Dean Bowman leads roundtable discussion about women in medicine
In 1849, Elizabeth Blackwell, M.D., became the first woman to earn a U.S. medical degree. Since then, women have been changing the face of medicine.
Each September, the American Medical Association (AMA) celebrates Women in Medicine Month, honoring influential women physician leaders. This year’s theme, “Women in Medicine: Innovators and Leaders Changing Health Care,” reaffirmed the AMA’s commitment to increasing the influence of women physicians and advocating for women’s health issues.
In celebration, the medical school’s first woman dean, Marjorie Bowman, M.D., M.P.A., and several of our medical school women faculty members joined in an informal roundtable discussion about their experience as women physicians and the importance of women physicians in health care.
Q: What attracted you to medicine?
Barhan: I was initially fascinated with science and biology. I enjoyed learning about how body systems functioned and malfunctioned. Being able to fix problems and help people live better was the ultimate positive reinforcement that helped me pursue a career in medicine. Later I found that I particularly enjoyed applying this knowledge and skill in the primary care and reproductive care of women.
McCarthy: I always loved biology, and the biology of human beings was the most fascinating. To be able to care for and cure a fellow human being is the greatest of all honors.
Roman: Love of science, combined with a desire to help people. Since my family heritage was in farming and teaching, I did not know any physicians other than my pediatrician growing up—and it really was my high school guidance counselor who encouraged me to consider becoming a physician.
Zink: I grew up on a farm just outside Dayton where my backyard became my biology lab. I delivered lambs, butchered lambs, took organs in to school for show and tell. I was intrigued. I did well in science in high school. My father was a dentist. I started helping him in the office when his staff took vacations during the summer while I was in middle school and junior high. I knew I didn’t want to be limited to people’s mouths.
Bowman: I also grew up on a farm, although it was a dairy farm. My extended family had little access to health care, and I felt I wanted to make a difference in ensuring that people had access to not only health care, but excellent health care. Medicine combined my strong interest in science with understanding the needs of populations of people, i.e., all of the aspects of all of the social-economic-psychological determinants of health.
Q: What challenges, if any, did you face as a woman in medicine?
Barhan: Taking personal time is the biggest challenge I have faced. A career in medicine is time consuming, easily encompassing 60 hours a week and sometimes significantly more. Adding family responsibilities to any demanding career easily consumes the remaining time. Giving myself permission to take personal time, from time that ends up being given to others, is the biggest challenge for me.
Roman: Fortunately I attended medical school in an era when there were no major barriers—and I am eternally grateful for those women a generation or two before me who were often the “first” ones. However, I had few female role models in academic medicine; in fact, when interviewing for my first job after residency at a medical school, I inquired about flexibility for part-time employment, as I was pregnant at the time. I received a lecture about how academia requires full-time dedication, and that I would never have a successful career in academia. Fortunately, I found a more flexible environment at Wright State—and after 22 years (including my first 10 as a part-time faculty member), I think most would say that I have indeed been successful!
Zink: It was a man’s world when I was in medical school in the early 1980’s. One-fourth of my class were women. On hospital rounds, it was assumed I was a nurse. I learned how to interrupt so I could get my point made when I was at a meeting where most of the attendees were men.
Bowman: I had the amazing opportunity to be the first woman chair of a clinical department at the University of Pennsylvania School of Medicine starting in 1996—but the school had been existence since 1765—that about sums up the issues for women in medicine!
Q: What advice would you give to women considering a career in medicine?
Barhan: Practice being assertive and authoritative early on. Practice challenging the norm if you don’t like it, or at least ask more questions and be heard. For some it comes easy, but for the majority of women, being quiet and agreeable is the default attitude because society responds to those likeable traits with positive reinforcement such that women carry these attitudes for life. With practice— and it really takes a lot of practice, because they’ll occasionally get frowns—women can become better negotiators, and ultimately they will then get more satisfaction out of their career.
McCarthy: Reach for your dream!
Roman: Go for it! Being a physician is a wonderful privilege, and I really can’t imagine a more personally satisfying career, despite the challenges.
Zink: It is a wonderful career with many options today. It is important to have a female perspective as we face the challenges in medicine today. It is a privilege to help people through the best and worst of times. We need to make health care accessible to all citizens.
Bowman: Don’t think about the fact you are a woman most of the time. Remember, you are the excellent physician, the person that patient needs all of the time. Yes, I am the first woman this, and the first woman that, but being a woman is not how I get mutual goals met.
Q: What changes, if any, have you seen in how women physicians are treated by their peers, administrators, and/or patients?
Barhan: Patients have become more accustomed to women physicians. They believe in them and their abilities more now than 20 years ago when I got started. I am an ob-gyn and although one might think that women prefer to see women gynecologists, actually that was uncommon in the beginning of my career. I remembered patients asking to bring in the male member of the group, for their opinion and expertise. I remember patients asking if I was really the doctor. This hardly happens anymore.
McCarthy: In surgery, I have seen more women enter the field and other women are very supportive. We have a higher percentage of women faculty in our surgical program than any other program in the country. I proposed making the Association of Women Surgeons (an informal group brought together by Dr. Patricia Numann that met at the ACS) a formal society, and the following year it became a reality! My WSU colleague, Margaret Dunn, and I have both been presidents of this society. There is increasing acceptance of the role of women in surgery, but some challenges persist.
Roman: By and large, I feel that as more women have entered medicine, stereotypical comments about the role of women have diminished.
Zink: Women are more part of the mainstream. More women are in leadership positions.
Q: What accomplishment are you most proud of as a physician?
Barhan: Being an educator gives me the most satisfaction of all. I have the privilege and ability to educate two very important groups. For one, the next generation of physicians and two, the collegial environment in which I practice allows me to stay current so that I can be the best educator of my patients so they can make choices that are right for them.
McCarthy: Saving lives for a living. One of my friends has this posted in his trauma room (in Latin). Also my daughter Alison, who is in medical school.
Roman: On a patient level, it is simply knowing that I have made a difference in the lives of my patients, allowing them to feel hopeful again. In academia, I am most proud when I see our students succeed. With my involvement in the curriculum over many years, I hope that students not only have a solid foundation of knowledge and skills, but most importantly, leave with a curiosity about patients and strive to make a difference in their lives.
Zink: Having a voice in how medicine needs to change, teaching and mentoring the next generation of physicians. Giving voice to the value of reflection to help us be better physicians, to own what works and does not work about what we do and how we respond. To reflect on how what I do, affects me and helps me bring more compassion to who I am as a physician. Currently the great need in medicine is in primary care, but the U.S. system and training incentivizes students toward specialties. Being active on the state and national level over the years for U.S. health care reform and moving toward national health insurance.
Bowman: Being able to drive to success across the entire spectrum of medicine—from one-on-one patient care, to community health, to public health, to political influences on medicine, to educational leadership— all to bring true care to the health of people.
Q: How do you feel you have made a difference as a woman in medicine?
Barhan: I try to be a positive and successful role model for medical students. I remember the strong impact my best teachers made on me as a medical student and resident in training. Some people are never forgotten because they’re just that good. I try to emulate the same because I know that many students are watching and they deserve good role models.
McCarthy: Recognition of the family and personal aspects of physicians and their influence on the profession as a whole. Attention to factors influencing burnout and other parts of the physician.
Roman: I hope I have been a role model to students and psychiatric residents, both men and women—that one can “have it all” in being successful in a career while enjoying family and friends. While some might say that I have been successful at “balancing my personal life and my career,” I like the metaphor that I have a number of different balls to juggle—and that some of them are rubber and some are glass. The rubber balls symbolize projects, people, or aspects of my life that can be dropped and will bounce back, so no harm done. The glass balls were those that couldn’t be ignored for long, but at times, could be carefully placed aside for a bit in order to finish a project before a deadline, for example.
Zink: I am a role model to younger women. I demonstrate a collaborative style. I demonstrate compassion, and empathy for all my co-workers and colleagues.
Bowman: I know that I am a role model for others, as one of the few deans who is a woman, and by the volumes of calls I get to mentor other women for success inside and outside of medicine. Yet most of my success is not by emphasizing my gender, but by emphasizing my desires and goals, which are universal strivings, something I try to instill in all of my mentees, no matter the race, gender, or socioeconomic status. It is not about my gender, it is about quality of care, quality of education, and meeting the needs of the entire population.
Q: Has the increase in the number of women physicians changed the delivery or quality of health care? If so, how?
Barhan: It has changed for the better. Women are, by nature, facilitating in conversation. It has been shown in research studies that this communication style allows physicians to partner with their patients. Patients are more likely to divulge barriers to care, and this partnership style helps patients identify their problems and participate in their own solutions. I feel that having more women physicians has been an influence for this positive change among all physicians, male and female.
Bowman: I agree. On average women doctors provide the same quality of care for people as men doctors, yet, on average, women doctors are a little different in style and emphasis. For some people, at the right time and place, or for the right element, or the willingness for a patient to share a specific important aspect of their personal history, a woman doctor can be the best choice. We just need to be there and do it! Women in leadership are generally somewhat more collaborative and participative. Organizational leadership studies continue to find that style may well be what works best in today’s environment.
Roman: Studies have shown that women spend more time with their patients, are sued less than their male counterparts, and generally demonstrate greater empathy.
Zink: Women have demanded more options about practice, saner hours, part-time positions, and time for family. This has benefited both men and women.
McCarthy: Yes, healthier physicians make for healthier patients.
Marjorie Bowman, M.D., M.P.A., has been the dean of the Boonshoft School of Medicine since October 2012. She has worked in the U.S. Department of Health and Human Services, and served as a commissioned officer in the U.S. Public Health Service. At Georgetown University School of Medicine, she served as assistant dean and as division director for family medicine. She also served as chair of the Department of Family and Community Medicine at Wake Forest University for 10 years prior to moving to the University of Pennsylvania in 1996, where she was professor and founding chair of the Department of Family Medicine and Community Health and director of the university’s Center for Public Health Initiatives.
Sheela M. Barhan, M.D., is an associate professor of obstetrics and gynecology and clerkship director for the Women’s Health Rotation at the Boonshoft School of Medicine. She is an active educator of WSU ob-gyn residents in training and medical students alike. Barhan is a member of the Wright State Physicians Obstetrics & Gynecology group and a fellow of the American Congress of Obstetricians and Gynecologists.
Mary C. McCarthy, M.D., is Elizabeth Berry Gray Chair of the Department of Surgery at Boonshoft School of Medicine. She is certified in surgery and surgical critical care and has expertise in general and trauma surgery and critical care medicine. She is a Fellow of the American College of Surgeons and a member of the Halsted Society, the Society of Critical Care Medicine, and the American Association for the Surgery of Trauma.
Brenda Roman, M.D., is the assistant dean for curriculum and professor and vice chair for education in psychiatry at the Boonshoft School of Medicine. Roman’s clinical work has focused on the college population and the homeless population. Her scholarly work focuses on medical education, curriculum development, and women’s mental health issues. In 2013, she completed the prestigious Executive Leadership in Academic Medicine® Program for women.
Therese Zink, M.D., M.P.H., is a native Daytonian, and a professor and chair of the Department of Family Medicine at the Boonshoft School of Medicine. Before coming to Wright State, Zink was at the University of Minnesota in Minneapolis, where she served as a professor in the Department of Family and Community Medicine and the Rural Physician Associate Program. Her research interests include domestic violence and rural workforce.