$45 Million OHSU Lawsuit Hits a Nerve for #CardiologyToo
Sexual harassment policies don’t always work to plan, as this explosive case makes clear. When hospitals don’t listen, who will?
Cardiologists and other healthcare professionals may be shocked by the specifics set out in this week’s news of a $45 million lawsuit against Oregon Health & Science University (OHSU) and a former anesthesia resident. But they’re also not surprised.
Jason Campbell, MD, who is widely known as the TikTokDoc and whose dance moves brought joy during the COVID-19 pandemic, is accused in the suit of sending explicit texts, photos, and messages as well as sexual assault.
What stands out is here not the months-long, all-too-common ordeal described in the lawsuit. Rather, it’s the time line showing that the woman, an employee at the Portland VA Medical Center, where Campbell occasionally worked, had to repeatedly push for OHSU to put the behavior to an end.
Perhaps the most unsettling detail: Esther Choo, MD, a founder of Times Up Healthcare, is named in the lawsuit as not following through when first hearing about Campbell’s actions. She also reportedly texted the plaintiff: “It’s never worth it. Never.”
In theory, policies have been put into place to stop workplace sexual harassment—flirtations that don’t stop, unwanted attention that progresses to invasive touch, career moves held hostage by quid pro quo, or fears that telling the truth will turn ugly. But in medicine as in other realms, policies aren’t people.
Mary Norine “Minnow” Walsh, MD (St. Vincent Heart Center, Indianapolis, IN), past-president of the American College of Cardiology (ACC), told TCTMD that the OHSU situation has hit a nerve, coming as it does in the wake of the #MeToo movement. Many cardiologists seem conflicted about how to discuss such a difficult topic, however, especially when a physician as well-respected as Choo is involved, she said.
I resigned last night. pic.twitter.com/RuQa7fMML8— Arghavan Salles, MD, PhD (@arghavan_salles) March 5, 2021
Martha Gulati, MD, editor-in-chief of the ACC’s CardioSmart website, said that she’s been getting a lot of direct messages and texts from women about the lawsuit. A common thread is disappointment.
“We all respected Esther Choo. I had a real admiration for her,” said Gulati. Times Up Healthcare, and the #MeToo movement more generally, had given people the sense that there were stopgaps to system failure. The OHSU lawsuit undermined that hope, and several of the group’s founders have resigned.
From Oregon to Florida
Starting in January 2020, the lawsuit asserts, Campbell began sending the woman “text messages, pornographic photos, and sexually-charged social media messages.” Two months later came the alleged sexual assault: “Specifically, Dr. Campbell went into plaintiff’s office area, snuck up quietly behind plaintiff and without plaintiff’s express or implied consent, pushed his body and his erection forcibly onto plaintiff’s backside, pushing her into the desk in front of her.”
The plaintiff wasn’t alone. Two other women said they’d had run-ins with Campbell.
Nor was she new to this process. A few years prior she’d reported sexual harassment by Oscar John Ma, MD, who at that point chaired OHSU’s department of emergency medicine. Ma stepped down from his position in mid-2019 amid rumors of sexually-charged behavior.
This time around, it took more than 4 months—and 13 employees being aware of the reported conduct, including six in leadership roles—for OHSU to issue the results of its investigation on August 17, 2020. It concluded Campbell had “violated its policies and code of conduct” but, the plaintiff’s lawyers say, “did not address any violations of law or civil liability.”
What do you feel when you learn your friend is credibly accused of sexual harassment?— Dr. Ray Bignall (@DrRayMD) March 1, 2021
Lied to? That too
But *MOSTLY* you center the victim, you demand justice for the victim, & you BELIEVE them.
Every. Single. Time.
So that’s what I’ll do...
Choo, as well as OHSU’s director of resident education and its emergency medicine residency program director, all women, are among the notable “mandatory reporters” who failed to act, the lawsuit says.
Campbell remained an OHSU employee for at least several months after the university’s investigation. Most recently, he was employed by the University of Florida; the school, in response to a query by TCTMD, did not mention Campbell by name but said they’d “recently learned of a new hire who is the subject of allegations of misconduct from a previous institution [who] was immediately placed on administrative leave pending investigation.”
Here’s another good one: OHSU nominated J. Campbell when he was a known sexual assailant to the National Physician Hero Award of 2020 Awareness Magazine. This is beyond disgusting!https://t.co/tG601U2siz #ChooKnew #metoo #tiktokdoc #TimesUp #MedTwitter #sheforshe @thelundreport— Kelly Plubeau (@KellyPlu) March 4, 2021
For Cindy Grines, MD (Northside Hospital Cardiovascular Institute, Atlanta, GA), this lack of accountability is unacceptable. “If it wasn’t for her filing that lawsuit, he would still have a job in Florida and he would still be doing the same thing potentially. I think it’s a travesty that our legal system does not allow us to tell the next employer what has happened, and this wasn’t reported to the medical board either,” she stressed to TCTMD.
“There was nothing put in place to prevent him from going on and doing this again to another person, and I see that all the time,” Grines added. “There’s awful things that happen among physicians . . . and attorneys tell you that you are not allowed to say anything to anybody.”
The “suppression of information” must change, she said.
A statement released by OHSU on March 2, 2021, said the university does not condone the behavior described in the lawsuit and is working to evolve its "culture, policies, and practices.”Based on the results of their own investigation, OHSU said, “Dr. Campbell was referred for dismissal. He resigned in lieu of a dismissal hearing on October 23, 2020. OHSU subsequently reported our findings that Dr. Campbell violated our harassment policy and code of conduct to the University of Florida.”
Where to Turn
There are resources available for people stymied in their efforts to report misconduct by their hospitals or medical schools, including professional societies and peers. Walsh insists cases like this should not diminish the message: “You should report anything that happens to you in the time of your training and in the workplace.”
Gina Lundberg, MD (Emory University, Atlanta, GA), who has been involved in her own institution’s effort to address harassment, described it as a process. For input, they brought together a task force of physicians, administrators, staff from various departments, and others from a wide range of backgrounds.
“Even in that group there were a lot of different ideas about the spectrum of sexual harassment,” Lundberg noted. “Was it just the criminal behavior or was it also the unwanted, uncomfortable ‘bad’ behavior? And we decided to call it everything—if it intimidates you, if it affects your work environment, if it’s affecting you personally, then it’s harassment and intimidation. We decided to define it very broadly.”
Her advice to women is to move quickly, so that they aren’t accused of enabling the behavior. “Nip it in the bud,” she stressed.
It’s also crucial that mandatory reporters understand their responsibility, Lundberg said. When she’s approached by someone who wants to discuss misconduct, she’s clear from the outset that she has to act on any information she hears. “The rule is if somebody reports sexual harassment to me, I have to take it up the chain. But then a lot of times that young woman doesn’t want me to do it. She’s just wanting to vent or to share or seek my advice on how to handle it better,” Lundberg added.
Grines said that, in a best-case scenario, cardiology residents and fellows would first talk to their program director and then, if that fails, move upwards through the levels of hospital leadership. Beyond this, there should be a compliance hotline, where people can call to report problems.
“To be honest, it’s very difficult sometimes because you might know the person you’re reporting it to, or they might know this individual and maybe they’re friendly with the individual. And that’s where this compliance hotline is very helpful, because it’s all anonymous,” she said.
Going up the chain of hierarchy in hospital leadership is just one element of reporting, Walsh agreed. “In practice, it’s your HR department,” she said. “It is not, in my opinion, adequate to simply inform a senior person. It’s more effective to actually formally report it. People are afraid to do it because of retaliation . . . . In the training hierarchy, it is very true that your faculty and your program director and the chief of your division really hold the power to get you a job, ultimately, down the road. So it can be extremely difficult if you’re harassed or bullied in any way, or assaulted.”
Women aren’t the only ones affected, Walsh emphasized. “In the last several months, I’ve been asking every trainee when I’m interacting with them at the end of the week or whatever about racism, bullying, and harassment. And I’ve said, ‘What’s your experience?’ It’s an interesting inventory, because I’ve heard stuff that I never would have heard if I didn’t ask the question. Nothing like sexual assault, but just clearly, well, things that [show] medical students are really treated poorly.”
When it comes to harassment, she said, the attitude of “this kind of stuff happens” is not acceptable. At hospitals where zero tolerance is embedded in the culture, “you don’t act like that,” Walsh added. “You get fired. Literally, you get walked out.”
We need to create within academic medicine less hierarchies & power asymmetries and zero tolerance for toxic behaviours, injustices, gender harassment, abuse, oppression. We must stand up, speak up, & do the right thing when wrong occurs. Regardless of political alliances. pic.twitter.com/XyKlI6Naxw— Harriette Van Spall, MD MPH (@hvanspall) March 5, 2021
If taking things up the chain doesn’t work, Walsh said another resource is the Accreditation Council for Graduate Medical Education (ACGME), to whom trainees can anonymously report harassment. “The ACGME is in the business of protecting residents,” she said. Another route is to contact a senior person in your field who works at a different institution, to ask for insight on how to navigate the situation.
For outside support, Grines suggested contacting the ACC’s Women in Cardiology (WIC) section as well as the Society for Cardiovascular Angiography and Intervention’s Women in Innovations (WIN) program.
ACC President Athena Poppas, MD (Rhode Island Hospital, Providence), said the organization’s work on diversity and inclusion has, amid heightened awareness of sexual harassment, spurred “mentoring for both men and women, [with] both online and in-person forums to meet people and find support.” More formally, they’ve been working on professional development like implicit bias and anti-harassment training. There’s also been at a look at “what are best practices for supportive policies and structures, because they can’t just be dependent on the individual,” she said.
“It’s not a female problem, it’s a community problem,” said Poppas.
Story After Story
Despite much hard work, however, there are countless instances where abuse is tolerated.
Nasrien Ibrahim, MD, a heart failure and transplant cardiologist, told TCTMD that although she has no direct connection to OHSU, the stories remind her of her own. Her first “realization of sexual violence being brushed under the rug in medicine,” she said, came “when a surgery chief told me the size of his penis in the operating room when I was a medical student and I reported it to a woman in administration and she told me I needed to get used to this kind of stuff. . . . I was told by a department chair once that some chiefs rape their staff, so my complaints regarding that chief weren't so serious. I have been asked on dates during cardiology fellowship interviews by faculty interviewing me. I have been in many uncomfortable situations as a trainee, including a faculty member touching my thigh during a fellowship interview dinner. I remember calling an attending once while on night float to update him on a patient and introducing myself and the attending saying, ‘I recognize your sultry voice.’”
In an email, Ibrahim emphasized that she doesn’t want to take the spotlight away from the latest news. “Instead, I want them to know we are here to listen and support and share our trauma, too,” she said.
To the victim who reported the predator, I believe you. I stand with you. I applaud you. Victims who bring lawsuits against institutions & predators have been forced to do so by the inaction &/or retaliatory actions of these said institutions. It is often the last resort. A 🧵1/9— Meena Zareh, MD (@MeenaZareh) March 3, 2021
As mentor and educator, “I have vowed that if any of my mentees or trainees reported any sexual misconduct to me, I would go to the ends of the earth to get justice for them,” said Ibrahim.
The exact way to navigate that, though, isn’t obvious. Human resources does “what is best for the institution,” she noted. Times Up Healthcare’s role in the OHSU story, she added, begs the question: “When we turn to women in power and they tell us to ignore or suck it up, then who do we have?”
Mamas Mamas, BMBCh, DPhil (Keele University/Royal Stoke University Hospital, Stoke-on-Trent, England), agreed that this story hits close to home for cardiologists. “People are saying, ‘We’ve done all this work; we’ve highlighted that sexual harassment should not happen on our watch, there should be zero tolerance; we’ve produced all these structures; and yet it’s failed when applied to a popular individual,’” Mamas observed.
Gulati, likewise, pointed out that the OHSU case shows how far an online persona can go, both in regard to Campbell’s charisma and to Times Up Healthcare’s appeal. “It seems to be institutions are putting a lot of weight on likes and followers,” said Gulati, adding, “I think the academic medical community needs to do a deep reflection: what are our priorities?”
She recalled an ACC session a few years back, in which a young woman told participants about being raped. “She was asking for advice. The room was silent. You could hear a pin drop,” Gulati said, adding, “She had raised her hand and told us her story. Some of us knew about it; I had read about it in the paper. Not only was the room silent, but many of us were crying.” She felt helpless, she said, knowing that outsiders could not dictate how a hospital responds to a particular instance of sexual harassment or assault.
Still, women going through this should seek support from colleagues in their field, Gulati said. “It’s very isolating. Working in a toxic work culture is just as bad as the harassment—when what you report is not believed or minimized or not even addressed. This culture of harassment and abuse,” she said, “can really paralyze an individual and ultimately either make them leave their job, which is not fair, or get fired because they won’t be able to do their job [when] their mental health is affected and they’re not in a safe environment. None of us should be forced to work like that.”
For Ibrahim, the OHSU lawsuit is a turning point. “It's time for my generation of physicians and the generations after mine to hold people accountable. We are not letting up, so get out of our way. Whether about sexual harassment, racism in medicine, police brutality, and any social injustice, we are not letting up,” she said.