I love America Ferrara’s monologue in Barbie. Similarly, the impossibility of being a woman in medicine, as so clearly stated in Dr. Jennifer Lycette’s recent essay in KevinMD, absolutely resonates with me.
And yet, let’s not forget that in 2021, two of five practicing physicians were women, with certain fields including (my own) dermatology, internal medicine, and pediatrics having a female predominance. Studies support that these female physicians have better patient outcomes than male physicians. The trope of the male physician and female support staff is behind us. Nevertheless, stereotypes and implicit bias are tough to reshape. Because of this, the road can be difficult to impossible at times, but our active presence every day is changing the traditional patriarchy of medicine.
Of course, I’ve had and have times when I don’t think I’m good enough. There are ups and downs, but I try to embrace that showing up each day proves that I am good enough. Grades, honors, and accolades neither make a good physician nor prevent medical errors. We will all make mistakes because no one of us is perfect. We are all only human. Let’s affirm that “good enough” is fully championing Suzanne Koven’s words, “You are not a fraud. You are a flawed and unique human being.”
I acknowledge that it is harder for women (and even harder for minority women or other underrepresented groups) in medicine, but you and I can both do this, especially together. What is literally impossible is to be a one-woman island in medicine. Doctors need patients, for one thing. And we need colleagues and mentors and sponsors and advocates and support staff. We need a community that believes in us being good enough.
I am lucky to have a female mentor, someone who is internationally recognized and who believes I am good enough. As part and parcel of that, she encourages me to be assertive. Early on, she told me to ask to be promoted. She also said that if I got any pushback, I could mention her name to protect myself from appearing overly aggressive or ambitious. Her belief and support protected me. It is hard for me to imagine being where I am without her.
And I am lucky not just to have one mentor who believes I am good enough – I have had at least ten others in my career so far, both male and female. I have learned from them not only how to navigate the patriarchy of medicine but also that I can dress the way I want because they do. I am a leader because they have taught me, explicitly and implicitly, tips on how to lead. Sometimes I am bossy, because sometimes they are, too. Sometimes I talk over people (without intending to) like they do. We are all still good enough.
And I am lucky that there have been system changes. I’ve benefited from my group’s standard of paid maternity leave with good cross-coverage. I also did not have to demand equal pay because system-wide, then Dean Alpern of Yale School of Medicine performed an annual review of salaries to address existing disparities in salaries based on gender. While the Dean admitted the system was still imperfect, as evidenced by a 2020 settlement in favor of four female cardiologists at Yale who were paid unequally in 2016 to 2017 compared to male colleagues, there is increasing awareness as well as small and big wins.
Dr. Lycette’s timely article demonstrates that there are still plenty of challenges for women in medicine. Let’s get old together, be rude sometimes (and apologize), brag in circles that will celebrate us, fail and be able to admit it (again, especially in circles that will celebrate us), show emotional intelligence, and face our fears, and get out of line when we need to because the system still requires that. It is tiring, and I get tired. But let’s keep changing the narrative together. We are worth it.
Christine J. Ko is a dermatopathologist.
