Women in Pediatrics: Progress, Barriers, and Opportunities for Equity, Diversity, and Inclusion

Abstract

Gender bias and discrimination have profound and far-reaching effects on the health care workforce, delivery of patient care, and advancement of science and are antithetical to the principles of professionalism. In the quest for gender equity, medicine, with its abundance of highly educated and qualified women, should be leading the way. The sheer number of women who comprise the majority of pediatricians in the United States suggests this specialty has a unique opportunity to stand out as progressively equitable. Indeed, there has been much progress to celebrate for women in medicine and pediatrics. However, many challenges remain, and there are areas in which progress is too slow, stalled, or even regressing. The fair treatment of women pediatricians will require enhanced and simultaneous commitment from leaders in 4 key gatekeeper groups: academic medical centers, hospitals, health care organizations, and practices; medical societies; journals; and funding agencies. In this report, we describe the 6-step equity, diversity, and inclusion cycle, which provides a strategic methodology to (1) examine equity, diversity, and inclusion data; (2) share results with stakeholders; (3) investigate causality; (4) implement strategic interventions; (5) track outcomes and adjust strategies; and (6) disseminate results. Next steps include the enforcement of a climate of transparency and accountability, with leaders prioritizing and financially supporting workforce gender equity. This scientific and data-driven approach will accelerate progress and help pave a pathway to better health care and science. Gender bias and discrimination have profound and far-reaching effects on the health care workforce, delivery of patient care, and advancement of science and are antithetical to the principles of professionalism. In the quest for gender equity, medicine, with its abundance of highly educated and qualified women, should be leading the way. Because women comprise the majority of pediatricians in the United States, pediatrics has a unique opportunity to stand out as progressively equitable. Indeed, there has been much progress to celebrate for women in medicine 1-7 and pediatrics. 3,4,7 However, many challenges remain, and there are areas in which progress is too slow, stalled, or regressing. 8-14 Moreover, women with intersectional identities (ie, simultaneously belonging to multiple underrepresented groups, including gender, race, sexual orientation, ability, age, or socioeconomic status 15) may experience heightened levels of bias and discrimination, sometimes called a "double bind." 16 Therefore, this report focuses on persistent disparities and highlights key a Executive Leadership in Academic Medicine Program,

Ensuring Equity in Compensation and Career Advancement for Female Physicians

“…First, as shown by the authors, commitment cannot be tacit and must be coupled with action. A recent precise appraisal 7 examined statements about gender equity from various pediatric organizations and then tabulated the number of women subsequently elected or appointed to their councils, boards of governors, and Csuites. The actual numbers showed little if any improvement in gender balance.…”

“…The actual numbers showed little if any improvement in gender balance. 7 Secondly, the compensation model must be definitive, preferably based on national standards, and broadly understood among the faculty. In circumstances in which women may be especially disadvantaged because of labor force characteristics such as work hours and subspecialty, equitability and fairness may be more likely achieved by a total compensation model without in-built incentive pay, other productivity-based bonuses, or differences in nonsalary benefits.…”

Recognizing and addressing implicit gender bias in medicine

“…Institutions have issued statements on the importance of gender equity, and impressive organizational programs have provided networking, mentorship and leadership training to support women's careers. 1 However, women remain underrepresented in senior faculty and leadership roles in academic medicine, comprising only 22% of professors, 36% of associate professors and 24% of medical school deans in Canada as of 2016/17. 2 Women physicians still have fewer opportunities for promotion, fewer opportunities to publish, lower pay and less funding for research.…”

Gender differences in research reporting

“…Although detailing solutions to eradicate gender inequity more generally is beyond the scope of this editorial, we espouse a scientific and data-driven approach and refer readers to a vast body of research, largely led by women, which consists of many studies that are novel, seminal, and ground-breaking. Summary reports of these studies help to synthesize and disseminate the literature on interventions to promote equity in medicine 910. Intentional efforts are needed to fairly acknowledge women’s contributions.…”