"Do we need a National Women Physician's Day" - one year later

Last year on February 3rd, I wrote a post entitled "Do we need a National Women Physician's Day"?  The question was rhetorical in nature, as I strongly support (as did the post) having a separate National Women Physician's Day.  The day is celebrated on the birthdate of Dr. Elizabeth Blackwell, the first woman to receive a medical degree in the United States of America.  Dr. Blackwell once said:  "If society will not admit of a woman's free development, then society must be remodeled."

Dr. Blackwell's statement is absolutely true.  We should (and we are) remodeling society, slowly but surely.  We've made a lot of progress over the years, but we have so far to go.  Two examples from this past year are notable. 

First, in September of last year, a physician in Dallas, Texas became quite famous for a statement that he made in the Dallas Medical Journal.  The journal had asked several physicians to comment on the gender pay gap (a study published in 2016 in JAMA Internal Medicine found that women physicians earn, on average, 8% less than their male counterparts, while a survey conducted on Doximity found that women earned almost 28% less than their male counterparts in 2017) in medicine.  Dr. Gary Tigges, an internal medicine physician practicing in Dallas, stated that, "Yes, there is a pay gap.  Female physicians do not work as hard and do not see as many patients as male physicians. This is because they choose to, or they simply don’t want to be rushed, or they want to work the long hours. Most of the time, their priority is something else… family, social, whatever."  He went on to say, "Nothing needs to be ‘done’ about this unless female physicians actually want to work harder and put in the hours. If not, they should be paid less. That is fair.”  Dr. Tigges later offered an apology, but only after he was forced to resign and only after he was absolutely blistered (deservedly so) on social media.

Second, a group of (male) investigators in Basel, Switzerland published a study in the journal, Critical Care Medicine that compared the simulated outcomes from a cardiopulmonary arrest when the resuscitation team was led by a male versus a female physician.  In this study, which did not involve actual, real patients (and involved only medical students, who never actually lead resuscitation teams in real life scenarios), female-led teams showed less "hands on time" and longer delays to initiate chest compressions (both of which impact outcomes) compared to male-led teams.  The study's investigators wrote, "The management of a cardiac arrest situation by a team of first responders is a highly time-critical emergency event that requires short and precisely verbalized commands by a determined leader, rather than a focus on social relationships or affective issues. A cardiac arrest situation should therefore favor males as primary leaders. Our results are in line with this conclusion."  A large, retrospective study was published just this month in the same journal that looked at the outcomes in 1,082 adult cardiopulmonary arrests that occurred in two hospitals.  The odds of survival (i.e., actual outcomes rather than surrogate outcomes, such as "hands on time" and "time to initiate chest compressions") were significantly improved when female physicians led the resuscitation team.

We clearly have some work to do.  First, there is a gender pay gap that we have to address.  Does the opinion of one physician that women physicians don't get paid as much because they don't work as hard as their male colleagues mean that all male physicians feel this way?  Absolutely not.  But the fact that one physician felt justified in making this kind of claim in such a public way is illustrative of part of the problem that women physicians face.  Second, the fact that a group of investigators felt justified in making a statement that resuscitation teams should always be led by a male physician, based on a study involving simulated cardiopulmonary arrests managed by individuals with limited training and experience is also noteworthy.  The study was the focus of conversation at a number of national meetings, and representatives from the journal stated that they published the paper as written in order to generate discussion.  Mission accomplished.  The fact remains that studies involving real patients and real outcomes continue to show superior outcomes when female physicians are involved.

So, I ask again.  Do we need a National Women Physician's Day?  Until the gender pay gap is eliminated, and when female physicians receive the respect and recognition to which they are entitled, I say absolutely and unequivocally yes.

Thank you again to Dr. Elizabeth Blackwell for leading the way.  And to all of my female physician colleagues, enjoy your day!