Today, Dr. Elizabeth Blackwell, the first woman to graduate from medical school and become a physician in the United States, would be 200 years old! So, as we celebrate Dr. Blackwell's 200th birthday today (and, not by coincidence, National Women Physicians Day), I have to ask one more time, "Do we need a National Women Physicians Day? The short answer - 100% yes!
I first posed this question a couple of years ago (Do we need a National Women Physicians Day? posted on February 3, 2018). At that time, I briefly reviewed Dr. Blackwell's professional life and some of the challenges she had faced as the first woman in medicine. Notably, she had applied to a number of medical schools throughout the northeastern United States without any success. The faculty at New York's Geneva Medical College actually referred the question of admitting a female to the all-male student body, who in a rather surprising turn of events, voted "yes" largely as a joke. She was admitted to medical school, and the rest, as the saying goes, is history. I went on to discuss a few of the studies showing that female physicians earn less than their male counterparts and frequently suffer from gender bias, discrimination, and sexual harassment in the workplace. I also highlighted a study suggesting that women may actually have better outcomes compared to men!
The following year on February 3, 2019, I posed the same question (Do we need a National Women Physicians Day - one year later). That year, I again wrote about Dr. Blackwell and provided a quote - "If society will not admit of a woman's free development, then society must be remodeled." I talked about two examples of gender bias and overt discrimination. The first example was an editorial written by a Dallas physician who suggested that the reason women physicians were paid less than their male counterparts was because they didn't work as hard. The second was a simulation study published in the journal, Critical Care Medicine, in which the investigators suggested that resuscitation teams led by female physicians was not ideal - ""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." Notably, this was a simulation study - a follow-up study with actual patients suggested the opposite. Patients suffering cardiac arrest did better when the resuscitation teams were led by female physicians.
Last year (Today is National Women Physicians Day), I again talked about Dr. Blackwell. And once again, I talked about the gender pay gap and the evidence that women physicians continued to suffer gender bias, discrimination, and sexual harassment in the health care setting. So, if I were to summarize where things currently stand, I would have to say that things are not much better.
More concerning, as I discussed in a post last week (COVID-19 and women), things might even be worse. The COVID-19 pandemic has not only made things worse, we may even have slid backwards. Women are leaving the workforce in far greater numbers than men - this is true in just about every sector of the economy, including health care. It's a struggle for a lot of us in academic medicine these days, but this may be even more the case for women. This is concerning - we had problems with gender disparities in academic leadership positions, editorial boards, and conference speakers even before the pandemic (check out a brief report published last year by my former colleagues in Cincinnati). Just last month, a group of investigators published a study in the journal Pediatric Critical Care Medicine that found that the percentage of researchers publishing clinical trial results in the field of pediatric critical care who are women still lagged behind the percentage of overall women in the pediatric critical care medicine workforce.
While we have a lot of work still ahead, I remain optimistic for the future. Just a few weeks ago, we witnessed the swearing in of the first female Vice President of the United States. There is a greater awareness for issues around gender diversity, equity, and inclusion in medicine today - perhaps COVID-19 will further illuminate these issues for us. With awareness comes change - I've known a number of colleagues who have declined invitations to speak at national meetings where there weren't enough women speakers invited as well (don't participate on "manels"). Just this past year, the Journal of Vascular Surgery retracted a really offensive study judging public social media posts of women surgeons wearing bikinis on off-hours as “potentially unprofessional”in response to a number of complaints on social media.
There is hope. And it can start today, on this the 200th birthday of the first female physician in the United States. Dr. Blackwell said it best, "If society will not admit of a woman's free development, then society must be remodeled." Let's remodel society.
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