‘Superwoman,’ ‘Cinderella’ narratives fail to empower women in medicine
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Portraying professional women as superheroes who “do it all” can foster a narrative that can hold them back from career advancement, according to a presenter at the 2023 AWIR annual conference.
“Nothing is more empowering than seeing women educating women and lifting up other women,” Aline Charabaty, MD, clinical director of gastroenterology and director of the Inflammatory Bowel Disease Center at Johns Hopkins Medicine-Sibley Memorial Hospital, in Washington, D.C., told attendees.
Charabaty aimed to challenge what she called the “Superwoman” and “Cinderella” narratives of women in medicine.
The Superwoman narrative forces women to “have it all” and “do it all” even when it is not logistically feasible, according to Charabaty. Regarding the Cinderella narrative, Charabaty said that women often take on more responsibilities without receiving gains in pay or career advancement.
Both of these narratives lead women to say yes to all additional tasks requested by their hospital or employer because they feel their careers will not advance if they say no, she added.
“We need to think about how we, as women, can change these narratives,” Charabaty said.
Some hard facts demonstrate that although 66% of rheumatology fellows are women, just 41% go on to become practicing rheumatologists. Additionally, although 40% of rheumatologists in academia are women, Charabaty reported that women are 50% less likely than men to receive an NIH grant for research.
Moreover, although women and men are equally likely to be the primary investigator in rheumatology research, women publish far less than men overall and are less likely to be senior authors, Charabaty said.
“This can affect our promotion in academia,” she said. “We get stuck at the assistant professor and instructor level.”
Although more women are taking leadership roles at the American College of Rheumatology, awards commonly go to men more than women, according to Charabaty.
All of this leads to one important statistic.
“Women make $38,000 less than men in rheumatology,” Charabaty said. “Over 40 years, that is $1.8 million less.”
There are “simple answers” to some of these issues, she noted. For example, women work 7 fewer hours per week than men, which means less billing and less relative value units (RVU).
“So, it makes sense that we make less,” Charabaty said.
However, that alone fails to explain the entire situation.
Women tend to spend more time with patients because patients tend to share more medical and psychological information with female practitioners, extending each individual visit, according to Charabaty. Consequently, the patients of women often demonstrate better mortality and repeat hospitalization rates than men. However, because they see fewer patients, this does not translate into revenue for the employer, which can inhibit salary and career advancement.
All of these factors have led Charabaty to question whether the superhero narrative is actually empowering. She noted that both the Superwoman and Wonder Woman characters were created by men.
“You are told you have to be strong, you have to be nurturing, you have to save the day every day and come out looking gorgeous and happy,” Charabaty said. “That’s not empowering. It is taking power from us about who we want to be and how we want to be.”
Such rigorous expectations limit flexibility for women, she added.
“It is also isolating, because you are supposed to do it all on your own,” Charabaty said. “It makes you not ask for help.”
All of this leads to burnout.
“But we are also missing opportunities for tangible gain, not going through doors that are open,” Charabaty said. “By doing it all and embracing that Superwoman ideal, we are actually sabotaging our career advancement. We end up with no time and energy to do the things we need to do to advance our career.”
One solution is to use time and energy only for meaningful activities, or those that lead to true fulfilment or career advancement.
“Outline goals and manage your time and energy in a way that helps you to achieve those goals,” Charabaty said.
Learning how to delegate responsibility and say “no” are also critical.
“Delegate to people who are influential or who can elevate the project,” Charabaty said. “And too many yeses will keep you away from the yes that matters.”
Although each individual woman can make these steps on their own, Charabaty stressed that advocating for other women is also important to dispel the narratives on a broader level.
“If you have a seat at the table, pull up a chair for another woman,” she said. “We need to get unstuck from all these ideals and do what is meaningful and important to us.”
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Charabaty A. Women in Medicine: Wonderwomen or Cinderellas? Time to Change the Narrative. Presented at: Association of Women in Rheumatology annual conference; Aug. 10-13, 2023; Orlando, Florida (hybrid meeting).
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