Women increasing in ophthalmic leadership positions but not yet at parity
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In the United States at the last census, 51% of the population designated themselves as female and 49% male.
As noted in the accompanying Healio | OSN cover story, the majority of practicing ophthalmologists today are men. The percent of ophthalmologists who are men increases with every decade of life. In medical school and ophthalmology residency training today, the gender balance for first-year medical students or ophthalmology residents is approaching 50% women. If the future ophthalmology workforce shortage projected by many is not somehow remedied, I project that today’s 18,000 predominately male ophthalmologists will evolve to only 12,000 ophthalmologists who will be 50% to 55% women. It will be an amazing challenge for this small group of ophthalmologists to provide quality care and advocate for our fellow citizens’ growing vision needs.
There is a sustained trend toward greater gender diversity in ophthalmology. As I have stated in prior perspectives, we are doing better in gender than we are in race, as we have a significant lack of Hispanic, Black/African American and Native American/Alaskan/Pacific Islander ophthalmologists.
I thought it would be interesting to look at three organizations in which I have personally dedicated decades of leadership: Minnesota Eye Consultants, the American Society of Cataract and Refractive Surgery and Healio | OSN. I was especially interested in leadership by women in these organizations and publications.
First, Minnesota Eye Consultants (MEC), which I founded in 1989. I served as the managing partner of MEC for the first 15 years. There have been a total of six managing partners at MEC in our 35 years, and two of them have been women. In our first decade, MEC added five new partner-track ophthalmologists, and only one was a woman. Since then, we have hired an additional 10 partner-track ophthalmologists, and five have been women. At MEC, we employ an ophthalmologist-led integrated eye care delivery model of practice with MDs, ODs and physician assistants (PAs) practicing side by side. Thirteen of our 19 OD/PA eye care professionals (ECPs) are women. Including all ECPs, MD, OD and PA, we are well more than 50% women. In addition, our support staff is primarily women. In our practice, male and female ECPs are paid using the same reimbursement formula, and our highest-compensated MD and OD are both women. If we are a model for the future eye care practice, women will dominate in the delivery of eye care and be fairly compensated.
Next, a look at women in leadership starting with the ASCRS, in which I have been a member since 1978, am a past president and today serve on the Executive Committee. ASCRS has elected 39 presidents since inception, and only four have been women. The first 16 presidents of ASCRS were all men. In the early years, ASCRS leadership was clearly male dominated.
Today, there are 12 members of the ASCRS Executive Committee, and three are women. The Leadership Committee has eight members, and again three are women. ASCRS has 12 Clinical Committees, each with a chair, and this is where the future Executive and Leadership members and ASCRS presidents are mentored and developed. Currently, six of the 12 ASCRS Committee chairs are women. ASCRS is committed to increased gender diversity, and this once male-dominated organization is actively recruiting and supporting women leaders.
Finally, a brief look at Healio | OSN and the Journal of Cataract & Refractive Surgery, two examples for editorial board participation by women.
Ocular Surgery News was founded in 1982, and the first Chief Medical Editor was Donald Sanders MD, PhD. I served as a founding Associate Medical Editor, and initially, we had 31 Editorial Board Members, all men. In 1993, we expanded the OSN Editorial Board to 42 and added our first woman. In 1996, I assumed the position of Chief Medical Editor, and we focused on increasing the diversity of our Editorial Board. Today, we have 37 women as Healio | OSN Editorial Board Members. One woman, Elizabeth Yeu, MD, is an Associate Medical Editor, and five women, Kendall E. Donaldson, MD, MS, Nicole Fram, MD, Preeya Gupta, MD, Wendy Lee, MD, and Allison Shuren, JD, MSN, are Section Editors. Women are finding an increasing place at Healio | OSN.
Another example is JCRS, the official journal of ASCRS and ESCRS, for which I also serve as an editor. JCRS has 50 editorial board members, and 12 are women. This journal has employed six chief editors since inception, and all have been men. One of two current associate editors is a woman, Lillian Werner, MD, PhD. While male editors dominate at JCRS, female participation is increasing.
Medical school, internship and residency training participation has achieved gender balance today between men and women. Retiring ophthalmologists, which number between 500 to 600 per year, are predominately men, and their replacements are predominately women. Balance between male and female ophthalmologists in clinical practice is increasing and will likely approach parity in a decade or two at most. Women today are still underrepresented in society leadership and on editorial boards, but their representation is growing. I expect increasing mentorship, many positive examples to follow and an increasing willingness to serve will enhance future gender diversity among our society leaders and editorial board members.
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