Welcome to the Ethics Forum! The optometric profession has long recognized its ethical responsibilities to patients, colleagues, other health care professionals and the public. This forum provides an opportunity to review a hypothetical case study containing potential ethical challenges and includes suggestions on how one might handle the situation based upon the American Optometric Association Standards of Professional Conduct and Code of Ethics.

If you have any questions on ethics, please submit them to EthicsQuestion@aoa.org. The AOA Ethics and Values Committee will respond to your questions as soon as possible. If you have an ethical challenge you wish to share, please feel free to submit a case description to ethics@aoa.org. The case description will be reviewed by the AOA Ethics and Values Committee and may be featured in a future Ethics Forum.

Harassment in the Workplace

By Morris Berman, O.D., M.S., FAAO & Glenda Savitz, O.D.

Case Study #13

A busy optometric practice employs two staff members and a newly hired office manager. The office manager tasks a staff member, who has worked in the office for 25 years, with converting all medical records to a new electronic system. The office manager creates an unrealistic deadline for completion of the project and regularly pressurizes the staff member about her progress, criticizing her work. The staff member construes this behavior as harassment. The office manual does not provide any policies or procedures relating to workplace harassment. What recourse does the unhappy staff member have if she wishes to continue working in the practice?  

Running a successful practice requires the coordinated efforts of every member of the team. Good communications among all staff members play an important role in maintaining office efficiency and producing outcomes that positively influence patient satisfaction. Such communications may occur informally or formally, through one-on-one encounters and regular staff meetings.

In the case study cited, a glaring omission is the absence, in the office procedures manual, of a section that addresses harassment and bullying. Descriptive examples of these behaviors should be provided, with guidelines for addressing such occurrences, since the optometrist is obligated to provide a safe workplace for all employees. 

How do we differentiate between harassment and bullying1? Workplace bullying is repeated, unreasonable and unwelcome behavior directed toward an employee or group of employees that creates a risk to health and safety. While harassment and bullying share common themes, the big difference is that workplace harassment is explicitly illegal, while bullying is not explicitly illegal. However, depending on the specific facts of a situation, bullying behavior may also be considered a form of harassment.  There are state and federal laws that offer protections to workers who can demonstrate that they were victims of workplace harassment2. To prove workplace harassment, one must show that you are being targeted as a member of a protected class and that the behavior creates a hostile work environment. Protected classes under federal employment statutes include race, color, religion, sex (including pregnancy), nationality, age (40 or older), disability or genetic information.

Workplace harassment categories3 include:

  • Management harassment: Occurs when a manager's behavior results in a worker feeling intimidated. This form of harassment in the workplace generally involves verbal comments that are threatening, insulting or discriminatory.
  • Co-worker harassment: Occurs when an employee treats another in an unlawful or disrespectful manner at work. 
  • Physical harassment: Involves physically touching another employee by striking, kicking or pushing them.
  • Verbal Harassment: one of the most common kinds of harassment in the workplace that involves words that could be deemed threatening or discriminatory  

Sexual harassment: Includes physical touch, circulating inappropriate images and making suggestive or explicit comments in the workplace. When possible and safe to do so, an employee who feels harassed should discuss the situation directly with the person exhibiting the unwanted behaviors, in a professional manner at the time of the incident, rather allowing time to elapse. If this does not result in an apology or modified behavior, or if the individual being harassed is reluctant to confront the co-worker, the incident should be raised directly with the optometrist.

It is the responsibility of the optometrist to:

  • Assure victims of harassment they are safe from retaliation, irrespective of the outcome of events.
  • Document the reported incident in detail.
  • Ask open-ended questions and remain unbiased and respectful.
  • Agree to keep information confidential as the law allows for it. In some instances, the optometrist is required by law to pursue the issue further.
  • Interview all witnesses who may be able to provide insight for the investigation.
  • Give the other party an opportunity to weigh in.

Additional recommendations:

  • The optometrist needs to act without delay, to provide effective resolution of a complaint and prevent the employment relationship from breaking down. Corrective action may range from informal counseling (verbal warning), formal counseling (written warning), suspension without pay, termination of employment and even prosecution if appropriate.
  • The optometrist needs to exercise careful judgement, taking into consideration the circumstances, the infractions' seriousness and the employee's past record. It is important to maintain perspective as people interact continuously in the workplace and situations can occur when comments are misunderstood.
  • The optometrist needs to create and periodically update the office policy manual. Consider posting the office policy on harassment and providing harassment training for all employees, as this may prevent offenses and protect the office against future lawsuits.

The optometrist should talk to his or her insurance broker about whether your policies offer coverage for harassment allegations.  Such coverage is usually found in an employment practices liability insurance (EPLI) policy, or less commonly in directors and officers liability insurance (known as D&O) policy.  

A safe working environment for all employees reflects the standards and behaviors set by the optometrist. It is essential to have effective communications with employees and an office policy handbook explaining standards of professional conduct and workplace expectations, and corrective actions. There are many good examples to draw from and the draft should be reviewed by legal counsel or a consultant with expertise in human resources.         


1.       http://stories.avvo.com/money/business/difference-workplace-bullying-harassment.html

2.       https://www.eeoc.gov/laws/types/harassment.cfm

3.       https://www.upcounsel.com/workplace-harrassment    

About the Authors:

Morris Berman, O.D., M.S., FAAO, is a member of the AOA Ethics and Values Committee. Dr. Berman currently serves as dean at MCPHS, School of Optometry in Worcester, Massachusetts.

Glenda Savitz, O.D., is residency trained and is in private practice at Eyespot in Chestnut Hill, Massachusetts.