Opinion | Dr. Esther Choo and Dr. Reshma Jagsi: 'We should have health systems designed with multiple safeguards in place so that sexual assault does not occur to begin with.' - NBCNewsTHINK
. For example, the committee now recommends the routine use of chaperones during patient examinations of the breasts or genitals.
However, it is difficult to know if such guidelines are being used. The adoption and implementation of such rules are not tracked and incentivized. There is little common knowledge about what an adequate institutional response to incidents of assault or harassment even looks like; thus, health care organizations have little benchmarking or pressure to meet thresholds of quality or safety in this area.
Even for those with the desire and the courage to report, reporting pathways for sexual assault are notoriously obscure, complex and inconsistent from institution to institution. Sometimes the human resources department, sometimes Title VII, sometimes Title IX, sometimes a hospital ombudsperson, sometimes the hospital chief of staff, sometimes an anonymous online form — the point of contact depends on who the assault or harassment happened to or who suffered the assault/harassment.
As in other organizations, reports go to those employed by the hospital or health care system and invested in its welfare, creating a conflict of interest from the outset that favors the person who committed the assault.
Compounding the challenges to effective responses to assault is the silencing of incidents. Once an investigation is underway, those who reported the assault are typically prohibited from speaking about the incidents. At the same time, any complaint triggers social and professional retaliation, in which those reporting the assault are shamed and subject to criticism and those who are reported are defended .
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