ASCO 2019: Gender Equity Needs a Diagnostic Approach

In the opening remarks from Monica Bertagnolli, MD at the recent American Society of Clinical Oncology (ASCO) 2019 Annual Meeting, she challenged the medical community to take an active, diagnostic look at the disparities that exist in the access and affordability of quality care.

“We need to make a dedicated effort to ensure that … data include underrepresented minorities,” Bertagnolli said of her experience visiting underserved regions across the country.

I would like to echo her challenge, asking that we go further in our examination of health equity in medicine and address gender equity in the medical workforce. It’s time to make an equally dedicated effort to ensure that our health care providers reflect the populations we serve. We can begin this work now by taking the same active, diagnostic look at how women are faring across all specialties and positions in medicine today.

Unfortunately, the data are discouraging. Women make up just 18% of hospital CEOs. In academia, they comprise 16% of deans and roughly 20 percent of full professors at medical schools. This is the face of women outnumbering men in both enrollment in and graduation from those same institutions.

We don’t just have a pipeline issue; we have a leaky pipeline.

To this end, I applaud organizations like ASCO for elevating the discourse around the systemic underrepresentation of women at the highest levels of clinical practice, biomedical research, and academic leadership.

Indeed, a number of sessions at ASCO featured the issue of gender and bias in medicine, including three abstracts on which I collaborated. In each of these abstracts, my colleagues and I evaluated key data points — from the overall inequities that exist among leadership in academic faculty to the gender differences in professional titles and practical barriers that prevent women’s ascension to positions of influence. The results have been elucidating. We’ve found that female speakers are less likely to garner professional respect: just one in three women had the benefit of attending women-specific professional gatherings, and that academic programs with women in leadership have a higher percentage of female faculty.

These are important insights that can help shape necessary reforms.

For all the progress, however, it’s not enough to carve out a few sessions; we need a gender equity lens that permeates in all shared learning and all specialties of medicine. This isn’t just good for our industry; it’s good for patient care. With a patient population that skews female and is increasingly diverse, our workforce and leadership should mirror our broader demographics. We know that this kind of identity reflection builds empathy, strengthens relationships, improves adherence, and results in better health outcomes.

As we fit our conferences and conversations with such a lens, it’s essential that we start with data. As people of science, we have a professional obligation to examine facts before we create solutions. We do that routinely in the practice of medicine but less so in the work of equity. Rather, we so often react to negative data by simply adding a few more women or people of color to the boardroom. That’s insufficient.

Studying root causes is ingrained in our training and it’s time to bring that same scrutiny to our work on gender equity at all levels of medicine. An understanding of the many ways inequity manifests itself in medicine, paired with change agents dedicated to creating a more equitable, just, and inclusive profession, is the key to our success.

In September, I’ll be joining colleagues from across the country as we host the Women in Medicine Summit. Action-oriented convenings like this are just what we need to move the needle on research and evidence-based intervention. The theme for this year’s Summit, “An Evolution of Empowerment,” speaks to the importance of charting a path and lifting others as we climb. I invite you to join us in this gathering as we bring together the data solutions, people, and policies, that meaningfully advance Bertagnoli’s promise of welcoming more underrepresented groups to the table.

Shikha Jain, MD, FACP is a board-certified hematology and oncology physician on faculty at the Rush University Medical Center in Chicago. She is an assistant professor of medicine in the Division of Hematology, Oncology and Cell Therapy and the physician director of media relations at the Rush University Cancer Center.

She is a member of the Women's Leadership Council at Rush; founder and co-chair of the Women in Medicine Symposium at Northwestern; and co-founder and co-chair of the Women in Medicine Summit: An Evolution in Empowerment. She was a Doximity Fellow.

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