Female doctors have made progress lately in increasing their leadership, influence and sheer numbers in medicine. But more can be done to harness and highlight the unique contributions that women make in the field. As one female physician says, "Women are humanizing medicine just as it's becoming more technologically advanced and fragmented."

It's September, and on organized medicine's calendar, that means it's Women in Medicine Month.

Yet Maria Minon, MD, actually has some mixed emotions about celebrating women in medicine. As a physician who's shattered a few glass ceilings in her career and watched female colleagues do the same, she appreciates what women have endured in their quest to simply be accepted as medical providers and she knows those struggles aren't over.

But she also sees a different landscape for women in medicine today compared with 30 years ago when she entered medical school--and she wonders if maybe it's time to stop singling women out for praise. "Women would be offended if we celebrated a 'Men in Medicine Month,'" notes Dr. Minon, who is vice president of medical affairs and chief medical officer at Children's Hospital of Orange County. "Perhaps this is something we need to sunset. Perhaps we could have Physician Leaders' Month or Academic Medicine Month, instead of highlighting physicians' gender."

Dr. Minon's comment is an indication of the progress women have made lately in increasing their leadership, influence and sheer numbers in medicine. But clearly it's not the end of the story, because more can be done to harness and highlight the unique contributions that women make in the field, as the female physicians and med students in this article illustrate.

Boosting Education and Leadership
Laura Faye Gephart, a student in the Class of 2009 at Loma Linda University School of Medicine, would like further change to start in medical education. She says it tends to stomp--intentionally or not--on valuable attributes women bring to medicine. Gephart feels that female doctors should be inspired to champion women's health issues and to address problems that women deal with more than men, including domestic violence, sexual harassment and the stressful balance of professional and personal responsibilities. "Women ought to be able to do that better than men, but unfortunately, the structure of medical education does not reward, but punishes empathy, be it with female or male patients," she says.

Even if medical education isn't perfect, women have trampled upon the last barriers to access, changing the demographics at schools nationwide. "When I went into medical school in 1972, my class had 12 women," Dr. Minon says. "The previous class had three." Now, she notes, medical school graduating classes are pretty much 50-50 male-female--and in some schools there are more females than males. Indeed, the American Medical Association reports that 50.4 percent of medical school applicants for the 2004-05 school year were women. That same year, females represented 48.8 percent of med students and 47.1 percent of graduates.

As women have filled the medical schools, they have also begun filling pre-professional and professional physician leadership posts. "You see female residents in areas where you never saw them before," Dr. Minon notes, areas like orthopedics and neurosurgery. Dr. Minon used to be the only woman attending meetings for chief medical officers of children's hospitals. "Now there's another woman CMO in Little Rock, Ark., and one was just appointed at Denver Children's," she says. Still, out of the 40 children's hospitals that participate, that's only three female CMOs--even though most pediatricians are women. Dr. Minon expects the ratio to shift as the current generation of young female physicians reaches the stage of career experience she's attained.

Women's representation in medical school administration and affiliated medical center administration lags as well. But that can improve by integrating women physicians more fully into medicine overall, Dr. Minon suggests. "The change won't occur by gathering women alone," she says. "Women need to participate in meetings and committees with men. Maybe 50 years ago we needed women in medicine in small committees with female-focused agendas because we were diluted in large meetings. But now we need to be in the mix with everybody."

Dr. Minon certainly practices what she preaches. Gov. Arnold Schwarzenegger just appointed her the newest member of the California State First 5 California Commission. And she's chair of the Children and Families Commission of Orange County and on the board of directors of the Ronald McDonald House of Southern California. In addition to her role at the hospital, she is an associate clinical professor of pediatrics at UC Irvine. In May, Dr. Minon was named the 2007 Orange County Medical Association Physician of the Year.

Gephart already hears Dr. Minon loud and clear on the need for leadership. She has served as the LLU delegate and alternate to the Medical Student Sections of the California Medical Association and the American Medical Association. Gephart has also been the CMA-MSS vice chair of chapter development and the AMA-MSS Region 1 community service liaison. Currently, she is LLU AMA chapter vice president and the national AMA-MSS vice speaker.

Balancing Medicine Out
Their leaps in leadership aside, female physicians still find their demanding professional roles are often matched with significant personal responsibilities. And some tired opinions about balancing family and work do linger.

Gephart explains: "As a medical student, specifically one dedicated to organized medicine and community service, I can speak to how frustrating and disheartening it is to have doctors, male or female, imply that I must only work part time or not at all because I will have kids. Women at all levels of education need to be told the truth--that work and family life are not mutually exclusive."

Three times, Gephart recounts, fellow students in her MCAT class asked her if it's really possible to maintain a marriage and pursue a medical education. Her second anniversary is next month; she married two months into her first year of medical school. "It is depressing and infuriating that intelligent, driven young women are being scared away from the practice of medicine," she says.

Oxnard pediatrician Imelda De Forest, MD, is chief of staff at CHW St. John's Regional Medical Center. She's also a physician in private practice, a divorced mother of 13-year-old twins and the primary caretaker for her live-in mother. "My plate is full," she says, in what is surely an understatement.

Dr. De Forest reflects on her various roles: "Before I assumed the medical staff presidency, I had to check with the children's father. I explained that it was a tremendous opportunity for me, but one that would require a huge time commitment, including a lot of time out of town. He said, 'OK, fine. We'll work it out.' And I talked to the kids and explained, 'Here's what's going to happen.' They've been exposed to medicine since they were small children, sometimes waiting with a nanny in the lobby while I checked on patients. They know what Mommy does, and we've always tried to make things balanced, to make it work."

Shaping the Future
Maybe that's the best way to explain what women bring to medicine--an emphasis on trying to make things balanced, to make them work. Many women in medicine, in fact, are using their insider status to shape important changes in women's health, raising awareness among researchers and insurers about the differences between the sexes.

Asma Jafri, MD, chair of the Department of Family Medicine at Riverside County Regional Medical Center in Moreno Valley, says female doctors have contributed to the growing recognition of diseases unique to women--conditions that were marginalized in the past as "all in their heads." Women in medicine "can advocate for female patients and be champions for resources needed for research, access and political advocacy," Dr. Jafri says, citing the lack of coverage for birth control, osteoporosis screening, and cardiovascular disease diagnosis and treatment by so many insurers as a vivid example of the disparities that remain.

"Men were able to get Viagra covered within the first year it came out," Dr. Jafri says. "But women have to wait several years after a treatment is shown to be beneficial before they are able to avail themselves of it with ease. I believe women doctors can advocate for their female patients' research needs and find ways for them to benefit just like the men. Women treat female patients as women, not as female versions of male patients. That's what sets us apart and makes us such valuable healthcare providers."

Another thing that sets women in medicine apart is they tend to downplay what sets them apart, preferring to focus on what makes everyone the same. For example, Dr. Minon says, "Possibly women have more practiced listening techniques, but, of course, there are many physicians, both male and female, who practice excellent listening skills."

Dr. De Forest echoes the sentiment as well. "Women are very hands-on. And we try to put ourselves in our patients' shoes. Of course, I'm not saying men are not empathetic or compassionate. But women have a maternal instinct they bring to practice. When patients present to us, we know they need to know that we understand what they're feeling. Of course, I'm not saying men don't get it."

Male-female similarities are there right from the start, Gephart says, noting that both genders are generally attracted to medicine for the same reasons: the potential to effect positive change; respect; a challenging intellectual career; and a nice lifestyle. The flip side is true, too, Gephart says. "As a medical student, I know both men and women can be attracted to medicine for purely the wrong reasons: money and status. I have met both men and women who should spare future patients the agony of interaction. And I have met both men and women who will connect with each patient as a human, trying to empathize and practice compassionate medicine."

Still, discounting male-female differences too much doesn't make sense since there is clear evidence of women physicians' influence. "I think women in medicine are bringing about very positive changes," Dr. Jafri says. "They are questioning a lot of the old dogma and creating a new paradigm of accomplishing the same goals without the sacrifice that was required a generation ago. They do not have to live up to unrealistic expectations set by the old school. They are setting new professional expectations for everyone in medicine, both men and women. Women are humanizing medicine just as it's becoming more technologically advanced and fragmented."

Sharen Knudsen Jeffries, MD, an otolaryngologist in San Bernardino, is on board with that. "Women bring a feminine energy to the healing dynamic," she explains, "and that's sorely needed in medicine today." Feminine energy--which has nothing to do with gender--is associated with compassion, collaboration, intuition, nurturing and succoring. For the most part, though, doctors learn medicine in a paternal environment. The trouble is that patients, by and large, are looking for healing partners. Dr. Jeffries concludes: "Women can play a role in introducing feminine energy into the practice of medicine. I believe strongly that medicine will change for the better as those female traits are woven into the modern practice of medicine."

FEATURE ARTICLE SIDEBARS

In Her Own Words:
Thelma Korpman, MD, Shares Her Journey in Medicine

Read this doctor's description of her career. If you didn't know she was female, could you tell? Probably not until the end. That's progress. But her comments near the end will remind you that the progress has been fairly recent, and that there's still a way to go.

"I have been in anesthesia practice for 30 years and I have not regretted my career choice for one second. It is a privilege to care for patients, and every day new challenges present themselves in a continuously changing environment. I spent the first 23 years of my career in private anesthesia practice and then moved on to Kaiser Permanente, where I currently practice. My personal lifestyle needs were always satisfied in both practice settings. Kaiser Permanente has given me the opportunity to use all the knowledge and experience I gained during the prior 23 years and apply them to my job of running an eight-room ambulatory surgery center. If I could relive my professional career, I can hardly think of a single change I would make."

She continues: "Men and women physicians are equal partners in the medical field. Throughout my entire career, I never let my gender get in the way of my goals and have consequently enjoyed a completely fulfilling professional life. I do remember getting propositioned during my medical school surgery rotation oral exam. The question posed by the examiner was, 'Your place or mine?' I do remember being asked on the interview for my private practice job how I was planning to get my housework done if I took the job. I do remember that before I was hired in private practice, the surgeons were asked if they would allow a woman to administer anesthesia for their patients. Women in this profession were rare then and, rather than get upset over those little bumps--which now would be sexual harassment--the high road was to be competent and become a leader to make it a little easier for the women who followed."

For the record, Thelma Korpman, MD, MBA, physician in chief at Ontario Vineyard Ambulatory Surgery Center, serves as a delegate to the California Medical Association and is past chair of the District 2 delegation. She is currently treasurer of the CMA Political Action Committee, CALPAC. Dr. Korpman is a past president of the San Bernardino County Medical Society--and was, in fact, the organization's first woman president. She is also involved in the American Society of Anesthesiology and the California Society of Anesthesiology.


Teaching Future Generations:
Doctors, AMA Women Physicians Congress Laud Mentors
Female doctors and medical students agree on the importance of mentoring future generations of physicians.

"It is critical for women in professional roles to mentor medical students who are going to be their successors," says Asma Jafri, MD, chair of the Department of Family Medicine at Riverside County Regional Medical Center in Moreno Valley. "There is the art of medicine that is not written in any textbook that women need to teach junior doctors. They can be role models for students struggling with conflicts about gender identity in the broad house of medicine."

The value of mentoring is reflected in this year's theme of Women in Medicine Month, the annual September event sponsored by the American Medical Association. "Sharing a Passion for Medicine" acknowledges doctors who have contributed to the success of women physicians and provides a chance to thank colleagues or teachers for their efforts. Further, the AMA Women Physicians Congress is sponsoring its first annual Physician Mentor Recognition Program, designed to honor those who have encouraged and guided women physicians. For more information, see www.ama-assn.org/ama/pub/category/2221.html.

Loma Linda University School of Medicine student Laura Faye Gephart believes in the power of woman-to-woman mentoring. "A man cannot know what life as a woman is like," she states. "He may be able to speak about doctoring, and even perhaps empathize with the specific challenges of doctoring as a woman, but only a woman has lived the experience. Thus, she knows intimately the potential pitfalls for up-and-coming female practitioners."

Oxnard pediatrician Imelda De Forest, MD, can speak from experience about the value of a female mentor. Her mother and her aunt were both physicians. "I always thought, 'When I grow up, I'll be a doctor, too,'" she says. "But as I went through pre-med, I started to have doubts. I felt like I wasn't performing up to my expectations. I thought I might not be good enough and that maybe I should get married, have a family and not waste the money on medical school."

But Dr. De Forest's mentors urged her to keep at it until she could make an informed decision about her future. She was, after all, only 15 when she started college. So she kept at it, at first because the only alternative was to drop out and look for a job. "During my third and fourth years, it really clicked that medicine was for me," she says now. "Once I started to experience direct patient contact, that's what appealed to me and kept me going."