A jury in Cook County, Illinois, last month awarded $1 million to an emergency medicine (EM) physician who claimed his hospital fired him in 2011 for reporting that another physician was sexually harassing female residents, or so he believed. For Brett Ohlfs, MD, the trial wasn't about proving the allegation about his former colleague at Advocate Christ Medical Center in suburban Chicago, part of Advocate Health Care, the largest health system in Illinois. The issue was whether or not Advocate retaliated against him for raising the issue. The jury said it did. Shortly after his dismissal, Dr Ohlfs and his wife and children moved to Redding, California, and he got a job at Shasta Regional Medical Center. Five years later, he describes what happened at Advocate as if it were a fresh wound. "I'm still kind of the black sheep," he told Medscape Medical News. "Money would never make me whole for what we've been through." What Dr Ohlfs alleged is nothing new. Three in 10 women in a survey of high-achieving medical academics said they experienced sexual harassment on the job, according to a study published earlier this year in the Journal of the American Medical Association. Kimberly Templeton, MD, president of the American Medical Women's Association, told Medscape Medical News that the most egregious form of harassment is when physicians use their position of power to gain sexual favors from colleagues, but that is also the least common. Harassment for women mostly takes the form of "constant denigrating remarks based on sex," said Dr Templeton, a professor of orthopedic surgery at the University of Kansas School of Medicine in Kansas City. Dr Ohlfs' experience illustrates how hearsay and workplace politics in a close-knit — perhaps too close-knit — hospital department can create something worthy of a soap opera. And the soap opera may continue. Advocate Health Care, which has denied firing Dr Ohlfs for reporting sexual harassment, could appeal the verdict or seek a new trial. "We're disappointed in the ruling and are closely reviewing the decision to determine next steps," Advocate said in a statement emailed to Medscape Medical News, its only comment on the case. "We take every allegation or concern raised by those we serve or those we employ very seriously. We have robust policies and procedures in place to ensure the safest and best environment for our physicians to practice and associates to work. "When this matter was brought to our attention five years ago, we completed an investigation in accordance with our policy. It was determined that no further action was required." Medscape Medical News pieced together the whistle-blowing saga with the help of court documents and records of the Illinois Department of Human Rights (IDHR). "You Had Better Never Mention This Again!" Hired by Advocate in 2004, Dr Ohlfs stated in court and IDHR records that several female EM residents told him that an attending EM physician, who was married, was propositioning female residents, showing them photos of himself naked, and having sex with them. This attending physician — Dr G, for the purposes of this article — had hooked up with at least three residents, two of whom went on to become fellows and attendings themselves, according to Dr Ohlfs. Dr Ohlfs said he learned that it was standard practice to warn first-year female residents about Dr G. "I can't believe that no one's done anything about this," he quoted one resident during a deposition as saying. Given the ability of an attending to impact a resident's career for good or ill, female residents could get the impression that they needed to give in to Dr G's sexual overtures to advance in their careers, according to Dr Ohlfs. He aired the subject when he met with Chintan Mistry, MD, then the head of Advocate Christ's EM department, in February 2011 to discuss a performance issue. Dr Ohlfs told Dr Mistry that he was tolerating sexual harassment in his department. "You have a sexual predator on your staff," Dr Ohlfs said. Dr Mistry's response, Dr Ohlfs said, was furious. "You had better never mention that again!" he quoted Dr Mistry as saying. In his testimony, Dr Mistry remembers the meeting differently. Yes, he was angry with Dr Ohlfs, but not about the allegation of harassment, which was news to him. He had even asked for details — in writing — about the alleged sexual predator and his prey, but none were forthcoming. Dr Ohlfs acknowledges that he didn't identify Dr G at this point. Dr Mistry said he didn't have enough information to pursue an investigation. Dr Ohlfs said he immediately started to worry that his allegation might cost him his job. Dr Mistry, now chief medical officer and vice president of medical management at an Advocate clinic, did not respond to a request for an interview, and Advocate Health Care declined to make him available for one. Dr G declined to comment except to "state unequivocally that the sexual misconduct claims made against me were baseless." He said he is now working on an as-needed basis at Advocate and on a part-time basis for the University of Texas. Dr Ohlfs' fears of losing his job gained more substance when he met with Dr Mistry in April 2011 to discuss performance issues again, according to court and IDHR records. This time around, Dr Ohlfs named Dr G as the alleged sexual predator. Dr Mistry testified that at one point during the conversation, he gave Dr Ohlfs the option of either resigning or being fired. However, Dr Mistry said the allegation about a sexual predator wasn't the reason why he wanted Dr Ohlfs out of Advocate. Rather, the reasons centered on the quality of Dr Ohlfs' contribution to the department, his "bizarre behavior," and verbal outbursts. "There's defamation going," Dr Ohlfs said about these accusations in his interview with Medscape Medical News. "It's hard to live with this stuff." He said Dr Mistry didn't just threaten his job in that April 2011 meeting. He testified that Dr Mistry vowed to give him a bad job reference if he spoke about their conversation with anyone else. After his second meeting with Dr Mistry, Dr Ohlfs went on a medical leave of absence for several months, citing stress and anxiety. During that time, he met with the human resources department at Advocate and shared his concerns about Dr G as well as his dealings with Dr Mistry. On July 8, 2011, when Dr Ohlfs was ready to return to work, Advocate officially fired him, not citing any cause. Punished for Revealing Family Secrets? In 2012, Dr Ohlfs went to the IDHR and accused Advocate of firing him in retaliation for his whistle-blowing activities. In a February 2013 ruling, the state agency said that there was "substantial evidence" supporting the charge of a retaliatory firing. Because of conflicting testimony, IDHR said, a court needed to try the case. Dr Ohlfs proceeded to sue Advocate. Dr Mistry and several Advocate administrators filed a countersuit, accusing Dr Ohlfs of illegally recording telephone conversations and meetings, but eventually dropped it. The judge in the whistle-blower case did not permit Dr Ohlfs' attorney, Christina Hatzidakis, to question Dr G either in his deposition or during the trial directly about his supposed sexual misconduct. Dr Mistry, however, testified that Dr G had denied the allegations in a conversation with him. Several female physicians said in depositions that they had heard rumors about Dr G's alleged philandering. In more substantial testimony at trial, another female physician said that Dr G had romantically approached her, and that his affairs at Advocate Christ were common knowledge. However, it was Advocate, not Dr G, that was on trial. In the end, the jury decided that Dr Ohlfs had opposed what he reasonably believed was sexual harassment, and that Advocate fired him for complaining about it. Looking back, Dr Ohlfs expresses second thoughts about characterizing Dr G as a "sexual predator." "It's a strong word," he told Medscape Medical News. "It may have been inappropriate." Nevertheless, "he would pursue individuals that attracted him." Dr Ohlfs believes Advocate could have avoided the lawsuit had it cleaned up its EM residency program back in 2011. "My goal was not to get into a legal battle," he said. "My goal was not to get [Dr G] terminated. My goal was to control what was perceived as inappropriate behavior." He said the "inappropriate behavior" seemingly was tolerated at Advocate Christ Medical Center because the EM residency program there was so close-knit, with many of the attendings having trained there. "It becomes almost like a fraternal relationship, a family," he said. An issue such as sexual harassment then becomes a family secret, and exposing it risks rejection by the family. "The threat of ostracism is very powerful," Dr Ohlfs said. Source
