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Sexual harassment in the dental profession: Your rights and how you can respond

Dec. 14, 2017
No industry is immune to sexual harassment, including dentistry. In this article, a dental hygienist and former human resources manager discusses what you can do when you encounter sexual harassment in your workplace, as well as what your rights and responsibilities are. 
"I figured I wouldn't be taken seriously."
"I was afraid of getting a bad reputation as the hygienist known for reporting the boss for harassment."
"I'm a guy . . . it sounds ridiculous to say I was sexually harassed."
It seems that every day, there is a new allegation of sexual harassment in the mainstream news. The complaints are as varied as the people and the industries they represent. We are hearing about it in Hollywood, the media, and politics, to name a few.

Although we may not hear about all of it, no industry is impervious—including dentistry. I recently came across several accounts of sexual harassment in online dental communities where many came forward to share personal accounts and experiences.

Having a background as both a human resources professional and as a hygienist, these stories and questions plagued me. I saw how many of these allegations were either not reported to management or not addressed when reported. I heard many reasons for not reporting: I was afraid of getting a bad reputation as the hygienist known for reporting the boss for harassment—who would hire me? I might have been misinterpreting the person’s intent. I figured I wouldn’t be taken seriously. The person was an outside salesperson; it had nothing to do with my office. The dentist isn’t going to dismiss a paying customer or a personal friend because of what I said. I’m a guy . . . it sounds ridiculous to say I was sexually harassed.

Worse still were the cases that were not addressed after being reported, or that even escalated. Some situations could have possibly been resolved with a simple, straightforward conversation about what is appropriate and what will and will not be tolerated. Instead, many of these situations flew under the radar and continued without the knowledge of management, support, or employee empowerment. There was one case of a patient who had a habit of grazing the hygienist’s breasts, and the solution among the staff was to book him with a different hygienist each time. This is not only disrespectful and unfair, but employers have a duty to prevent, investigate, and remedy harassment. Employees have a responsibility to report harassment to a manager or someone more senior if the offender is the manager, not pass the offending person on to an unsuspecting colleague or successor.

Your rights—and responsibilities

It got me thinking about how these situations are handled in dentistry and if dental professionals—both employers and employees—are aware of their responsibilities and rights. After all, many of us work in small doctor-run practices without the infrastructure and expertise of a human resources and legal team to help set clear policies and guide decisions in cases where claims are made, claims that can sometimes be a slippery slope. Interpretations of certain behaviors can vary widely, particularly if the behavior not egregious. For example, one person may find a hug given by a patient to be inappropriate. Another employee may welcome a hug from that same patient and see nothing offensive or sexual about it.

Do employees know what to do in cases where they feel they have been harassed? Do practice owners/managers know how to handle an investigation? Are there written policies? What if the harasser is the owner or manager (or both)? What do you do if you speak up at work and are told you are overreacting, are not taken seriously, not believed, or there are repercussions to your allegations? Do the same laws apply to small business as they do to larger companies? Do the laws vary by state?

Defining sexual harassment

In order to answer these questions, we need to first look at what constitutes sexual harassment. Workplace harassment (including sexual harassment) laws are part of the Civil Rights Act of 1964, Title VII, which is a comprehensive set of laws prohibiting discrimination in all aspects of employment. The Equal Employment Opportunity Commission (EEOC) is the agency of the federal government that was established to interpret and enforce discrimination laws. The employer must have a certain number of employees to be covered. The number is typically 15, but may vary depending on if the employer is a state or local government agency, a federal agency, or a labor union. Does this mean that if you work in a private company with fewer than 15 employees, you have no protection under these laws? No. There are individual state and/or local bodies that handle such claims and often apply to smaller numbers of employees. There is also the possibility of civil law for recourse.

Harassment is defined as unwelcome verbal, written, or physical conduct that creates a hostile or intimidating work environment. With regard to sexual harassment, there are two types. The first is called “quid pro quo” (a Latin phrase meaning “something for something”). This occurs when an employee is forced to comply with a superior’s sexual demands in order to secure some economic benefit, such as a promotion, pay increase, or continued employment.

The more common type of harassment is defined as a hostile work environment. This is when unwelcome serious or pervasive conduct has the effect of unreasonably interfering with an individual’s work performance or creates an offensive work environment. The most egregious examples here would include such behaviors as harmful or offensive contact (physical, verbal, or both), threats, or physical exposure. This type of behavior may also be in violation of criminal law and should be handled immediately and very seriously. Other hostile environment examples include pervasive inappropriate jokes or conversation, offensive visual materials, comments about appearance, innuendo, patterns of “accidental” touching, repeated invitations . . . the list goes on.

What to do when it happens to you

It is important to realize that harassment doesn’t prohibit simple teasing, offhand comments, and isolated incidents that are not extremely serious or pervasive. It is equally important to realize, however, you have the right to speak up even in those less-than-serious or pervasive cases. For example, imagine a patient asks you if you ever date patients or makes some joke that isn’t appropriate. You can politely but firmly explain that you didn’t appreciate it. Your response can be something as simple as, “No, I do not date patients,” or “Perhaps you meant no offense, but I find that comment inappropriate. I’d appreciate it if you stopped doing that.” It’s best not to reply with a witty retort, as that can often fuel more inappropriate banter. Your best tactic is portraying confidence, seriousness, and setting a professional boundary. Nip it in the bud. It may be difficult, and in some cases, may be done by a supervisor on your behalf. Often these clear conversations can cause the behavior to cease as the person becomes aware they offended you.

What happens if the “person in charge” is the offender? Perhaps you work in an office where the doctor has made comments about your “beautiful” blue eyes or rubs your shoulders after a long day and it makes you uncomfortable. Simply telling the person in a professional way that it makes you uncomfortable can stop the behavior.

Perhaps in these two examples, the behavior continues or escalates. The patient is continually asking you on dates and telling offensive jokes despite your conversation. Perhaps the doctor ignores your boundary and the touching continues or becomes more inappropriate despite requests to stop. Perhaps the way the person is speaking to you is becoming more suggestive or overt. In this case, it is pervasive and becoming more serious. This is when escalation may be necessary.

In cases where it is not the employer who is the alleged offender, it is important to escalate through management at the office first. Only if they are nonresponsive should you escalate to the EEOC or state agency responsible in your area. You could also consult an employment attorney. You may be asking at this point, “Who do I report this to if there is no other person in charge in the office and my office is too small to fall under the 15-person EEOC rule?” In those cases, the EEOC recommends to contact one of their local field offices directly. They will be able to help you determine if there is a state or local agency that enforces the law in your case. If not, they will be able to advise you of other recourse options. Be aware that there are statutes of limitations on claims and it is unlawful for employers to retaliate against an employee who makes a complaint or files a claim of harassment.

Document, document, document

It is also advisable to document all situations, even those that are less serious and pervasive, with the date, time, people involved, and what was said. Document your actions, the steps you were told to take, and the responses to your actions. If this behavior becomes more frequent or escalates, you have good documentation of your earlier conversations.

This documentation should be stored separately from the patient record in cases where the alleged offender is a patient. Keep a copy of everything you document. It is also advisable to alert the person in charge at your office. The manager may want to speak to the person as well, or may know of similar instances of this same person with other employees. With solid documentation, you can be prepared for future potential interactions, escalation, or both if it is determined it is pervasive. If the documentation is about the employer, keep it secured with you outside the office in case you have to escalate your claim. When it comes to escalation of a claim, there is a responsibility on the claimant to show that a reasonable person in the plaintiff’s position would objectively believe the conduct was hostile, abusive, or offensive.

If harassment can be proven, employers may be responsible for compensatory and punitive damages. This will depend on who committed the harassment and what action the company took to correct it. It is important for both employers and employees to understand their rights and responsibilities. Claims are to be taken seriously and escalated if serious or pervasive. Thorough documentation is of the utmost importance. Remedies can include a variety of scenarios such as a conversation that stops the behavior, the termination of a coworker after a thorough and well-documented investigation, the reassignment of an outside sales or delivery person, the dismissal of a patient from the practice, or legal action which may include criminal charges depending on the offense. As with any matter such at this, a person should obtain legal advice from an appropriate source, such as a federal or state agency or employment attorney.


Finally, consider that we deal with the public and that brings forth a mixed bag of personalities. It can be like Forrest Gump and his box of chocolates: “You never know what you’re gonna get.” Certain patients bring a lot of fear with them to the office, and this fear could show itself as strange comments said out of nervousness. We need to be able to maintain a personal boundary in a professional way. Sometimes a person who doesn’t know you well is unaware of what you may find inappropriate. Other times we are going to deal with people who may be less than above board and we need to have the knowledge, resources, support, and empowerment to address these situations. Lastly, we think we know the threshold of our employers, coworkers, and patients, but we ourselves may accidentally cross the line. As much as it is wonderful for a team to laugh and have fun, we need to be cognizant we work in a business environment. A good practice is that if something can be construed as offensive to someone within earshot or view, it is best to leave it out of the office.

We also need to consider the relationships that may occur outside of the office (including those on social media) that could potentially affect what happens inside the office. Clear-cut and fair written policies on this subject are important in all offices, even those that think it could not happen to them. Some states also have requirements on having these written policies in place. It is important to be familiar with your state regulations and consult the appropriate experts when needed.

Editor's note: This article first appeared in RDH eVillage. Click here to subscribe.

Julie Whiteley, RDH, BS, made the transition to a career in dental hygiene after working in both the financial services and biotechnology industries as a human resources manager. She holds a bachelor of science in business administration with a concentration in management from Merrimack College. She later went on to pursue a career in dental hygiene, and graduated from the Forsyth School for Dental Hygienists. She has more than 15 years of direct clinical experience.

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