Female physicians can change the landscape by caring for themselves, other women
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MIAMI — Women in gastroenterology should know what they bring to an institution and to a practice, quantifying their worth and furthering the path for other women to join the field, a presenter at Scrubs & Heels Summit 2022 said.
“It’s not just equal pay. ... It’s knowing your return on investment, the big picture, the value of attracting more patients. We need to sell ourselves in these contexts,” Maria T. Abreu, MD, AGAF, director of the Crohn’s and Colitis Center and professor of medicine, microbiology and immunology at the University of Miami, said during her presentation. “We have to make sure our environment meets our needs: ... the screen brought down, the smaller scope. We have to advocate for ourselves and take care of ourselves.”
The gender divide
“Women fellows are more likely to be single, not have children, and alter their family planning,” Abreu said. “We have seen the enemy and it’s ourselves.”
She cited a study showing that 73.3% of respondents felt leave was inadequate, 47.3% of physician first-time mothers did not take maternity leave at all and another 28.3% only took a portion of what was offered. Even among those who had two and three children, more than 40% did not take any maternity leave. This may be attributed to the similar percentages who reported maternity leave was entirely unpaid.
This trend may continue into practice when returning, hindering a woman’s ability to succeed within medicine, Abreu said, citing another study that showed women were more likely to step back from leadership roles and prioritize their family over work and how the current pandemic further divided female physicians from their male counterparts.
“We have had this Galapagos-inducing evolution in technology that is going to ultimately liberate us,” she said. “Why can’t we now — because of Zoom and telemedicine — be more flexible? It’s only a matter of creativity.”
And creativity is where women can stand out and show their worth, she added.
The gender pay gap
In light of the recent Physician Compensation Report showing female physicians make on average $122,000 less than men in medicine and, in gastroenterology specifically, more than $86,000 less, Abreu called on the audience to change that and “know your worth.”
“We need to close the pay gap,” she said. “It’s up to all of us.”
Recent studies show that colonoscopies performed on women take 8.8% longer for all endoscopists (P<0.001) and of the colonoscopies female endoscopists perform, 71.2% are on women while male endoscopists are more evenly split, performing 50.8% of colonoscopies on women (P<0.001). The authors hypothesized this could account for 9.6% revenue loss per 8 hours of endoscopy time for women in the field.
“Patients want women gastroenterologists to do their scopes ... but women’s colonoscopies take longer than men,” Abreu said. “This is about return on investment. We need more women in practice, because more women are going to want to come to see us. We are better doctors.”
Anecdotally, Abreu said she hears this from patients and data shows that having a female physician can also improve patient outcomes.
“Being conscientious is much more important than being intelligent. You only kill people when you don’t care,” she said.
This is the data women in gastroenterology need to move the needle on compensation, because they can prove their worth.
“Monetize our worth,” she said. “You are going to attract a different practice ... people who may have otherwise gone to the practice next door.”
The path, pipeline for women
With multiple societies in gastroenterology, the incoming pipeline of women in gastroenterology has an outlet and many opportunities to both take hold of leadership roles and see the representation of women in those roles.
Looking at gastroenterology departments at academic institutions, Abreu cited a study showing just 19.4% of leadership roles are held by women — an underrepresentation of the nearly 30% of gastroenterologists who are women. Private practice, she said, may be even harder to quantify as the “rules” and expectations are not as transparent compared with academia.
“It’s a subliminal message that we send when we have women faculty with whom people might identify attract other women,” Abreu said. “Who is on your faculty? Who is going to stand up for them? Who is going to set that path forward?”
In the years to come, there will be two female presidents of the AGA with Barbara Jung, MD, AGAF, and Abreu, who will overlap with both a Black female president of the ASGE with Jennifer Christie, MD, and a female president of the ACG with Amy Oxentenko, MD.
“We have this trajectory of women, and my hope is that the three of us together will do something that’s focused on women to make it easier. No one has to suffer because we had to break some barriers,” Abreu said. “We can help the field in the broad way and hardwire some of these things we’ve been talking about,” such as parental leave and equal pay.
“We define our future. We define our future in a personal way ... and then the collective,” Abreu continued. “It’s the long game ... We are up here telling our story as if we knew it was all going to work out well. As if we had this grand plan. But the issue is the grand plan to be here took time. It took delayed gratification along the way.”
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- Andersson KL, et al. Dig Dis Sci. 2022;doi:10.1007/s10620-021-07079-y.
- Dillon EC, et al. J Gen Intern Med. 2021;doi:10.1007/s11606-021-07134-4.
- Jamorabo DS, et al. Ann Gastroenterol. 2021;doi:10.20524/aog.2021.0597.
- https://c8y.doxcdn.com/image/upload/v1/Press%20Blog/Research%20Reports/Doximity-Compensation-Report-2021.pdf
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