More from September 2013 - Vol. 32 No. 09
Cristina Cabrera-Muffly, MD
Assistant Professor, University of Colorado
Aurora, CO for Women in Otolaryngology (WIO) Section
Last month, while driving my 3-year-old to daycare, he emphatically stated, “Mommy, you can’t be a doctor and a mommy.” This was a complete non sequitur to the prior discussion of trucks on the highway that morning.
Completely taken aback, it took all my willpower not to pull over and address his comment. Instead, I calmly stated that I was both a mommy and a doctor and vowed to repeat this message multiple times in the coming weeks. His statement did get me thinking, however. Is this just “kids say the darndest things,” or does he have a point? As an academic otolaryngologist, can I be as successful and advance in my career as quickly and as effectively as my male colleagues, or does motherhood put me on the dreaded “mommy track” to nowhere?
There has been a lot of discussion about motherhood and career advancement recently. The two loudest voices in popular culture are Facebook COO Sheryl Sandberg through her book Lean In: Women, Work, and the Will to Lead (which reached No. 1 on The New York Times bestseller list) and Anne-Marie Slaughter, whose article in The Atlantic, “Why Women Still Can’t Have It All,” was the most read story on The Atlantic’s website ever. While both argue that societal constructs such as lack of female role models to sponsor changes, the stigma of maternity leave, and impractical school schedules keep women from advancing in their fields, they differ in their opinions about how to solve the problem. Sandberg puts the onus on women themselves, advising them to be more ambitious and aggressive. Slaughter opines that ambition is not enough, and real progress will not occur until the subtle (and sometimes not-so-subtle) stereotypes about working mothers begin to change.
In light of this debate, I turned to other female academic otolaryngologists for their opinions. One woman stated, “There is no such thing as ‘mommy track,’ and I think we have to be careful what women in otolaryngology or any field use as a term to describe what we want.” Another recommended renaming the mommy track to the “integrated career and family track.” No one liked the term “mommy track” and I wholeheartedly agree. If we are to propagate the species, pregnancy and childbirth are a biologic fact for women, not a “track” to be chosen in lieu of a career. By labeling working mothers in this way, we become an easy target for our colleagues to diminish our contributions. After all, women do not leave medicine only for motherhood. No one would think to label an “illness or disability track.”
How do we become both the types of doctors and mothers we want to be? The greatest frustration voiced by many women was the lack of work schedule flexibility. While in medicine we cannot work from home, adjustments in school schedules and operating room schedules would make it significantly easier to care for both our patients and our children. Summer vacations and late school start times are difficult for any working parent, not just female physicians. The ability to be flexible also depends on the home support system. Most women I spoke with who had partners at home attributed much of their success to such assistance.
Another theme was that opinions about female career advancement seem to be a “generational difference, not a gender difference.” One woman stated that both she and her male colleague have young children, and they both work hard during the week but do not volunteer for “extras” such as having dinner with a new faculty candidate or spending Saturday at a low-yield meeting. Most women felt that faculty members early in their careers, whether male or female, prioritize family life more than a generation ago. Another woman commented, “The old guard that worked and neglected their families might not only have it wrong, but their disconnect from society might keep them from being as good a doctor as one with a balanced life. There is value in life outside of medicine, and we are richer for it.”
“Solutions for systems and institutions must meet and improve lives for all, not just one group, and not just for women” stated one. I could not have put it better myself. It is critical to have a supportive chair and mentor who can facilitate these solutions. Subtle departmental cues, like believing that it is okay to go home early to play a round of golf but not to take your child to the doctor, negatively impact every member of the department. Why should chairs and mentors strive to help women find solutions for balancing work and home? The answer is to improve both immediate and future productivity. Women who feel supported will work harder and be more committed to their careers and their departments.
In “Gender disparities in scholarly productivity within academic otolaryngology departments” Eloy, et al.1 show that women produce less research output early in their careers, but meet or exceed this output later in their careers. If women leave before they become a professor, they will never achieve that later career contribution. Secondly, there is a significant potential impact of having a female mentor available to you as a female resident or medical student.
The only way to increase the number of female professors and chairs is to encourage them to step into the pipeline when they are residents. Is it any surprise that in my role as associate program director to a male program director, female residents turned to me first when divulging they were pregnant? In my case, the male program director was just as supportive as I was, but as a woman who had just had a child, they felt more comfortable approaching me about how to announce their pregnancy to the department. When they confided in me, I always told them the road would be difficult, but it was still possible to achieve their goals in their career. The keys are to work as hard as possible, find good help at home, and don’t let anyone have low expectations of you. In short, they, too, can be both a doctor and a mommy. Hopefully, some day, my son will understand this, too.
Eloy JA, et al. Gender disparities in scholarly productivity within academic otolaryngology departments. Otolaryngol Head Neck Surg. 2013 Feb;148(2):215-222.
Dates to Remember
Go to http://www.entnet.org/conferencesandevents to see a full listing; to list events, email email@example.com.
September 29-October 2
AAO-HNSF 2013 Annual Meeting & OTO EXPOSMCoding and Reimbursement Workshops
September 13-14 – Minneapolis, MN
October 25-26 – Las Vegas, NV
November 8-9 – Chicago, IL
Instruction Course and Miniseminar – Call for Papers is open. Masoud Saman, MD, with
Claude Douge, MD
Having completed my surgical internship at Saint Vincent’s Hospital (affectionately known as “Vinny’s”) Manhattan, NY, the year its doors were permanently shut, I feel compelled to ponder the life of a man whose portrait hung by the elevators and whose anecdotes I heard each time my attendings remembered that I was an OTO-HNS resident. The portrait’s subject was the prominent surgeon, musician, and gentleman from Pennsylvania, who spoke with a noble accent and whose charisma enlightened any room: John Joseph Conley, MD.
After receiving his medical degree in 1937, Dr. Conley started residency at Kings County Hospital in cardiology. Soon after, he was diagnosed with paroxysmal atrial tachycardia and was advised to switch to a less demanding specialty: otolaryngology.
His years during World War II in the U.S. Army Medical Corps in the South Pacific, working alongside plastic and maxillofacial surgery colleagues on reconstructing traumatic head and neck defects, gave him the experience that proved to be instrumental in his rise as a leader and innovator in head and neck and facial surgery upon his return to New York.
Dr. Conley was known to be eloquent and captivating. Once as the defendant in a case, he told the court that he would summon himself to the stand as the expert witness. He dressed handsomely and walked with authority. At Vinny’s, he worked with Ricardo Bizi, MD, the son of an Argentine otolaryngologist, and Robert C. Eberle, MD, of Geneva. Among his many unsalaried fellows were Peter Cinelli, MD, and Stanley M. Blaugrund, MD, with whom Dr. Conley chose to have surgery himself.
Dr. Conley’s contributions to head and neck surgery and facial plastic surgery ranged from novel techniques and approaches in cancer extirpation, to various flaps in facial reconstruction, and more. He paved the way for the new generation of otolaryngologists interested in these subspecialties. It is upon the shoulders of giants like Dr. Conley that we stand and proudly represent our field.
The John Conley, MD Lecture on Medical Ethics was founded in his name, and is delivered during the Opening Ceremony at every AAO-HNSF Annual Meeting & OTO EXPOSM.
Celebrate the Specialty’s History with Us
Marc D. Eisen, MD, PhD, cordially invites Academy members and their guests to the next meeting and reception of the Otolaryngology Historical Society (OHS), in Vancouver’s historic and elegant Vancouver Club, taking place in conjunction with the 2013 Annual Meeting & OTO EXPOSM.
Date: Monday, September 30, 2013
Time: 6:30 pm–8:30 pm
Place: Vancouver Club
Room: Bar Room III
An informal reception will follow a short program of presented papers on a variety of historical topics about the specialty.
Marc D. Eisen, MD, PhD, president, Otolaryngology Historical Society Welcome and Introductions
P. Ryan Camilon, BA, University of South Carolina Medical School “Vestibular Experiments Conducted in Space”
Amit A. Patel, MD, University Medicine and Dentistry of New Jersey “Thyroglossal Duct Cysts, Elephantitis, and More: the Different Sides of William E. Sistrunk”
C. Eduardo Corrales, MD, Stanford University “Otologic Anatomical Advancements in 18th Century England—or Lack of: the Case of William Cheselden”
Lanny G. Close, MD, Columbia University “Medical Education in America: the Impact of the Flexner Report over the Past 100 Years”
OHS members receive advance notice and a complimentary ticket for the evening reception. To renew your OHS membership dues of $50, please email firstname.lastname@example.org.
For OHS members who wish to bring a guest, there is a fee of $85 per guest ticket. If you are not an OHS member, but wish to attend this event, there is an $85 fee. Please email email@example.com for RSVP information. The AAO-HNSF 2013 Annual Meeting & OTO EXPOSM will convene at the end of this month in the beautiful city of Vancouver, BC, Canada. The setting, off the gorgeous Strait of Georgia and Vancouver Bay, will be truly inspiring. The trip to one of our northern neighbors’ most impressive cities will no doubt enlighten the international audience of otolaryngologists, residents, scientists, and administrators. We encourage all AAO-HNS members to register and take full advantage of the research presentations, miniseminars, clinical courses, and the always-informative OTO EXPO while in Vancouver.
The international flavor of this year’s meeting gives us the opportunity to look at our healthcare delivery system from a global perspective as we work to fully understand, and to mold, the details of healthcare reform. The changes currently underway ensure our healthcare system will demand that we adapt appropriately to these changes, and work to ensure our ability to provide the best care possible to our patients and their families.
Your BOG and the AAO-HNS are poised to help guide you through the myriad changes that have already occurred as a result of the Affordable Care Act (ACA) and will work to inform you of the further changes that await us in the coming years. The BOG meetings, in conjunction with related miniseminars being held during the Annual Meeting, will give members multiple opportunities to be informed about our changing healthcare system and to evaluate the impact of these changes on providers’ practices.
The BOG kicks off its events beginning on Saturday morning, September 28, with its Rules and Regulations Committee, Legislative Representatives Committee, and Socioeconomic and Grassroots Committee meeting sessions. These committees will discuss topics including pay-for-call, maintenance of hospital privileges, and acquisition of practices by hospital systems, as well as current legislative issues. We will have reports from the regional BOG representatives giving us an update of the current issues affecting their component local societies.
The regionalization of the BOG state and local societies is a modification of the BOG structure that was initiated more than a year ago. The BOG regions match the HHS regions that we are all familiar with. This regionalization will help solidify the conduit for the free flow of information from the local societies to the Academy and back. This regional approach will be vital as local issues related to healthcare reform, and/or local state legislative challenges occur. Changes are occurring swiftly and our ability to gather information and respond will be vital as we work to properly influence these changes.
Also on Saturday, there will be a BOG luncheon seminar where C. Brett Johnson, MD, the associate director of the Center for Medical and Regulatory Policy for the California Medical Association, will talk to us about Health Exchanges and the implications for our practices.
The Physician Payment Policy (3P) workgroup, in conjunction with the BOG, will present a miniseminar at 10:30 am on Sunday, September 29, called “Alternative Payment Models and Academy Advocacy for Physician Payment: What You Should Know.” Michael Setzen, MD, will moderate this discussion, which should be timely and relevant. There will be an additional miniseminar at 8:00 am on Monday, September 30, to prepare members for the transition to ICD-10 in 2014.
The BOG Executive Committee-sponsored miniseminar will take place at 8:00 am on Tuesday, October 1. This year’s seminar will address the impact of Accountable Care Organizations (ACO)s for the otolaryngologist practice. BOG Secretary Wendy B. Stern, MD, will moderate the seminar and our guest speakers will include Raymund King, MD, JD, who will talk to us on the legal implications of an ACO, and C. Brett Johnson, MD, who will be addressing physician concerns when considering joining an ACO. We hope to see many of you there and the panel will be ready to take your questions.
The obstacles we face every day in both the academic and private practice setting can be daunting as costs rise and reimbursement drops, making our goal of excellent patient care, delivered in an efficient manner, a challenge. Informing our members and responding to their needs is why the BOG exists. Our plan is to consistently provide our members with the most current information regarding the ever-changing healthcare landscape. We encourage all of you to make the trip north and enjoy the hospitality of our Canadian neighbors. Your BOG will help to provide you with the tools you need to navigate the healthcare rapids that may lie ahead in our home waters. See you soon in Vancouver!