It’s amazing what you can learn from the stranger sitting next to you on a flight.
As I wait for my neighbor to grab her seat next to me, I secretly hope she embodies the qualities I hope for in a fellow passenger – keeping to herself and not requiring in-flight medical assistance. I make eye contact with a young woman, maybe early twenties, who stops in the aisle and gives me the nod that she has the middle seat. As I let her in, she unloads an anatomy book. I immediately become interested in what she is studying and wonder if I should break one of my fundamental rules and talk to her.
Despite my internal conflict, I ask her, “Are you in medical school?” I am so proud of myself for assuming that she is studying to be a physician since I have never been asked this. Countless memories of being interrupted while studying at coffee shops replay in my mind. I’ll admit, I often couldn’t hide my annoyance when strangers assumed I was studying for nursing school because of my gender. My flight neighbor chuckles a bit and says, “No, I am in school to be a physical therapist. I wanted to be a doctor but I want a family and I know I can’t have both. My aunt is a doctor but she told me that to succeed in a man’s world you have to sacrifice all that you want as a woman.” With a polite smile, I follow the flight attendant’s instructions and turn off my iPhone in preparation for take-off, catching one last glimpse of the cover photo of my husband and daughter. Then, I rest my hands on my gravid belly.
Although there was no further discussion with my neighbor, my mind was racing. How did medicine get such a bad reputation for women? I must admit, I am blessed with a great job in a physician group that promotes fairness for all partners with equal pay and benefits. But the road was not easy and while applying for residency, I was often aware of being scrutinized for my gender. Interestingly, it wasn’t male physicians, but rather females who seemed to challenge one another as if we were in competition. We were all fighting to be the “token girl” accepted in a residency class.
Throughout my life I have always had lots of girlfriends. I attended an all girls high school, and my college years were filled with healthy friendships with both women and men. It was not until I entered the world of medicine that I felt so distant from other women. And then I become a mother. Like most new moms in the Facebook era I was added to a “mommy” group. These social media support groups are extremely popular but I immediately felt disconnected. So many of the posts were medical. “Should I vaccinate my child?” or “What is this rash? Should I take my baby to the pediatrician tomorrow or to the emergency room tonight?”
While I respected these questions I felt that I was more of a resource to these women than the reverse. Also, I did not want to “out” myself as the physician in the group because I feared being inundated with medical questions or, even worse, being villainized as a “Big Pharma check recipient” when I disagreed with those whose opinions conflicted with my medical knowledge. Some of my questions simply would not resonate – I needed advice on finding childcare that is flexible with my unpredictable hours but most of the mothers in the groups could not identify with the unique lifestyle that my career requires. And when I sought medical advice, I wanted evidence based answers and possibly a study attached to it for reference.
A few months after that flight, I found myself feeling overwhelmed about my future. I was 31 weeks pregnant with twins, working a full shift load, and still had no plan for how I would care for these babies and my 16 month old daughter when I went back to work. As an emergency medicine physician, I thrive in high-pressure situations and perform well under stress. How is it that I can manage multiple critical patients and perform complex procedures when minutes matter, but figuring out logistics of childcare for my children is my Achilles’ heel? How did other female physicians do it? Was my flight neighbor right – was I wrong to think I could have it all as a woman physician? And then the craziest idea came to me – could I expose my vulnerability to other female physicians? I knew I was not the only one feeling this pressure but I had been taught to never show weakness, especially in medicine.
I decided to create my own Facebook group for physician mothers. I nervously invited 20 friends who were also physician mothers, hoping I would not be viewed negatively for seeking support. A week later, the Physician Moms Group (PMG) had grown to 1000 members, and all my fears were dispelled. These women needed exactly this kind of network, but like me, had been too afraid to ask for it. We needed a safe space to discuss the challenges and rewards of being a physician and mother, seek advice on family and work matters, and celebrate the sacrifices we made for motherhood and medicine.
It is apparent that female physicians have unique challenges but we also share many of the frustrations of our male colleagues. Physician burn out is prevalent and discussed frequently on medical blogs. A bad patient interaction or rough day at work is carried over at home. The days of leaving the hospital or clinic feeling satisfied due to patient gratitude are becoming less common. A frequent theme in our group is the frustration that many patients do not even recognize that we are the doctors! Despite wearing a long white coat, introducing myself as “Doctor” multiple times and the large D.O. (Doctor of Osteopathy) label on my badge, I often hear the patients ask the nurse as I walk away, “When will the doctor be here?” How many times have I been overlooked while a patient directs all their attention to a male nurse or medical student although I am the one asking the questions? In a world of Press Gainey scores and customer-based medicine, this lack of recognition in the face of tremendous responsibilities contributes to female physician burn out.
In today’s world, the public views physicians as part of the healthcare problem. Most patients do not realize the battle happening after we leave the exam room. The healthcare work environment has become hostile thanks to increasing demands from regulatory agencies and insurance companies and the always-looming fear of lawsuits. There’s a toxic divide happening between healthcare providers perpetuated on social media as seemingly clever “us versus them” memes. But every member of the healthcare team is crucial to patient care and no one can do it alone. Ultimately, we are working toward the same goal – to help bring wellness to our respective communities for the greater good.
In an effort to raise awareness of the importance of a physician-led healthcare team and female physicians’ roles in medicine, PMG has declared February 3rd as National Women Physicians Day in partnership with Physicians Working Together (PWT) and Medelita. This day marks the birthday of Dr. Elizabeth Blackwell, the first woman to receive a medical degree in the United States in 1849. Dr. Blackwell initiated the movement that helped women gain entry and equality in the field of medicine. As part of her ongoing activism, Dr. Blackwell is quoted saying, “If society will not admit of a woman’s free development, then society must be remodeled.”
A lot has changed since Dr. Blackwell’s entry into medicine, and yet there are still challenges achieving the same respect and opportunities as our male colleagues. According to the 2014 Census of Actively Licensed Physicians in the United States, only 32% of all physicians are female. The percentage of women in surgical and competitive specialties also reflects that we are the minority. While it is unclear whether this is due to barriers women face in the male-dominated workplace or the perceived inability to achieve work-life balance, this needs to be studied and addressed so that women are encouraged to pursue careers as physicians and not fear answering their call to medicine.
My hope is that we can show unity celebrating this special day and recognize the accomplishments women have made in the name of medicine. I am optimistic that we can return to a time where the sacrifices we make in our own lives to care for others are appreciated. We must remodel the structure of medicine to make it possible for women to excel professionally while balancing a family. We have a responsibility to protect and nurture the practice of medicine, and I believe this starts by reshaping the way society treats the woman physician.
On February 3rd we asked the medical community to observe National Women Physicians Day in hospitals and clinics and for the public to do the same on social media by using hashtags #Iamblackwell and #NWPD. This is an exciting time for medicine as we are connecting virtually and creating a collective voice that can be used to create positive changes for physicians and patients alike. I can not promise a smooth journey to “remodel medicine” but I invite you to join me in this effort. And like any flight, let’s buckle up and enjoy the ride!
Special thanks to the strong women in PMG who helped make this monumental day happen! Especially to Drs. Dina Seif, Joyce Guirand and Lourdes Bahmonde for their support and guidance not only in motherhood and medicine but also for their sacrifices to expand the organization of PMG.