ROCHESTER, Minn. -- The scale of sexual harassment within health care is just beginning to be understood, not to mention the damage it can cause to victims, workplace cohesion and patient care.

Research shows academic medicine has more sexual harassment than any other scientific discipline, however, and that half of all female medical students have experienced harassment before completing their studies.

And the harassment is not only coming from fellow co-workers; nearly a third of all female doctors have reported experiencing sexual harassment from patients.

Thanks to a seismic shift set in motion with the #metoo movement in late 2017, health care organizations have seen a rise in sexual harassment awareness and complaints, leading to the launch in 2019 of Times Up Healthcare as a movement created to shine the light on the problem. Since that time, out of 4,000 cases sent to the Times Up Legal Defense Fund, the second-highest number have been for harassment experienced in health care.

As one of the largest private employers in the health care sector, Mayo Clinic has just released the results of a striking embrace of this project, by way of a two-year study of sexual harassment within its own doors. The paper, published last week in the journal Mayo Clinic Proceedings, detailed the nature and disposition of 153 claims of sexual harassment among its 65,000 employees, all complaints received between September 2017 and September 2019.

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Mayo was able initiate that review starting in September of 2017 because, while the #metoo movement did not arise until later that year, the clinic had by then already begun to compile sexual harassment reports in their own category.

Mayo Clinic staff have access to an anonymous hotline to report concerns about sexual harassment, whereupon human resources investigators trained in addressing those types of allegations take up a process that involves multiple layers of review and can involve Mayo Clinic's legal department.

Of the 153 allegations charted during this time, 88 were substantiated. The complaints contained 22 charges involving physicians or scientists, 59 involving staff, and seven involving "patients, visitors, contractors or vendors."

"We found that the overwhelming number of the accused were male, and nearly half were at the same organizational levels as the victims," said Dr. Charanjit Rihal in a statement.

A cardiologist and chair of the clinic's personnel committee, Rihal co-authored the study with the clinic's current and former CEOs, as well as executives from the clinic's offices for human resources, legal and diversity and inclusion.

"Though more time-trend data is needed," Rihal said, "this is consistent with other studies in that the predominant victims are women and the predominant accused are men."

The actions leading to complaints ranged from inappropriate comments and/or unwelcome advances (80% of the complaints), to electronic harassment via text or email (18%), to unwanted touch or physical contact (25%).

The paper went on to detail how those 88 substantiated cases were then resolved. The clinic based its penalties on the nature and severity of the misconduct, with lesser-severity actions receiving corrective actions and higher severity actions leading to termination.

Out of 88 substantiated complaints, 31 employees received formal coaching (including nine physicians or scientists), 22 employees received written warnings (including three physicians or scientists), and 35 employees lost their jobs ---- either by resigning or being terminated. (Resignation in lieu of termination is allowed at the discretion of the employer in limited situations.)

Those no longer employed by Mayo included 10 physicians or scientists, with state licensing boards notified as required by statute. Victims were kept notified of the outcome and asked to report any retaliation.

"Our novel approach includes being transparent about results as we work toward elimination of sexual harassment at Mayo Clinic," said Cathy Fraser, Mayo Clinic's chief human resources officer and a study co-author in a statement. "Until we eliminate every case of harassment, we cannot be complacent ― period."

The authors said the clinic chose to report these numbers "to encourage more transparency and benchmarking of data among institutions," and after providing active bystander training to 95% of its staff on supporting colleagues being harrassed, has seen complaints drop since a spike in late 2017.