The #MeToo movement has made it to medicine.

Sexual harassment and yawning pay gaps in American medicine are so common that female physicians and nurses nationwide banded together this year to form Time’s Up Healthcare, and Philadelphia now has its own signatories.

Doctors, nurses, pharmacists, administrators and researchers at Philadelphia’s most prominent medical schools, and hospitals have signed on, including Temple, Drexel, Einstein, and Penn State.

Time’s Up Healthcare aims to address pay inequities among health-care professionals, and at the CEO and C-suite level in hospitals, as well as eliminating sexual harassment in the workplace.

Medicine has long been a bastion of male physicians and faculty, particularly in academic hospitals, say the new group’s 50 or so members.

“There’s disproportionate power in many hospitals and universities” both nationally and in Philly, said Darilyn Moyer, CEO of the Philadelphia-based American College of Physicians, the largest physician specialty society. “Who are deans of medical schools and chairs of departments? Heads of divisions within departments? It’s not equal among men and women, that’s clear.”

For female doctors, pay gaps persist. Generally, male doctors earn 25% more than female counterparts, yet more than half of medical students are women for two years running. And nearly half of female medical students said they had been harassed by faculty or staff.

Fixing the composition of leadership at the top could move the needle, said Moyer, herself a physician in practice for 35 years and a founding member of Time’s Up Healthcare.

“Time’s Up Healthcare is getting the word out: We don’t tolerate harassment and discrimination in any form," Moyer said. "The organization also offers a legal defense fund, recognizing a lot of women being harassed aren’t in a financial position to file a lawsuit or hire a lawyer. But as a physician who works in a high-risk, high-reward profession, we don’t want it to come to that. We want to prevent it.”

Thomas Jefferson University this year ousted physician Charles Pollack, head of Jefferson’s Lambert Center for marijuana research, after he self-reported sexually harassing a subordinate. Pollack sent her amorous emails, persistently asking for dates, and even asking her to be a pallbearer at his funeral.

A married mother of three, she rebuffed him for months before finally complaining to human resources. An account of his harassment and mismanagement at the Lambert Center was detailed by The Inquirer on July 28.

“Pollack is a symptom of a larger problem,” said Esther Choo, a physician in Oregon and founding member of Time’s Up Healthcare.

In a thread on Twitter, she wrote, “In cases like this, the harasser almost always lands on his feet after a surprisingly short period out of the limelight. I give it six months for Pollack to quietly show up in another academic role or lucrative industry position.”

“These people fail upward. It’s not just that he kept a career going, but he had positions of prestige,” said Choo. “It’s called ‘passing the trash.’ Why can’t we just take out the trash?”

Why the movement now?

"More than half of medical students are women, yet they aren’t promoted to leadership positions,” said Resa Lewiss, an ER doctor and professor of emergency medicine at Jefferson.

“I have been witness to inequities in health care at every stage: medical school, residency, fellowship, and faculty. It’s never just one institution," Lewiss said.

Moyer said for decades she’s been mistaken for a nurse. “I always professionally and politely correct them, and do so for my colleagues as well. It’s probably consumed a lot of time over the course of my career. It happens to many women physicians several times a day. Imagine how that adds up.”

In response, Philadelphia signatories, found on the group’s website timesuphealthcare.org, include Drexel University College of Medicine, Einstein Health Network, Fox Chase Cancer Center, Penn State College of Medicine, Thomas Jefferson University and Jefferson Health, Lewis Katz School of Medicine at Temple University, and Rutgers School of Nursing-Camden. So far, Penn has not signed.

Roughly 40 institutions have signed the Time’s Up Healthcare pledge; the goal is 100 signatories by the year 2020.

Drexel’s medical school dean was a huge supporter of Time’s Up Healthcare, said Nancy Spector, professor of pediatrics and executive director of Executive Leadership in Academic Medicine (ELAM).

“It has taken over 50 years to go from zero women medical school deans to the 27 women deans who are now in this role," she said, crediting her ELAM program for some of their training. Currently, there are 153 medical school deans in America.

As for salaries, there are no medical specialties in which women earned more than men in 2018, according to the 2019 compensation report by Doximity, an online networking service for the medical profession.

Although the gender wage gap ratio within medical specialties was less stark in metropolitan areas, female specialists still make 23% less than their male counterparts. That gap narrows to 15% within primary care.

Doximity
There are no medical specialties in which women earned more than men in 2018. Although the gender wage gap ratio within medical specialties was less stark than in metropolitan areas, female specialists still make 23 percent less than their male counterparts. That pay gap narrows to 15 percent within primary care.

A landmark 2018 report from the National Academies of Sciences, Engineering, and Medicine found that sexual harassment takes a significant toll on women in science and medicine. In one survey for the report, almost half of female medical students reported being harassed by faculty or staff.

"We’ve realized medicine is one of the worst among the sciences,” noted Choo, an associate professor of emergency medicine in the Oregon Health and Science University School of Medicine in Portland, Ore. “And we have a particular shame and obligation to fix it.”

Solutions

But how does Time’s Up Healthcare actually make progress? The nonprofit is trying to enlist male colleagues in medicine as well to promote pay equity and a safe workplace.

Penn State’s pledge letter, for instance, spells out goals for Time’s Up Healthcare: “We cannot address a problem until we understand its scope and impact,” said the letter, signed by Craig Hillemeier, the recently retired dean of Penn State College of Medicine. “We will encourage the reporting, measuring and tracking of sexual harassment and gender based inequities in our institution."

Hospitals often don’t keep records of complaints of sexual harassment, for example, and are loathe to disclose complaints.

The 2018 National Academies report recommended annual updates that provide numbers and types of violations, how many are currently under investigation and have been adjudicated, and general descriptions of disciplinary action.

Doctors who harass are often in leadership positions with lucrative side contracts and board directorships.

FSD Pharma, the Canadian marijuana company whose top officers reside in Philadelphia, last week removed Pollack from the role of chairman of its scientific advisory board. A Massachusetts-based firm named ioVita, which conducts medical marijuana research, also removed Pollack’s name from its list of directors last week. Pollack had awarded a $300,000 contract to ioVita to compile a database of medical marijuana patients nationwide. The company never delivered the project and Jefferson has asked for its money back.

Track hiring and promotions

Now that women account for more than 50% of medical school applicants — two years in a row — America may have hit a tipping point.

Roughly 80% of workers in health care are women, but only 11% are CEOs of health-care institutions, said Moyer of the American College of Physicians.

“I call my goal the ‘JEDI’ health-care environment: just, equitable, diverse, and inclusive,” she said.

She and other doctors in leadership want health-care institutions to define hiring criteria in advance of evaluating candidates. Female physicians are penalized in status and pay for taking even a short time off to care for children. Creating larger practices to encourage teamwork, computerized complaint records, and shift work could also reduce inequality by limiting long hours and uninterrupted employment, female doctors say.

“We can’t reward bad behavior,” said Nina Gentile, a professor of emergency medicine at Temple and another member of Time’s Up Healthcare.

Gentile was the only female faculty member in emergency medicine at Temple in 1997. After a concerted effort, Temple began hiring more women in Gentile’s department.

“I heard all the potential negatives about them having children,” she said. "But I pushed forward because without that, it may never have happened.”