Japanese society, in general, has recently supported policies against sexual harassment. Many hospitals and medical schools were required to introduce institutional committees for preventing or managing this issue. Healthcare workers, including physicians, should have had an opportunity learning appropriate and inappropriate behaviors about sexual harassment. The #MeToo movement in global social media has also influenced Japanese society. There have been formal accusations against offenders, including a journalist and a government official with strong political power, who were alleged to conduct a sexual harassment throughout Japan.1, 2Medical professionalism has been the basis of physicians’ contract with society all over the world, and physicians in Japan are also considered to have the accountability to follow its moral principles. Thus, we previously conducted two surveys in 2005 and 2013, using a validated questionnaire (Barry Questionnaire, see Appendix 1) with six common scenarios related to professionalism.3 Each of six cases was related to the following issues: acceptance of gifts; conflict of interest; patient confidentiality; physician impairment; sexual harassment; and honesty in formal documentation.The scenarios accompanied multiple choice responses, including the “best” and the “second‐best” responses.Our results suggested that many resident physicians in Japan encounter challenges when responding to the scenarios related to professionalism.4, 5 Compared to residents in the 2005 survey, those in the 2013 survey performed better for five scenarios (gifts, conflict of interest, confidentiality, impairment, and honesty) but not for the harassment scenario. Therefore, we proposed the implementation of a validated assessment tool and the improvement of curriculum for teaching professionalism to students and residents.6, 7, 8As it was unclear how Japanese staff physicians perceive these six common scenarios related to professionalism, we conducted a survey for Japanese staff physicians using the same Barry Questionnaire. Participants in our survey included physicians of primary care, general medicine, or specialty throughout Japan. They were voluntarily invited through a members‐only medical portal website (M‐Three) in April 2018. The sponsor for this community had no role in design and data analysis of the survey. The participant was involved with obtaining a point gift for the online portal. In a total of 1000 participants, there were 916 (92%) men and 84 (8%) women physicians with median 26 years of clinical experience. In all participants, 42% were physicians of internal medicine; 707 participants (71%) worked in hospitals, in which 117 (17%) worked mainly in university hospitals.The current survey revealed the results like that for resident physicians. The most challenging was the sexual harassment scenario and only 46% provided the best or second‐best responses (Figure 1). Some (n = 42, 4.2%; 41 men and one woman) chose the response A (Do nothing, on the basis that the faculty member was simply showing his appreciation for a job well done), which seemed problematic because of under‐recognition of the harassment behavior. The next most challenging was the patient confidentiality scenario with 53%. Staff physicians were more likely to provide the best or second‐best responses to the scenarios related to conflict of interest (88%), honesty (82%), gifts (76%), and physician impairment (71%).
Figure 1
Proportion (%) of the best or second‐best responses to each scenario of medical professionalism
Proportion (%) of the best or second‐best responses to each scenario of medical professionalismThe current results suggest that many Japanese staff physicians were also unable to provide an acceptable response to challenges to professionalism in issue of sexual harassment. Japanese hospitals may need to widely address sexual harassment policy and establish reporting procedures and counseling for victims and witnesses.The response B (Report the incident to the program director as an example of sexual harassment) was selected most frequently (29%) and it may reflect the difficulty in confronting or approaching an offending physician who may likely be in powerful position in any organizations. The Barry Questionnaire considered it not to be best or second‐best responses as a professional action. Now it may be the time that we should recognize this action as less appropriate and deal with it as professionals.
CONFLICT OF INTEREST
The authors have stated explicitly that there are no conflicts of interest in connection with this article.
Figure 1