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“I know I am not alone in my thoughts; I am just echoing sentiments of other female physicians. We are mothers, wives, patient advocates, and educators. And we’re all suddenly finding ourselves in unchartered waters. In weathering this pandemic, I’ve taken time to reflect. I wish I could say I emerged from this introspection having conquered all my fears. Instead, I have discovered the immense strength it takes to be vulnerable. I can admit I do not have all the answers, and the uncertainty of tomorrow gnaws at me. I also know that despite the upheaval, I wouldn’t trade my job for anything in the world.”
Shweta Akhouri is a family physician.
She shares her story and discusses her KevinMD articles, “I have discovered the immense strength it takes to be vulnerable.”
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Shweta Akhouri. She’s a family physician, and she wrote the KevinMD article “I have discovered the immense strength it takes to be vulnerable.” Shweta, welcome to the show.
Shweta Akhouri: Thank you so much for having me.
Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today?
Shweta Akhouri: So where I am today reveals the culmination of what I’ve envisioned for myself all my life. Growing up in South Florida, I always knew I wanted to be a physician. I left Miami to pursue medical school and then residency training. I did my residency training at the University of Louisville in Kentucky. I graduated in 2018, and then immediately after, I took on a faculty position with the same residency program.
I really love academic medicine. I’m very passionate about it, and I really enjoy working with medical students and residents. Just recently, I decided it was time to move back home. So as of last month, in July, I moved back to Miami in the middle of the pandemic, while Miami was the world’s epicenter, and started a new job. I’ve taken on a new position as full-time faculty here with Florida International University’s Herbert Wertheim College of Medicine.
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Kevin Pho: And how has the pandemic affected both you and your practice?
Shweta Akhouri: It’s really affected every arena of my life. In my personal life, I think the care for my infant and my husband, who’s also a front-line physician seeing COVID patients as a hospitalist, has always been a big concern for me. We’ve gone months without seeing any family or friends, because we always considered our household to be high-risk and never really wanted to expose anyone else to us.
And then in my professional life, again, I feel like everything else in the past few months has taken a back seat. I was serving as medical director for our family medicine clinic, so it was up to me to come up with protocols to keep our staff safe, our clinic safe, our patients safe. I was constantly educating myself on management of COVID patients so I could learn how to take care of these patients that we were seeing in the hospital, at a time when guidelines and management were changing almost daily, and then also disseminating that information to my trainees.
Just overnight, I felt like we all had to become experts in telemedicine and perform telehealth, so that was a huge adjustment. And again, not only did I learn for myself, but I also had to train my colleagues and residents on telemedicine. And now that I’ve moved to Miami, our entire faculty here is really trying to figure out how to teach medical students, first, second, third, and fourth year, via Zoom, which is again a huge adjustment. How do we teach clinical skills via Zoom? Because in Miami, we still aren’t quite ready to safely reopen.
So it’s really been a big adjustment in so many ways, and I’ve been really amazed to see how well every physician I know has learned to adapt, and how we’ve just quickly reframed our minds around everything we knew about practicing medicine and have been able to adapt to deliver the best care for our patients and still train students and residents in the best way possible.
Kevin Pho: I’ve had several medical educators on my show, and I always like to ask this question. Do you have any advice that you can give to medical students and trainees, especially as you’re progressing through the pandemic?
Shweta Akhouri: It’s difficult times for everyone. As faculty, as somebody who was involved in the process of interviewing medical students for med schools and interviewing residents for residency programs, I understand that knowing that everything is going to be done remotely this fall can be very scary and anxiety-provoking. But just understand that we’re all here for you. We understand this is unprecedented. You will end up where you need to be and be very successful in your career, regardless of the situation that we’re currently in.
Kevin Pho: Great. So let’s get into your KevinMD article, “I have discovered the immense strength it takes to be vulnerable.” Now, for those who haven’t read your article, can you walk my audience through it and share the story of why you decided to write it?
Shweta Akhouri: Yeah. So in a nutshell, I wrote this article in a journal-style format, just highlighting the challenges of myself, really, during this pandemic as a female physician. The goal for this article was for other female physicians to be able to read it and hopefully find some support, some comfort, and solidarity in knowing that they’re not alone.
To give you a little bit of background, I’ve always been very interested in educating myself and speaking up about the challenges of women in medicine in general. I remember during training and med school, I had some wonderful attendings that trained me, but I never really had a strong female role model to look up to. So when I took on a faculty position, I really wanted to be that role model for my trainees, and I really want to be someone that constantly empowers female physicians.
So fast forward to the pandemic. As medical director, I found myself in meetings really every day, talking about our strategies for COVID-19. And in between these meetings, I was having sidebar conversations with my residents and other female colleagues about what each of us was doing for child care and how we were concerned about bringing home an infection to our elderly parents or loved ones. And unfortunately, even though that was always at the forefront of my thoughts, you know, care for my baby and my husband, it was never on the agenda for any of these meetings. So that’s kind of why I decided to write this article, because I knew I wasn’t alone in feeling that way, and I felt like other physicians could also relate.
There was something really unexpected and beautiful that actually came out of this process. One of the things I do highlight in this article is the strength that it takes to be vulnerable, and as I was writing it, I realized that I needed to practice what I preach. So I did actually call a meeting with all of our colleagues, where we all kind of sat down. I shared with them my struggles, my concerns, and my fears and encouraged them to do the same. I reached out to my residents and encouraged them to share with me as well, or even just vent if they needed to. And I think it just ended up being a really nice small exercise in actually being vulnerable in the workplace, which was really nice, and I knew that it kind of brought us all a little bit closer.
Kevin Pho: Now, you mentioned some of this already, but I was wondering if you could go into more detail. What are some of the obstacles that female physicians face today in the medical field?
Shweta Akhouri: So there are so many, and I think the obstacles have obviously been around prior to the pandemic and will continue to be there. Some of the things that I have talked to my residents about and held seminars about are just knowing about the gender wage gap, just understanding that that exists. Understanding that we as women typically have trouble negotiating when it comes to salaries and benefits, so just being OK with that and just giving, you know, residents tips on how to be better negotiators. So that’s something we’ve talked about.
The imposter syndrome is very strong, and I think a little bit stronger in female physicians, especially when you’re first starting out as junior attendings or faculty members. So just talking about those things and making them aware that these exist. Those are some of the things that we’ve talked about.
Kevin Pho: What can medical institutions, medical schools, hospitals, what are some specific things that they can do to address some of these issues female physicians face?
Shweta Akhouri: I think the first step would probably be to create a safe environment where females feel like they would be supported in bringing up their concerns, whether it be about their personal lives, private lives, or issues that they may be facing, discrimination in the workplace from other colleagues. I think that’s probably the first and most important step that medical institutions can take.
I think it’s important to be aware that these disparities exist and talk about them openly, rather than just brushing them under the rug. And then as educators, I think we should always just constantly be empowering our residents and medical students in general just to speak up if they feel that they’ve been discriminated against and harassed.
Kevin Pho: One of the things I really liked from your article was the concept of embracing vulnerability, and I like the fact that you did call that meeting to address some of these concerns. Now, for those female physicians who may be listening to this podcast, what are some ways that they specifically can embrace vulnerability?
Shweta Akhouri: I think first and foremost is removing the stigma from the concept of vulnerability, and understanding that showing vulnerability is not a sign of weakness. In fact, it’s actually a sign of strength. It takes a lot to put yourself out there. I think oftentimes we’re so caught up as female physicians in just trying to be perfect and stoic, you know, because we feel like we have to keep up with our male counterparts, and we don’t want to give anyone a reason to ever say anything, or anyone to doubt our abilities.
So I think the first important step would be to just understand that there is no stigma to it and that it’s actually welcomed. And just a small example would be, you know, like we called a meeting, and I know my colleagues would have been supportive. I was not surprised that they were, but it’s just that we’re just so hesitant oftentimes to bring it up. But try to find ways to do that.
Kevin Pho: We’re talking to Shweta Akhouri. She’s a family physician, and she wrote the KevinMD article “I have discovered the immense strength it takes to be vulnerable.” Now, over the past few months during the pandemic, what are a few things that you’ve learned over these few months that you could pass on to some of the other physicians who may be listening to you here on this podcast?
Shweta Akhouri: There’s so much I feel like I’ve learned. I think for me, I was always aware of the gaps in the health care system, but what this pandemic has really done is expose them as glaring holes in the system and really expose the severity of some of these problems. So, you know, from PPE shortages and the supply chain, to understanding the severity of the disproportionate impact that illness can have on minorities, to really seeing the mistrust that’s been festering in the population for the health care system and physicians, and kind of seeing that exposed. I think those are the things that I’ve really learned, among many other lessons in this pandemic, that going forward, hopefully we can address some of these issues as we start to rebuild.
Kevin Pho: And my final question: Do you have a take-home message that you want to share with the KevinMD audience?
Shweta Akhouri: Yeah, and I would probably just reiterate what I said. I really want my audience and readers to understand that there is no stigma to being vulnerable, and what goes on in our personal lives affects our work life, regardless of our gender. This goes for both males and females. So a mutual understanding between colleagues of these things will definitely make work a happier place for us to be and will translate into better patient care and to us being better healers.
Kevin Pho: Well, thank you so much for your insight and your time, and thank you so much for being on the show.
Shweta Akhouri: Thank you.
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