Talk Less, Do More: Why It's Time to Just Put the Women in Charge

Talk Less, Do More: Why It's Time to Just Put the Women in Charge

Miriam Knoll, MD

Jun 11, 2019

Originally published on Forbes; republished with permission.

When Dr. Jeffrey Flier walked into the Bornstein Amphitheater at Brigham and Women’s Hospital in April 2019, he immediately noticed the bare walls. He reminisced on Twitter how empty the walls of the auditorium were.

What had changed? Dr. Betsy Nabel removed all the portraits of retired chairpersons that had been hanging on the walls of the Bornstein Amphitheater. Students had been vocal about their discomfort with the 31 portraits, of whom 31 were men. All but one was white.

Many physicians argued with Dr. Flier over Twitter. They were happy Dr. Nabel erased the reminder of all-male and non-diverse leadership and welcomed the change.

Whatever your opinion on the portraits (Keep them! Burn them!), I’ll have to admit I'm bored with the discussion. While the debate is well-meaning, it truly misses the point of discussing gender equity in medicine.

Here’s why:

Women aren’t underrepresented in medicine. Starting in 2017, more than half of medical students were female. The issue is, women physicians aren’t leading and face inequity in many other areas like compensation and opportunity.

Here’s an argument I hear often:

“It takes time. Women only starting going to medical school  in large numbers very recently, over the past 30 years. Eventually, women doctors will catch up. Give it time.”

This view takes the approach that demand for female leaders is fed by supply. They believe that time will fix the disparity, because the reason for the disparity is that there simply aren’t enough qualified and interested women doctors to fill leadership roles at this time. They believe, further, that once enough women graduate from medical school, complete their training, and build their careers (which takes many years), these women will eventually get to the top just like their male peers have done for decades. Agreed?

Whether this theory makes sense to you or not, the problem with this argument is that it simply isn’t true. Decades of research tell another story that's more complicated. For over twenty years, researchers have been describing a phenomenon called “the leaky pipeline,” which is a metaphor for how women are not simply shepherded through the entrance to a career pipeline until they make it through the other side to success. What happens, instead, is that a large percent of women fall out of the pipeline, meaning they fall out of their intended journey to leadership. Many leave the pipeline altogether. An abundance of research describes the how and why this occurs, including lack of sponsors and mentors, lack of opportunity, punitive motherhood policies, and inflexible work environments.

So why should we stop talking about portraits of men hanging on the walls of an auditorium? Because it distracts us from what needs to be done, which is to fix the problem. Now. When leaders don’t represent us, daily reminders of the inequity reinforce the sting.

Here’s what should be done instead: real actions that promote women and under-represented groups in medicine. And that’s doable, starting today.

First, we need to combat the unconscious bias that “cream rises to the top,” because many of the best and brightest won’t get to the top echelons of leadership without a deliberate, guiding, helping hand. Talented early-career women need the attention from current leaders, so as to combat the leaky pipeline that would inadvertently allow them to drop out of the pathway to success. Any open leadership position should be filled only after seeking out candidates from underrepresented groups. Don't assume they'll apply if they're qualified and interested. And don't assume that if they didn't apply, they're not qualified and not interested.

This is what we need to focus on: action. A great example is ASCO's decision to offer free onsite childcare for attendees of the 2019 Annual Meeting, which I advocated for when I first attended and noted how difficult it can be for parents to go. Going to conferences is important for a physician's career because that's where one can network, present research, and participate in national organizations. Offering onsite childcare at the meeting makes it easier for parents to attend; more importantly, it validates the many responsibilities women face early in their careers, when job growth and opportunity is integral.

We'll know we're making progress when the relics of the past are no longer jarring, because at that time they’ll represent reminders of how things used to be, and not how they remain today.

Because, if our leadership was truly diverse, would we care whose portraits decorated our walls?


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