Physician exposes sexism in healthcare

Prognosis: treat the causes, not the symptoms

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What if mustaches outnumbered women?

Based on a cross-sectional analysis of 1000 academic medical leaders, the number of mustached chairs, 19 percent, outnumber those held by women, 13 percent. This study was done by Eleni Linos and was among the many striking studies Dr. Esther Choo gave Feb. 7 at the Valley River Inn. Dr. Choo’s presentation, titled Sexism in Healthcare, was hosted by the Lane County Medical Society with about 150 people in attendance.

Dr. Choo’s medical career includes an undergraduate and medical degree from Yale, residency at Boston Medical, and a Masters in Public Health from OHSU in Portland, where she is currently an Emergency Physician and Associate Professor.

Over the course of an hour, Dr. Choo covered gender disparities in medical careers and academia, the implicit bias that causes both men and women to undervalue women, the high prevalence of sexual harassment in medical school and beyond, the reasons why increasing the number of women in leadership positions should be prioritized, and how it benefits the business of medicine and improves patient outcomes.

In short, women are “paid less, promoted less, and rarely in charge.” There is no specialization in which women earn more than men, including those traditionally held by women, such as pediatrics and nursing. The career trajectory after a woman leaves residency and enters the workforce flows through what Dr. Choo calls a “leaky pipe,” in which the number of women seeking and hired for leadership positions decreases as they move toward more prominent leadership positions.

“Overall, women constitute 65 percent to 80 percent of the healthcare workforce, including all roles, but only 30 percent of senior leadership positions, 13 percent of CEOs overall, and 0 percent of CEOs of Fortune 500 companies,” Dr. Choo said.

The underlying mechanisms that contribute to gender inequity are complex and compounded when intersected with race, ethnicity, and ability.

“To fix harassment, we need to change the culture of medicine so that there is equity across the board in hiring, salary, promotion, leadership, and inclusiveness,” Dr. Choo said. “To fix equity, we have to create a culture where we address harassment with urgency and rigor and have zero tolerance for it so that women, and everybody, can thrive and be productive, and move up without barriers to advancement. We need to believe, understand and talk about how these efforts are smart for business and healthcare investments,” Dr. Choo said during her final statement before taking audience questions.

A man who has a private practice in Eugene asked the first question.

“Maybe I’m blind, ‘cause I don’t see it. Is this a regional difference? Is this just academic medicine?”

Dr. Choo responded that data from academia is more accessible and people are available to respond to surveys. Wage gaps are greater in private practice than they are in academia because there are “some checks and balances”. She also said there are no regions where the gap disappears.

“As far as not seeing it, that is a whole section of a longer talk that I give. It is very hard to see it on a day to day basis. It’s a huge barrier to this conversation that I give all of this data, but people say, ‘It’s just so disproportionate to my day by day experience’, and that’s particularly true from white men – and you happen to have a mustache.”