ASRA Pain Medicine Update

Oct 30, 2019, 12:59 PM by Vivian H.Y. Ip, MBChB, MRCP, FRCA

 

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Medicine has come far in moving toward gender equality; however, we still have a long road ahead. ASRA recently created the Women in Regional Anesthesia Special Interest Group for like-minded practitioners to meet and collaborate. Other societies such as the International Anesthesia Research Society (IARS), the Association of University Anesthesiologists (AUA), and the American Society of Anesthesia are recognizing the need for more open discussion by having panel sessions in their annual meetings. The American Medical Association also holds a Women in Medicine month in September, and this year’s theme is “Celebrating Our Legacy, Embracing Our Future.” The British Journal of Anaesthesia is planning a special edition on women in anesthesia to foster openness and diversity.

 

I recently had the opportunity to interview Dr. Jeanine Wiener-Kronish and discuss how we can do more to promote a healthier environment in terms of gender equality. Dr. Wiener-Kronish has served as the chief of anesthesia, critical care, and pain medicine at the Massachusetts General Hospital in Boston for many years. She has been in multiple leadership roles, including AUA president and founding member of the Academy of Anesthesia Mentors. She is also the recipient of the Elizabeth A. Rich Award from the American Thoracic Society, which recognized her dedication and contributions to the field of lung disease research and commitment to functioning as a female role model and mentor.

You are recognized as a leader in anesthesia. Can you outline your role and your journey? What are the qualities of being a good leader?

I started out as the second female pulmonary fellow at the University of California, San Francisco. However, there were no salaried jobs for me in the department of medicine at the end of my fellowship and lab experience (four years of research with funding). After doing further research into careers and interviewing with multiple anesthesiologists, including Dr. Ronald Miller, I decided to do another residency in anesthesia. Dr. Miller and my anesthesia colleagues were incredibly supportive of my goals. I think the choice of a job must include a supportive leader and staff. It was the best decision I ever made, except marrying my husband—that was equally a great decision.

For all of those reasons, my legacy had to include support and mentoring my residents and faculty, and I hope that is one of my recognized abilities as a leader. A good leader has to be transparent, fair, and supportive. Other important qualities are an ability to effectively communicate with all faculty and leaders, and having kindness for all.

What has been a defining moment for you in your career?

Having a mentorship award named after me. 

How do you gain support and recognition from your department and colleagues? Do you think male and female faculty have different levels of support or sponsorship?

Gaining support requires not only achievement but helping others. Many people help themselves. But leading a department or other entity requires generosity. Women are traditionally viewed as nurturing and supportive, and they sometimes need mentoring in developing traits like dealing with conflict and making unpopular decisions.

Did you have a strong mentor? Any advice on seeking mentorship? What makes a good mentor-mentee relationship?

I had many mentors—both men and women. I think multiple mentors for different aspects of one’s career is essential. Don’t be afraid to ask for advice and help.

Why do we need more women in medicine?

We need more female role models. My dream is a profession in which both men and women are free to achieve to the best of their ability. Unfortunately, we are not there yet.

Leadership requires time and the ability to accept some unpleasant tasks, such as sometimes telling friends they are not doing their job well enough.

Women need to plan to be leaders so they can acquire the skills and necessary support, including child support and familial support, to make it work. Like all positions, it takes planning and effort. Men often ask for support from their wives; women need to do the same. My husband has been the best mentor and supporter I ever had. My parents also helped with child care, and now my husband and I help our daughter with her son.

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Women need to plan to be leaders so they can acquire the skills and necessary support, including child support and familial support, to make it work.

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Why do you think the gender gap is lessened at medical school, yet leadership roles are still male dominant? The theme for this year for International Women’s Day is “Balance for Better” in support of gender balance. What do you think is the most effective way for an organization to foster all types of diversity and inclusion in our specialty and to embrace our differences and values?

We need to constantly work to improve diversity in every way. During the 2019 AUA and IARS annual conferences, we had meetings on how to improve our diversity and leadership. Two female anesthesiologists, Dr. Maya Hastie and Dr. Megan Lane-Falls, will work with the dean of diversity at Columbia University, Robert Whittington, on a survey of anesthesia organizations to identify what we can do to improve diversity in membership and in our leadership. This is a great step in fostering diversity.

What are your thoughts about the #MeToo movement in medicine? Is it going to bring culture change? Should we have more in the way of wellness for women in medicine? How can we protect and support women and motherhood in the workplace? How do we say “no”?

The #MeToo movement is changing medical culture, perhaps faster than it ever has moved. That said, everyone in medicine needs to be devoted to patient safety—and that involves cooperation and collaboration, which has not always existed. This needs to be achieved without insults and harassment. Given the years of hierarchy and bad behavior in medicine, we also need to be aware that this process may take some time.

Also, total equality does not exist when patient care is involved—trainees should be aware of their lack of knowledge and be respectful to those with more training, including nurses, when patients’ outcomes are at stake.

Women need to have paid parental leave—but so do men. Saying “no” is ok and at times necessary; it is also helpful to let others complete tasks if they may benefit more from them. However, as mentioned previously, timing and getting support will also help more women become leaders. Female physicians in Sweden and Denmark leave work for a year or more for childcare and then may have trouble coming back and becoming leaders; sharing childcare responsibilities may be a solution. We cannot say yes to everything, so it is important to prioritize the many roles we all have: patient care providers, team members, academic mentors, and family members.

Any advice for our current trainees or junior faculty, especially women, to become more involved in national or international organizations and perhaps in leadership roles?

Because each person is different, no ideal answer exists. Finding the right support in a spouse, in a family, and at work is essential for success. Women at the 2019 AUA and IARS meetings stayed after the women’s breakfast and did some networking—that is really a successful use of time. Reaching out to mentors, both men and women, is key. We all need to keep working on these issues to improve them.