In case you missed it:

In the June 2017 issue, Emergency Medicine News published “ER Goddess: Parenthood or Medicine? It Shouldn’t Be a Choice by Dr. Sandy Simons advocating for a more humane sick call policy and speaking to the challenges of being both a parent and an emergency physician. The next month, Emergency Medicine News published a Letter to the Editor: Parenthood and Medicine, Each in Its Season by Dr. Geoffrey Martin in response, claiming it to be a “lie that women should be everything all the time to everyone.”

Almost immediately after the letters publication, a firestorm erupted, primarily on Twitter. Many tweeters questioned the editorial decision to publish such an inflammatory, divisive and arguably unhelpful response:

In response, this was the EMN response:

This policy was, to the best of our knowledge, previously not publicly available.

With that new knowledge, several of us in EM wrote Letters to the Editor, hoping to provide context that EMN arguably should have sought out, to provide an alternative view to views about femininity and motherhood that have held power for far too long, to allow those criticized to respond, and to correct inaccuracies in the letter.

Initially we each were told that all letters would be published per stated policy, with a 250 word limit (Dr. Martin’s Letter was 323 words, but there was such a word count listed in the print materials). We rewrote these letters, editing them down to fit the stated requirement.

Months later, we have now been told that, “we aren’t running any letters about this issue because we do not want to activate any further discussion on that topic,” and that the policy to run all letters has been changed.

Yet the letter by Dr. Martin remains largely unanswered. FemInEM has agreed to publish our responses, and we thank them for this platform.

Sincerely,

Dr. Kyle Fischer

Dr. Ari Friedman

Dr. Nikita Joshi

Dr. Megan Ranney

 

Letter to the Editor, Kyle Fisher, MD

August 25, 2017

Dear Editorial Board,

I am writing today to urge the Editorial Board to change EMNews’ policy regarding publication of opinion pieces. In recent months, several overtly sexist and racist pieces have appeared in the magazine’s opinion section. Per representatives at EMNews, the underlying policy guiding leading to the acceptance of these pieces is that all submissions are accepted, so long as they are not libelous.

This policy is misguided at best and harmful at worst. Although deep respect for the First Amendment is a fundamental American value, it is not without limits. It in no way compels independent publications to amplify the voices of individuals who propagate false stereotypes or rehash settled debates.

The damage of these publications is not trivial. First, they serve as an embarrassment to the field of emergency medicine. Although some may decry this as a misunderstanding from readers as to who’s view the comments represent, the real-world effect is the same. It gives a platform and credibility to debunked theories while simultaneously bringing down the respectability of our field.

Second, these articles distract from the important issues facing emergency care. With each publication, there is a predictable human response to respond to opinions and beliefs that are not in touch with our collective values. As a result, rather than additional content on the  important issues facing our specialty, we are drawn back into old fights that most have moved on from long ago. 

Finally, this policy diminishes the perceived respectability and impact of other accepted opinion pieces. As someone who has previously published in the Letter to the Editor section, I was under the impression that our ideas were printed for their value to the field of emergency medicine. Now I question whether the quality mattered at all.

In residency, I was taught that if you identify a problem, you should be ready to follow-up with a solution. Otherwise, you’re just whining. Here’s mine: In order to be accepted for publication in EMNews, a piece must conform to the “Mission, Vision, and Values” of the organization. It’s as simple as that. If EMNews hasn’t articulated these principles yet, that would be a welcome start.

Respectfully,

Kyle Fischer, MD, MPH

 

Letter to the Editor by Ari Friedman, MD

August 25, 2017

To the Editor:

I read with dismay the recent letter which you chose to publish on “Parenthood and Medicine.”

While the letter’s title refers to parenthood, the letter-writer chooses to focus on motherhood specifically, claiming it to be incompatible with “expert ability” as a doctor. As justification, he approvingly cites a book by Vender, whose first two pages alone speciously build an argument that, “Feminists, in effect, are swindlers,” and feminism is “a radical movement and ideology.” To cite but two factual errors, feminism did not begin in the 1960s, and lower wages for women are not simply attributable to fewer hours worked– including among physicians.  This citation is hardly a solid foundation on which to build Dr. Martin’s sweeping claims.

Left unchallenged in Dr. Martin’s missive is that there could be any other possible distraction from the work of doctoring. I once worked in a lab in which the least productive member was admonished to stop spending so much time in the gym. Emergency medicine is a field whose practitioners have notoriously variegated pursuits outside of the hospital. I suspect if he reflected objectively Dr. Martin could recall plenty of examples of residents and physicians with non-parenting activities requiring significant time commitments. I suspect reflection would also bring forth plenty of examples in which an involved parent of either gender proved themselves to be a superb doctor, in spite of, or perhaps because of, their parenting. I personally found having children to be enormously focusing, and I am a far better student now for having had them, despite the thousands upon thousands of hours spent caring for them.

Allow this member of the digital generation to offer some advice to EMN, which seems to devote so much of its non-clinical discussion space to casually constructed arguments about the youth of today’s poor work habits and lack of devotion to their craft, especially if those ‘youth’ happen to be mothers of any age. When you commit yourself to publishing any argument, no matter how poorly considered, you will wind up giving far more space to those who lack the scholarly chops to publish in other fora. The many brilliant clinician-parents, clinician-researchers, and clinician-researcher- parents in emergency medicine are too busy with important pursuits to devote time to re-litigating battles fought by their great-grandmothers.

Consider as well applying a more erudite editorial hand to EMN articles other than letters. Comments such as the recent “too busy playing daddy” find their way into EMN manuscripts on unrelated topics. This does not require censorship, rather positive editorial involvement to tease out what the author really means. I suspect that a simple editorial query to Dr. Cook questioning why a gendered pronoun needed to be used at all, or whether he would have felt it appropriate to say “playing mommy” would have made it clear that his words were relegating parenting to women’s work, at which men can only play. If only women can truly parent, and true parenting cannot be done contemporaneously with true doctoring, then our specialty is set to lose an enormous portion of its most talented workforce.

Sincerely,

Ari Friedman, MD, PhD

PGY2 Emergency Medicine

Harvard-Affiliate Emergency Medicine Residency

Beth-Israel Deaconess Medical Center

Boston, MA

 

Letter to the Editor: Nikita Joshi, MD

August 22, 2017

Dear Editorial Board:

I am writing this letter in response to Dr. Martin’s letter to the Editor which was recently published. I came across the letter on one of the many Facebook forums that are dedicated to women emergency medicine physician moms. My frustration and aghast at reading the letter was nothing compared to other people’s responses. I was even more surprised when I saw on twitter the response from the board stating that this was related to the defense of the first amendment, which turned out to be an erroneous interpretation of the first amendment.

I will keep this letter short, particularly because I am 7 days post partum from my 2nd premie baby who was born the day I read all of these comments. I believe that myself, and a significant number of my fellow women physicians, women physician moms, women who aspire to be physicians, and women physicians who will never desire to have children are certainly capable of multitasking and living full personal and professional lives.

In my opinion, the biggest issue with this particular letter to the editor is about having a stranger evaluate the choices that another individual would make towards their career and personal lives. I am lucky to work in an institution that fully supports my choices to have a balanced personal and professional life. I am lucky to work with men and women who do not judge these choices that we all make, because they realize that men and women will have instances in their lives that require balance. 

I urge you to please stop the perpetuation of the myths that somehow women are incapable. That is a choice that everyone should have the ability to make themselves, without the judgment or opinion of others, let alone a publication that seeks to be a voice of a specialty. Emergency Medicine is a great field, and one that I am proud to be a part of. Do not continue to share outdated views which may turn away other highly qualified diverse men and women interested in it.

Sincerely,

Nikita Joshi MD

@njoshi8

njoshi8@gmail.com

Pacifica, CA

 

Letter to the Editor, Megan Ranney, MD

August 25, 2017

Dear Editorial Board,

I am writing in response to Dr Martin’s misguided letter to the editor. I take particular umbrage with his statement that it’s not “in women’s nature” to be able to take on multiple roles at once.

Anecdotally: I took my boards at 38 weeks pregnant with my 1 st child, was awarded my first grant while on bedrest with my 2nd child, and ran the didactic curriculum for SAEM’s Annual Meeting during maternity leave. One of my friends wrote her K-grant (career development grant from NIH) while on maternity leave. Other friends write, train horses, serve as medical directors, and more – while mothers and wives.

Sure, balancing all these roles is sometimes painful, but no more so for me than for our spouses. And there’s no reason that women are the ones who should be told that it’s painful to do all these things simultaneously.

It’s this kind of antiquated message that dissuades young, motivated women from pursuing greatness. It’s due to this kind of societal bias that we have disproportionately fewer women in positions of medical leadership.

We owe it to our specialty, and to our trainees, to remember that ALL physicians – whether women or men – can be great physicians, researchers, administrators, and parents all at the same time. It IS in all of our nature.

Best,

Megan L. Ranney MD MPH FACEP

 

Email Communications and Author Instructions for reference:

August 25, 2017

Dr. Fischer,

Thank you for your email. May I ask you to try to get the word count a little closer to our limit of 250 words? (This policy is printed in every issue; please see p. 5 of our August issue.) Please also send me your city and state of residence or practice to include after your name.

It should appear in the October issue (space permitting) because September is on press.

Thank you for reading EMN and taking the time to write to us.

Regards,

Lisa

 

August 28, 2017

Thank you for your email. Please send me your city and state of residence or practice to include after your name. Our policy is indeed to publish all letters in the order received as space permits. Yours should appear in the October or November issue.

Thank you for reading EMN and taking the time to write to us.

 

January 29, 2018

Thank you for reaching out to Emergency Medicine News with your comments on a letter to the editor published in August. We value input and feedback from readers like you. Dr. Martin’s letter does not reflect EMN’s feelings about female emergency physicians or how they should manage their careers, and therefore we aren’t running any letters about this issue because we do not want to activate any further discussion on that topic. I hope you can understand our position.

We have since updated our letters policy. This updated statement is now running in a box in the letters section of each issue. We encourage you to continue to submit comments and feedback as they relate to issues in emergency medicine and/or EMN articles that appear in print or online.  

 

September LTE Author Instructions

Letters to the Editor

Have a comment about an EMN article? Like to share your views about issues in emergency medicine? Send your letter to the editor to emn@lww.com. Please limit your letter to 250 words and include your full name, title, and city and state of residence or practice.

 

January LTE Instructions

Letters to the Editor

Emergency Medicine News welcomes letters to the editor about any subject related to emergency medicine. Please limit your letter to 250 words, and include your full name, credentials, and city and state of residence or practice. Letters may be edited for content, length, and grammar. Submission of a letter constitutes the author’s permission to publish on all media, including print, online, and social media, but does not guarantee publication. Letters express the views of the authors and do not necessarily reflect those of Emergency Medicine News and Wolters Kluwer. Letters to the editor may be sent to emn@lww.com.