Introduction: Women in Medicine Erin Hayes Kelly, PhD,a Florence Rivera, MPH,a V. Fan Tait, MD, FAAP,a Susan Thompson Hingle, MD, MACP, FRCP, FAMWAb

The percentage of women physicians stress and burnout, resulting in early- and mid-career women in the United States is increasing, as increased wellness among women physicians (the WEL “cohort”) who women currently make up 35% of physicians. Furthermore, as the next engaged in networking and training the active physician workforce but generation of health care leaders, around wellness, equity, and nearly half of all US medical school there is also a need to empower leadership over the course of an 18- graduates.1 Although progress has women with skills in leadership and month curriculum. Expert national been made in increasing the number equity. Developing and promoting faculty from these organizations of women in medicine, equity issues these skills can help accelerate addressed intersectionality remain, as women physicians report changes in a medical culture that throughout their presentations and having less control over day-to-day currently disadvantages women. discussions. Seeking “to describe how aspects of their work, are often race, class, gender, and other compensated at a lower rate, In 2018, the American Academy of individual characteristics “intersect” experience more challenges in the Pediatrics (AAP), American Academy with one another and overlap,”9 balance between work and home life, of Family Physicians (AAFP), intersectionality offers “a lens and are more likely to report American College of Physicians through which you can see where burnout than their male (ACP), American College of power comes and collides, where it counterparts.2,3 Furthermore, women Obstetricians and Gynecologists interlocks and intersects.”10 This physicians with multiple identities (ACOG), American Psychiatric interdisciplinary supplement was that have been historically Association (APA), and American created to highlight the issues faced marginalized and excluded, including Hospital Association (AHA) formed a by women in medicine and those who identify as Black, partnership to develop the Women’s disseminate the portfolio of learnings Indigenous, and/or people of color Wellness through Equity and that resulted from the WEL 8 (BIPOC), experience additional Leadership project (WEL). curriculum. disparities in terms of pay and Collectively, these 6 organizations discrimination.4–7 Rooted in were committed to addressing issues As a final contextual point of organizational and societal culture, of equity and leadership for women background, it is essential to these disparities cause stress and physicians by fostering needed and recognize the challenges facing our burnout among women. Working to sustained changes. Funded by the world at the time of this writing (Fall create gender equity in health care Physicians Foundation, this project 2020/Winter 2021). Over the past can help ameliorate this additional convened a diverse group of 18 several months as the coronavirus

aAmerican Academy of Pediatrics, Itasca, Illinois; and bSchool of Medicine, Southern Illinois University, Springfield, Illinois

DOI: https://doi.org/10.1542/peds.2021-051440B Accepted for publication 00 00, 2021 Address correspondence to Erin Hayes Kelly, PhD, American Academy of Pediatrics, 345 Park Boulevard, Itasca, IL, 60143. E-mail: [email protected]. 630-626-6075. PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275). Copyright © 2021 by the American Academy of Pediatrics FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose. FUNDING: Funding for this supplement was provided by The Physicians Foundation. Funding was not provided by the NIH. POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no conflicts of interest to disclose.

Downloaded from www.aappublications.org/news by guest on September 27, 2021 PEDIATRICS Volume 148, number s2, September 2021:e2021051440B SUPPLEMENT ARTICLE disease 2019 (COVID-19) pandemic wellness among the diverse group of The Path Forward: Using Metrics to has unfolded, the need for support physicians who are women. Promote Equitable Work for physicians has grown Environments discusses how metrics significantly. The pandemic has INTRODUCTION TO THE SUPPLEMENT can promote accountability when rapidly impacted communities, coupled with transparent reporting. The purpose of this interdisciplinary physicians and other health care supplement is to offer a compilation professionals, and health care Innovative Wellness Models to of best practice strategies for systems. Numerous accounts have Support Advancement and Retention supporting diverse groups of women Among Women Physicians presents documented the acute and long- in medicine. Manuscript authors three wellness-oriented proposals to term stress that physicians are include national experts who served promote the professional fulfillment experiencing associated with the as WEL faculty and members of the and well-being of women physicians. pandemic, both professionally and inaugural WEL cohort. The 8 articles personally. included in this volume address Women’s Wellness Through Equity and Leadership (WEL): A Program However, like the trajectory of many of the current challenges to Evaluation presents drivers of COVID-19 itself, certain groups of improving gender equity and explore strategies for advancing success and areas for improvement physicians have faced even greater from the WEL evaluation findings. threats to their well-being during women in medicine. These articles also represent the breadth of the the pandemic. Women physicians Finally, the supplement closes with WEL curriculum, with some with children are one such group. a Women in Medicine: Call to Action Past research has found that explicitly focused on wellness, from the Chief Executive Officers of childcare responsibilities typically equity, and leadership, and others the 6 inaugural WEL partner fall on women, even women who on topics that span all 3. All articles organizations AAP, AAFP, ACP, work outside the home.11 Many weave in elements of ACOG, AHA, and APA. This call to women physicians with children intersectionality, acknowledging the action outlines several needed have therefore faced additional particular challenges faced by strategies that must become part of challenges as they attempt to specific groups of women. the fabric of medicine to truly create continue work during the pandemic, equitable work environments. State of Women in Medicine: History, either because of a need to separate Challenges, and the Benefits of a from their children to avoid Diverse Workforce offers a historical exposing them to COVID-19 or ABBREVIATIONS perspective on women in medicine because of pandemic-related and demonstrates the importance of AAFP: American Academy of barriers to childcare and/or a diverse healthcare workforce. Family Physicians managing their children’s remote AAP: American Academy of learning. Another group facing Advancing Women to Leadership Pediatrics increased threats to their well-being Positions Through Individual Actions ACOG: American College of includes BIPOC physicians. The and Institutional Reform presents a Obstetricians and COVID-19 pandemic has exacerbated case-based guide to assist women Gynecologists ACP: American College of the significant inequities existing in physicians to navigate common Physicians the US, making the negative effects scenarios that may impact career AHA: American Hospital of racism and discrimination even transitions. more evident, often with devastating Association and fatal outcomes. Furthermore, Building Inclusive Work APA: American Psychiatric Association the racial disparities in COVID-19 Environments discusses the need to BIPOC: Black, Indigenous, and/or positivity and death rates have been dismantle exclusionary systems and people of color compounded by the most recent policies and create environments COVID-19: coronavirus disease rampant and egregious examples of grounded in diversity and equity. racism in the US with accompanying 2019 WEL: Women’s Wellness through calls for addressing racial injustice. Promoting Culture Change Within Equity and Leadership These events have only heighted the Organizations identifies and project need for individual level support addresses the need for culture and training, and organizational and change in medicine with systemic change, to promote representative cases.

Downloaded from www.aappublications.org/news by guest on September 27, 2021 S2 KELLY et al REFERENCES 4. Weeks WB, Wallace TA, Wallace AE. How Equity and Leadership (WEL): a program 1. Redford G, Boyle P. AAMC launches new do race and sex affect the earnings of evaluation. Pediatrics. primary care physicians? Health Aff (Mill- initiative to address and eliminate gen- 2021;148(s2):e2021051440I wood). 2009;28(2):557–566 der inequities. AAMC. January 29, 2020. 9. Coaston J. The intersectionality wars. Available at: https://www.aamc.org/ 5. Weeks WB, Wallace AE. Race and gender Vox. May 28, 2019. Available at: https:// news-insights/aamc-launches- differences in general internists’ annual www.vox.com/the-highlight/2019/5/20/ new-initiative-address-and-eliminate- incomes. JGenInternMed. 18542843/intersectionality-conservatism- gender-inequities#::text=While% 2006;21(11):1167–1171 law-race-gender-discrimination. Accessed 20women%20have%20made%20up,years 6. Saadi A. American-Muslim doctor reflects February 7, 2021 %20of%20experience%2C%20and% on bigotry at some top hospitals, and 10. Columbia Law School. KimberleCren- 20specialty. Accessed February 7, 2021 beyond. WBUR. January 8, 2016. Available shaw on Intersectionality, More than 2. McMurray JE, Linzer M, Konrad TR, at: www.wbur.org/commonhealth/2016/ Two Decades Later. Available at: Douglas J, Shugerman R, Nelson K. The 01/08/hospital-bigotry-opinion. Accessed https://www.law.columbia.edu/news/ November 16, 2017 work lives of women physicians archive/kimberle-crenshaw- results from the physician work life 7. Swindler S. Portland doctor Esther Choo intersectionality-more-two- study. The SGIM Career Satisfaction responds to racism in the emergency decades-later. Accessed February 7, Study Group. JGenInternMed. room. The Oregonian. Updated August 16, 2021 2000;15(6):372–380 2017. Available at: www.oregonlive.com/ 11. Jolly S, Griffith KA, DeCastro R, Stewart A, portland/index.ssf/2017/08/ 3. Schernhammer ES, Colditz GA. Suicide Ubel P, Jagsi R. Gender differences in portland_doctor_responds_to_ra.html. rates among physicians: a quantitative time spent on parenting and domestic Accessed November 17, 2017 and gender assessment (meta-analy- responsibilities by high-achieving young sis). Am J Psychiatry. 2004;161(12): 8. Kelly EH, Miskimen T, Rivera F, Peterson physician-researchers. Ann Intern Med. 2295–2302 LE, Hingle ST. Women’s Wellness through 2014;160(5):344–353

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Downloaded from www.aappublications.org/news by guest on September 27, 2021 Introduction: Women in Medicine Erin Hayes Kelly, Florence Rivera, V. Fan Tait and Susan Thompson Hingle Pediatrics 2021;148; DOI: 10.1542/peds.2021-051440B

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