We love being doctors! We love being women! Putting the two together, however, can be challenging at times.
Despite women entering the profession of medicine at higher rates than ever before and female medical school matriculants surpassing male numbers this past year, there remain many challenges to being a woman in medicine.
- Disparities in compensation;
- Slower progress toward achieving academic advancement;
- Underrepresentation in leadership positions;
- Shortage of mentors in medicine at all levels;
- Discrimination and implicit and explicit gender bias;
- Imposter syndrome; and
- The need for better work–life integration.
Recognizing that physicians are truly privileged to engage in meaningful work, we are grateful that the American College of Physicians has taken on this complicated and multi-faceted issue.
Working toward gender equity is important, not only because it is the right thing to do for women in medicine, but also for the profession and society as a whole. Numerous studies show that diversity can inspire creativity, innovation and productivity and that diverse teams have better outcomes. We are not saying that women are better physicians than men, but simply that each brings unique qualities, talents, attributes and strengths to the profession. Our visits with our patients are longer, more participatory and more patient-centered. We ensure our patients engage in prevention with greater frequency.
Female physicians have a higher rate of burnout, and societal expectations for women in their personal roles as the dominant caregivers for family contribute to this phenomenon. Burnout can lead to early departures from the profession of medicine, as well as to suicide. There are approximately 400 physician suicides each year. The aggregate suicide rate ratio for male physicians compared to the general population was 1.41 and for female physicians the ratio was 2.27. From personal experiences, we know that losing a colleague to suicide is devastating. We must work as a community to improve the systems in which we work so that women physicians feel welcomed and supported and can reach their full potential. Not doing so will worsen the anticipated shortage of physicians combined with the increasing complexity of the patient population. This is a perfect storm in the making if we don’t address this as a community.
When one of us was elected the first female president of her hospital’s medical staff in its 103-year history, the CEO commented, “It never occurred to me we had never had a woman president.” This illustrates one of the many challenges we face as women in medicine: the assumption the status quo as the norm. Calling attention to gender inequities will start many needed conversations that will lead to important and necessary changes.
When one of us was elected as the Chair of the American College of Physicians Board of Governors, a colleague referred to me as “the princess of the ACP,” a damaging statement that demonstrates the implicit bias that women in medicine face, and a precipitating factor that set off a prolonged experience with Imposter Syndrome. Imposter Syndrome commonly impacts high-achieving women and is a psychological pattern where people doubt their accomplishments and have a persistent, internalized fear of being exposed as a fraud. That one statement made by a colleague caused me to pass up interesting professional opportunities for fear of failure and work so hard to overcompensate that I was pushed dangerously close to burnout.
But let us be clear: this is not just a women’s issue. This is an issue for the profession of medicine as a whole. Calling attention to these gender inequities will start many needed conversations that will lead to important and necessary changes. We know that we all need to work together to make needed changes. We know that there are like-minded people of any gender who understand the power of their privilege and their ability to open up opportunities and influence change. Together, we can unlock the potential for women to fully participate in medicine, improving physician collaboration and patient care.
Dr. Sue Bornstein is the former ACP Governor forTexas Northern ACP and current member of the ACP Board of Regents. I am Executive Director of the Texas Medical Home Initiative.
Dr. Susan Thompson Hingle is a professor of medicine at Southern Illinois University School of Medicine and the immediate past chair on the American College of Physicians Board of Regents.