’s order (PBN 5/16/19).
Jennifer L. Curry, an attorney and shareholder with the Baker Donelson law firm in Baltimore, sees similar complaints in professions such as law and medicine, sometimes with other related types of discrimination involved.
“For example, in [Washington] D.C. there’s a law prohibiting discrimination based on family responsibilities and marital status,” Curry says. “I’ve seen women going through residency and having to work long hours who experience discrimination not only based on gender, but based on family status — that is, they have children — or marital status —they have children, but are not married or are divorced.”
Not just legal
Even when it doesn’t result in a lawsuit, gender inequity can be a problem for clinical staff effectiveness. Studies have shown that as the number of female physicians in a practice increases, so do reports of “burnout” among the female physician staff, as well as suggestions that discriminatory work environments may play a part in the problem (PBN 11/11/19).
A recent study in the Journal of the American Medical Association (JAMA) shows that women physicians spent about 41 minutes more per day on electronic health record (EHR) tasks than their male colleagues, even though the female cohort “cared for significantly fewer patients per hour and month.”
In the same issue, JAMA editorializes that this study aligns with prior studies in academic medical centers, suggesting that “observed gender differences are likely driven by inherent and socialized physician traits, as well as by gendered differences in patient and staff expectations of physician accessibility.”
Commenting on the JAMA items in a May 22 AMA article, Sara Berg, MS, says that “promoting gender equity in medicine requires an acknowledgement of the underlying causes of gender-based disparities, creation of policies and resources that will promote gender equity and collaboration to improve the environment for women and the profession overall.”
Look, listen, act
Kim Crowder, founder and CEO of Kim Crowder Consulting, a workplace diversity consultancy in Indianapolis, observes that despite recent growth, the minority status of women in medicine still works against them, particularly in surgical specialties. “Women who become part of that professional practice do not always find allies and support, either amongst colleagues or in the general workplace,” she says. Crowder also notes that female representation is even thinner at the management and supervisory level, which adds to the problem.
Among expert suggestions for better management of gender discrimination issues:
- Look “Health care organizations must first acknowledge that discrimination issues happen in every workplace, whether HR is aware or not,” Crowder says. “Accepting this allows workplaces to begin solving societal problems that impact their workplaces instead of waiting for employees to be grossly mistreated or the victims having to risk their careers and reputations in reporting this abuse.”
- Listen Crowder says clients who have been successful “build relationships with those who specialize in workplace equity to assess their current work environments, hear directly from employees in the workplace while upholding confidentiality, and turn that feedback into actionable steps for organizations to take.”
- Act Workplaces must show their willingness to respond to discrimination with action.
Training is always important, Curry says, but leadership has to set a standard by its behavior as well as its words. “Leadership has to be clear that certain things are not acceptable,” she says. “If they don’t take that role on, people will never take it seriously no matter how much training they get.”
In extreme cases, Crowder says, this may mean doing what Keller alleges New York Presbyterian failed to do in her case: support the victim against superiors.
“Organizations must be willing to release employees with both reported and witnessed abuse history,” Crowder says.
Also, look for possible diversity bottlenecks. For example, Monica Hon, vice president of the Advis health care consultancy in Tinley Park, Ill., suggests you review your mentoring program to “confirm its effectiveness and how participants are being held accountable for progress made. Often forced mentoring fizzles out with neither party being held accountable.”
While “nothing immunizes any employer from allegations of discrimination or even actual individual, isolated acts of discrimination, the best an employer can do is to take allegations of discrimination seriously, thoroughly investigate them and take prompt remedial action when warranted,” says Mark F. Kluger, a labor and employment lawyer and co-founding partner at Kluger Healey in Fairfield, N.J.
JAMA, “Gender Differences in Time Spent on Documentation and the Electronic Health Record in a Large Ambulatory Network,” March 24, 2022: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790443
JAMA, “Gender Differences in Electronic Health Record Work—Amplifying the Gender Pay and Time Gap in Medicine,” March 24, 2022: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2790444
AMA, “For office-based physicians, gender inequity pops up in the EHR,” May 22, 2022: www.ama-assn.org/practice-management/physician-health/office-based-physicians-gender-inequity-pops-ehr