Orthopedic trauma surgeon Dr. Lisa Canada joins the podcast to discuss her pioneering work in reforming surgical culture. Dr. Canada, who recently made history at UNC by being the first orthopedic surgeon to win both the Faculty Teaching Award and the UNC Mentorship Award, is a co-founder of Speak Up Ortho.

Speak Up Ortho was born from an overwhelming collection of anonymous stories revealing the pervasive culture of harassment, bullying, discrimination, and retaliation (HBDR) experienced by women in orthopedic surgery. Dr. Canada shares how this organization is fighting to create a workplace where speaking up is not only safe but encouraged, and offers concrete tools for confronting bad behavior at every level of the surgical hierarchy.

Featured

• The Birth of Speak Up Ortho: The pivotal Facebook group post in 2021 that generated over 355 egregious stories of sexism and harassment in under 24 hours. This demonstrated that these problems were happening now, not just in the past, leading to the creation to foster diversity and inclusivity.
• Major Themes of Abuse: Stories revealed a profound sense of hopelessness and helplessness among medical students and residents due to fear of retaliation. Examples ranged from overt sexual harassment to subtle, pervasive bullying.
• The Power of Bystander Intervention: Learn the Five D's of bystander intervention that anyone—from scrub tech to medical student—can use to stop the cycle of abuse:
  • Direct: Step in and speak up.
  • Distract: Change the mood (e.g., "What time is it?" or drop something).
  • Delegate: Find a senior person or authority figure to intervene.
  • Delay: Check in with the person afterward ("I witnessed this. Are you okay?").
  • Document: Offer to put the incident in writing for the victim.
• The Problem of Isolation and Bullying: She discusses how the fear of retaliation leads to a cycle of isolation and bullying—including covert behavior and "death by a thousand cuts"—which ultimately contributes to physician depression and suicide.
• Setting a New Standard: She explains the critical need to change the culture so that it is okay to speak up without fear of being ostracized. The goal is to set an example that bad behavior is not acceptable and to provide alternative forms of teaching to replace bullying as a form of learning.
• How Leaders Should Respond: For those receiving reports of HBDR, She advises leaders to:
  • Investigate Deeply: Go beyond the two individuals to include witnesses and look for patterns (it's rarely a single event).
  • Analyze Data: Review case logs and opportunities to ensure fair treatment.
  • Find a Solution: Focus on restorative action like implicit bias training or anger management, while also recognizing that sexual harassment is a crime that requires mandatory reporting.

Other Resources

• Royal Australian College of Surgeons (RACS) Survey: Comprehensive bullying and harassment study that served as a model for raising awareness globally.