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Think Twice Before Hitting ‘Reply All’

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Dear Director: I send group emails to our emergency department on a fairly regular basis. About every other week, one of my docs will reply to the entire group with an overtly political message. I worry about members of my group being offended and relationships being strained. Can I make him stop?

Let’s face it: A lot of work gets conducted over email. It’s estimated that many professionals spend 25% of their work time on email and may be answering 50 emails a day. What’s more, a lot of those emails get sent over a company’s electronic mail system. That means your boss owns those messages and has a vested interest in monitoring the memes, cat videos and political rants contained therein. So the short answer to your question is simple: keep your work emails work related. Leave politics and religion at home – or at least on your Gmail account.

But work relationships are rarely that simple. The reality is that many physician groups are like families. I typically send out 1-2 group emails a day and in addition to typical work issues I use them to announce births and family-related issues (deaths, emergency surgeries, etc..). Our providers know each other personally and want to know these things. They respond with congratulations and with condolences, with thoughts and prayers.

Because of this familiar bond that is formed, it’s easy to cross the line. Families, after all, routinely wade into hot button issues like politics and religion. When your team starts wading into that gray area over email, here are a few helpful guiding principles, from basic etiquette to critical employment law.

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Don’t Create A Hostile Work Environment
A hostile work environment is any situation that makes a person feel consistently uncomfortable at their place of work. The Civil Rights Act of 1964, as amended in 1991, states that a hostile work environment can be created by inappropriate conduct stemming from situations where a person feels harassed or discriminated against because of their race, religion, gender, national origin, age, or disability – the “protected classes.”

We usually think of hostile work environments as being created by overtly offensive behavior, intimidation or bullying. Many will remember Ritchie Incognito, a Miami Dolphins football player, who frequently bullied his teammate Jonathan Martin, calling him demeaning names.  Martin contributed $15,000 for a player’s trip to Las Vegas saying he felt obligated to contribute “fearing consequences if he didn’t hand over the money.” A report issued in February 2014, outlined Incognito’s pattern of harassment, characterized it as “bullying,” which ultimately led to Incognito’s suspension from the Dolphin’s during the 2013 season. He missed the 2014 season but did return with another team in 2015.

But you don’t have to threaten someone in a locker room to be guilty of workplace harassment. The Federal Communications Commission has gone on the record in saying that unwanted email communications is one form of workplace harassment.

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So how does this relate to something as innocuous as a work related group email that happens to contain a political rant? The first is a practical consideration. That political diatribe is statistically likely to anger or alienate half of your colleagues. You’ve just drawn a dividing line between yourself and many of your coworkers. That division could negatively impact future interactions on shift, like a sign-out or getting help on a case?

Legally, there is the issue of simply not knowing how your pointed words will be felt by the group. A political or religious statement sent to a group might feel innocuous to you, but you may offend someone you don’t even know. Consider how an email in support of President Trump’s travel ban might make a Muslim colleague feel? How would a statement in support of Planned Parenthood be received by your Catholic colleague? There is no way to know everyone’s background, and thus what speech could create a hostile environment in the eye of the beholder. Perhaps this sounds too politically correct for you, too big brother. My response? This is work. Ask yourself one more time whether your side comment could offend someone or make someone needlessly uncomfortable. When in doubt, leave it out.

Proving a hostile work environment is not easy.  Investigators from the Equal Employment Opportunity Commission (EEOC) will make an assessment based on the “totality of the circumstances” and consider the severity of harassment as judged from the perspective of a “reasonable person” in a similar position.  These circumstances include: verbal or physical abuse, frequency or repetitiveness of the abuse, was the conduct hostile or patently offensive, was the alleged harasser a co-worker or supervisor, whether others joined in the harassment, and what happened when management became aware of the situation.  Someone who feels they are in a hostile work environment can file a lawsuit against the harasser and the company.

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Of Course There are exceptions
As in all things, you need to know your audience. While overt religious commentary is not recommended on a department email, there are exceptions. I worked in a Catholic hospital for many years after residency and we started meetings with prayer. Given the hospital mission and background that was normal and appropriate. Emails with prayers were also normal. In my current role, a prayer to kick off a meeting would be highly out of context, though an occasional email from the hospital chaplain is perfectly appropriate.

Some Ground Rules for Email 
Whether you’re writing an email (or a Facebook post), there are a few good rules to keep in mind.  Start by understanding that work email, particularly emails that address the group, aren’t the same as the group texts you have with friends and family. Be professional. These emails may get reviewed by your company or hospital. Keep topics on point and understand that work emails can end up as evidence in court. Use common sense and common courtesy so you don’t end up in trouble (or fired) for sending something inappropriate. If you are going to write it/publish it/put it on social media, be prepared to own it and take responsibility for it. While I love the Bitmojis my wife and daughter text me, they don’t belong in work emails. Jokes and sarcasm don’t always translate in written format and also don’t belong in a group email. Finally, HIPAA is definitely a risk when it comes to email (and social media) so never betray a patient’s or a colleague’s trust or personal information.

Management Responsibility
As an employer, you have a responsibility to keep the workplace free of harassment, bullying, and otherwise in compliance with Title VII of the Civil Rights Act.  First, if an employee makes a complaint, we, as managers, have an obligation to investigate the complaint and keep the workplace compliant.  Failure to take action can be considered promoting a hostile work environment and can put you and your group/hospital at risk. Definitely get your HR experts involved as soon as a potential case comes across your desk. Just as important as fulfilling your management HR obligations is being aware of group dynamics and taking care of your people. Building and maintaining a team is critical to the department’s success so keep an eye out for offensive behavior and address it quickly before it escalates to a hostile work environment complaint. While we don’t all need to be friends, we do need to be able to work collegially, and work’s a lot more fun when you enjoy working with each other and spending time together. If you’ve been offended by someone at work, or don’t like them, how likely are you to help out in a patient care situation (difficult intubation or multi-trauma) or even pick up the extra chart to keep the ED moving.

In the above example, it sounds like you’re facing something that may have the potential to make people in your group uncomfortable but there is no official complaint. You must take action but it doesn’t have to be official or harsh. I think a 1 on 1 meeting, done casually, to express your concerns that the workplace (and related emails) should be reserved for official business should suffice. Some people may just need a gentle reminder that not everyone may share their sentiments and polarizing emails risk dividing a group. Group work emails, like work parties, are considered extensions of the office and work rules apply. We can have our individual opinions outside of work, but within our work community, we should focus on patient care.

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ABOUT THE AUTHOR

EXECUTIVE EDITOR Dr. Silverman is Chair of Emergency Medicine at VHC Health and a Medical Director with USACS. Previously. he taught a leadership development course for over a decade. Dr. Silverman’s practical wisdom is available in an easy-to-use reference guide, available on Amazon. Follow on X/Twitter @drmikesilverman

2 Comments

  1. Great, succinct and legally helpful article. Thank you!

    Just one thought:

    Since women entered the medical work force in any number they have suffered emotional, psychological and significant financial duress. As long as we didn’t complain, the workforce was “respectful” and not “hostile”.

    Now, when women and minorities are asking to be treated with respect, the idea of a “Hostile work force” is an open idea. We have lived under a grossly hostile work environment for decades.

    My request if that if you are a “good” white male, you spend some SIGNIFICANT time making sure you honor and respect, hold up and laud, your women and minority members. That would go a long way towards easing the demonstrable and ugly “hostile environment” in which I worked in my entire career.

    Physicians need to learn how to work together, politically. We have power we are not using at all. Perhaps these discussions are a path to learning how to do that. Perhaps another way besides just “being quiet”, “being accommodating” is available.

  2. Forgive the typos. Also, one more thing: Women leave the workforce in massive numbers. There is a reason. No one is addressing it to any degree. This is shameful.

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