What’s Working for Women in Medicine — and What’s Not

By Lucy Berrington, M.S., Vital Signs editor

Voices of Women in MedicineThere may be no more compelling measure of women’s ambitions to make their mark on medicine than the numbers; women make up almost half of new US medical graduates and a third of the practicing physician workforce. For Women in Medicine Month, an initiative of the American Medical Association, this year’s theme is Born to Lead. Women physicians and medical students are making and taking new opportunities, grappling with persistent challenges, and driving institutional change — a process that may be accelerated by the rapid evolution of health care practice and expectations. “The traditional health care model in medicine is being upended,” says Maryanne Bombaugh, M.D., M.S., M.B.A., an obstetrician/gynecologist who practices on Cape Cod, and vice president of the MMS. “This is a great opportunity for women to help create new models that improve care for patients yet reflect and integrate the professional practices and personal lives of women physicians.”

Voices of Women in Medicine

For “Voices of Women in Medicine,” Vital Signs talked with 20 women at varying stages of their medical careers. The recurring themes of those conversations are explored in this issue, and on the MMS website and social media platforms. They ran counter to surprisingly durable myths — that women want to leave medicine early, eschew leadership positions, and lack the career drive of their male colleagues.

“You have to dig deeper and not feed into those stereotypes,” says Julie Silver, M.D., associate professor and associate chair in the Department of Physical Medicine and Rehabilitation at Harvard Medical School and the Spaulding Rehabilitation Network, and director of a women’s leadership program at Harvard. “Medicine has women who are really good leaders, but are making less money and missing out on certain opportunities.” The barriers are especially daunting for women physicians of color (diversity in medicine will be the theme of a future Vital Signs).

What Are Women Physicians Doing Right?

Women physicians appear to practice medicine differently than men. A recent study in JAMA Internal Medicine found that hospital patients treated by women had slightly lower 30-day mortality and readmission rates than those treated by men, a finding that has major health implications across a population. Some evidence suggests that female physicians may practice more evidence-based medicine, communicate differently, and treat fewer patients.

In the context of women’s clinical excellence, the persistent gender-based pay gap in medicine is especially frustrating. In April, Doximity drew national headlines for reporting that women physicians earn on average 26 percent less than male physicians of equivalent experience. Even within female-dominated specialties, male physicians make substantially more money, its survey showed. Similarly, while women physicians and researchers are advancing at all levels of academic medicine, they are less likely than men to be promoted. Such uneven rewards are the result of cumulative, subtle institutional barriers, research shows.

Is Organized Medicine Working for Everyone?

Some of those barriers may be found in unexpected places. A recent report in the journal PM&R, on which Dr. Silver was lead author, examined the distribution of awards by several national specialty societies — a metric for how women and men are navigating organized medicine, a key factor in career success. The researchers found a striking absence of female award recipients. Even medical societies that are invested in expanding diversity (the demographics of membership) may have a way to go on inclusion (the equal opportunity for members to benefit from and contribute to that institution), the study suggests. Dr. Silver does not generally see any bias as intentional, and has assembled a team of thought leaders to collaborate with specialty societies on inclusion. “Medical societies are perfectly positioned to be amazing partners,” she says.

The report did not look at statewide physician societies. The MMS, however, is looking at itself. A key strategic objective is ensuring that our membership represents the Commonwealth’s increasingly diverse physician and student population. The Society recently voted to collect demographic data, improving metrics for guiding strategy.

“The Society has been actively supporting women in medicine for three decades,” says Alice Coombs, M.D., an anesthesiologist at South Shore Hospital and a past president of the MMS. “An organization can flourish when diversity is part of its fiber and DNA; it benefits from the brilliance that comes with all groups. The governance structure of the MMS embraces the creativity and innovation that comes with diversity in membership.”

For more stories and insights from women in medicine, and to share your own, please go to www.massmed.org/wim2017 and follow the MMS on Facebook and Twitter.

 



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