Women physicians are a testament to evolution; they’ve spent years, decades even, navigating through systems that do anything but cater to their unique needs, and actually find a way to thrive within these systems.

My question is this: Why haven’t these systems really evolved with them? It’s now been 167 years since Elizabeth Blackwell became the first woman to graduate with a medical degree in the United States. Nowadays, just shy of 50 percent of medical students are women. Yet we still struggle with issues like maternity leave, pumping at work, asking for days off when the kids are sick, and career advancement; only 15 percent of academic department chairs are women and only 22 percent of tenured professors are women.

Trust me, I take a lot of pride in what I do, and find it incredibly fulfilling. I feel really fortunate to have a job that I love and a wonderful patient base, and to have had great colleagues and mentors. I think we (female physicians) all do, or we wouldn’t put ourselves through things like taking call when 39.5 weeks pregnant or voluntarily staying late for an emergency add-on, even if it means missing our child’s first soccer game. Or pumping in the MRSA-ridden hospital bathrooms because we’re afraid to ask for our — ahem, legally mandatory — nursing rooms. So gross.

Somehow, though, in doing these things, we’ve set up a system where a male attending who rearranges his schedule to make his child’s school play is praised, while the pregnant female physician stresses about asking to come in an hour late so they can go to their OB appointment.

There are obviously lots of issues at play here, but at the heart of it, I think we as females have been too scared to assert ourselves as women because of the following reasons:

1.We believe that we have to behave like a male to succeed. We’re not all built the same way, and have different strengths.  Are the male physicians trying to do everything we — on average — do better? (Studies have shown that we are more likely to follow evidence-based guidelines, score higher on care and quality, and tend to show more empathy and are perceived as better listeners.) Just as we use our other personal strengths to succeed, we should use those unique to our gender — like our ability to multitask.  While I know plenty of amazing male physicians, what percentage of them are performing as complex of a balancing act at home as the average female doc?

2. We fear that any complaining will be perceived as laziness or being difficult. Somehow we think that a male physician can complain about anything and everything, and it’s even humorous and results in change, but we think that if we do it, it’ll be used against us and be the subject of conversation once we leave the team room.  Throw in the fact that by nature, we like to please people, and we’re a lot less likely to point out unfair treatment and push for that salary bump or new title.

3. We think working part time or asking for altered schedules will make people think we don’t take our jobs seriously, and will contribute to our lack of professional success. These things can actually provide us with the energy we need to care for our patients and juggle all the multitasking more efficiently. Not to mention that happier physicians get better patient satisfaction scores, and physician retention/professional outcomes are far better when a female is given opportunities for a flexible or reduced work schedule.

4. We feel like talking about things like pumping or our kids will either gross our male colleagues out or make them think medicine isn’t our first priority. But we bite our tongues when they tell their inappropriate stories all the time (yes, you all know what you’ve been forced to listen to). This is the reason med student and resident forums are littered with worried posts about how to deal with pumping during lengthy board exams. It’s 2016: This shouldn’t be the source of more stress than the exam itself.

5. We seethe silently when patients and other hospital staff (including other physicians), don’t realize that we are physicians, but are afraid we’ll sound stuck up or catty if we address it. When was the last time you were referred to as a nurse or a social worker (and the male medical student with you was assumed to be the doctor)? I respect the professions I’ve been mistaken for; that’s not the issue. However, I do find the underlying sentiment behind assuming only males can be doctors to be indicative of a more serious problem, and we as females need to find (tactful) ways to reply.

Unfortunately, there is some truth in the consequences of doing these things. But there are enough of us to change that. Let’s not apologize for ourselves all the time, or be afraid to ask for what we need to make our lives work. This is not a call to arms or an attack on male physicians; they have their own attributes that make them invaluable to the system. Rather, it’s a plea for female physicians to recognize that we are smart, dedicated, and caring, and we also have a lot to contribute to our patients and our employers as women.

A change in culture requires women physicians to acknowledge that we are different from men and have different priorities — and to assert that these qualities contribute to the medical system instead of detract from them.

Nisha Mehta is a radiologist and founder, Physician Side Gigs and the Physician Side Gigs Facebook group.  She can be reached at her self-titled site, Nisha Mehta, MD, and on Twitter @nishamehtamd. 

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