A Gender Shift?
Women now constitute the majority in the ranks of younger doctors. A recent athenahealth survey revealed that more than 60% of physicians under 35 are female. How big has this shift been over time? The same study shows that over 82% of physicians over 65, are male. In 2017, the number of women enrolling in U.S. medical schools exceeded the number of men for the first time, according to the Association of American Medical Colleges.
The increasing number of female physicians, though, doesn’t mean we are seeing gender equality. Gender bias and barriers seem to still be rampant. Consider:
- Female physicians are more likely to report symptoms of burnout.
- Female physicians are paid 26 percent less on average than their male peers, according to one study.
- AAMC data reveals that women are still underrepresented in faculty and leadership positions at U.S. medical schools. They comprised 39 percent of full-time faculty, 32 percent of people promoted to full professor, and only 16 percent of departmental chairs in 2015.
- According to a University of Pittsburgh Medical Center study, women are less likely, even, to be chosen as speakers in grand rounds.
From the Athena Health article, Elisabeth Poorman, M.D., a primary care physician with Cambridge Health Alliance noted that “From medical school awards, to residency, to the rest of our careers, women and minorities are less likely to be recognized for the same accomplishments and more likely to suffer abusive treatment and mistrust from patients.” Perhaps more troubling, she points out that there is little institutional recognition of these problems or support for female physicians.
A 2017 New York Times article also addressed these issues and pointed out that both men and women show an increase in depression during residency, but the effect is much more pronounced for women. A major reason: work-family conflict, which accounted for more than a third of the disparity.
What We Hear from Our Clients
We work with hundreds of physicians every year. These findings are echoed every day as we work with the women in our coaching practice. Common observations:
- They are underpaid or not paid as well as their male counterparts.
- They tend to get bullied behind closed doors and even out in the open. More disconcerting – people are reticent to assist or do anything about it.
- They tend to get the worst call schedule.
- Males with less experience are hired or promoted over them.
- Patients mistake them for nurses or other caregivers.
- Patients are more likely to disrespect them or question their diagnosis.
- They struggle with the ability to speak up, ask for what they want, defend themselves, negotiate or advocate for themselves
- They don’t get support from other women – often because they are all afraid.
- They meet in secret for support, and even then, they are afraid to be completely vulnerable.
- Many have the added stress of handling primary responsibilities at home.
- Many would characterize their work environment as hostile.
- Those in the surgical specialties are bullied in and around the O.R.
- Others take credit for their work.
- If they assert themselves, they are penalized for having a bad attitude or being difficult to work with.
- They are penalized for having children and breastfeeding.
The profession, and institutions – academic and clinical, need to recognize and acknowledge these issues. If women are going to make up a large portion of our medical workforce, asking them to work in these conditions is unfair to them and a disservice to the patients they serve.
These institutions need to do a better job training, supporting and developing physicians so they can have long, successful, and rewarding careers, regardless of gender. The challenges facing female physicians require specific focus. Organizations need to realize:
- Female physicians are an asset.
- Female physicians contribute to the diversity that mirrors the patient population – creating more medical staff ability to relate to, and communicate with, patients.
- Creating a culture of psychological safety will not only be better for female physicians but for all physicians and staff.
- Senior leadership needs to recognize the issues and prioritize solutions.
At the same time, we need to support female physicians, and equip them to function in this environment, rather than waiting for it to change. This starts with building support structures and skills to:
- Improve the professional communication, advocacy, and negotiation skills to manage these challenges
- Better support each other
- Practice good self-care
- Exercise better judgment related to career decisions
- Learn how to channel their purpose or what motivates them to increase engagement and enhance performance
A few helpful resources to consider:
- One-on-one, physician-specific, coaching can provide a psychologically safe process to better navigate their specific situations.
- Leadership development training (even if they have to seek it out on their own at first)
- A peer-to-peer mentor program (both internal and external)
- Assertiveness training
- Targeted, specific, personality and behavioral diagnostic tools can provide insight into natural tendencies which may be getting in the way of more effectively coping with these challenges. If the situation is not going to change in the short term, improving self-awareness and emotional intelligence can help them better manage some of these challenges.
A Recent Project with Female Orthopaedic Surgeons
With all of these issues in mind, the J3P team was asked by the Department of Orthopaedic Surgery at UCLA to work with the female physicians in the department including residents, fellows and attending physicians. This work included use of a proprietary, physician-specific personality/behavioral diagnostic, which provides a heightened level of self-awareness.
This information was then used for training and individual coaching. According to Susan Bukata, M.D., Vice Chair of Operations, “The participants appreciated having dedicated resources to help them work through their challenges and provide a foundation for growth. There was a consensus that providing this type of training and having the one-on-one coaching, particularly, made the participants realize they aren’t alone in these struggles. They felt better about themselves and better equipped to manage their own situations.”
Dr Bukata also noted, “The coaching was valuable because women often feel that they aren’t heard in larger meetings. It also revealed that most of us could benefit from assertiveness, leadership, business skills, and communication training.”
Organizations need to do a better job supporting long term physician success and preventing burn-out, generally – but also need to recognize the unique challenges facing female physicians.
To learn more about how we support physician success, visit us at www.j3personica.com