AUSTIN, Texas — Women in endocrinology are grappling with multiple, accumulated disadvantages that complicate their changing roles, including gender differences in compensation, promotion rates, negotiation tactics and patient expectations, Ann Danoff, MD, said during a presentation here.
Speaking at the fourth annual women’s leadership luncheon at the American Association of Clinical Endocrinologists Annual Scientific and Clinical Congress, Danoff said there has been progress in the number of women entering medical school. Seventy-one percent of endocrine trainees are now women. Yet, many women across specialties often have a shared experience of feeling disenfranchised, she said.
“We must engage and, I will dare to say, demand, institutional support,” Danoff, chief of medical service at the CPL Michael J. Crescenz VA Medical Center in Philadelphia, said. “There needs to be an openness to change, and an embracing of new viewpoints. There has to be transparency about how salaries are arrived at [and] how promotions are arrived at.”
Female endocrinologists face a substantial gender pay gap and gender disparities in career advancement and mentorship opportunities, all the while confronting challenges related to childcare and an often-unbalanced domestic workload, according to Danoff.
“If you are part of a two-physician, heterosexual couple with kids and you happen to be the female part of that couple, you earn, on average, 2% less than women without kids,” Danoff said. “But by contrast, if you happen to be the male part of that couple, you earn, on average, 35% more than men without kids. It’s pretty striking, right? The women are getting penalized.”
Women also face what Danoff called a “visibility gap,” in part because women can be less inclined to forcefully express their point of view.
“I find it pretty common — and I think there is a habit among younger women — to end their sentences with this upward inflection, as if asking a question,” Danoff said. “If you have something to say, just go ahead and say it.”
All of these factors “add up to a self-worth gap,” according to Danoff. “And it kind of wears you down. There is a significant amount of blaming the victim, and I think we need to be very conscious about that.”
To bridge the divide, Danoff said women must do more than “take a seat at the table.” Women endocrinologists must seek out mentors, both formal and informal, and work together to support one another.
“Often you find your mentors in other places” Danoff said. “Importantly, look for peer mentors. And look both within and outside of medicine.”
Women must also consciously work to modify their own language and behavior, and examine their own biases, working to employ gender blinding whenever possible and avoid gender stereotyping in evaluations.
“This is hard to do, because we don’t exactly know what [the biases] are,” Danoff said. “You have to be pretty ruthless with yourself. All of us carry with us unconscious bias. Even me.”
Amplification of women’s voices, Danoff said, is also important.
“If you’re lucky enough to be at a table where there are more than two women in a leadership position, when a woman says something, so she gets heard, acknowledge it and repeat it,” Danoff said. “I think that really makes a statement.”
“I hope I’ve given you a few ideas,” Danoff said. “They’re just the beginning of things we can do individually and collectively to move the needle and get things to be a bit more equal. We have to think broadly and think beyond our personal gains. How do we do it? We need to work on ourselves. We need to work with others, our friends, our colleagues, our partners and our institutions.” – by Regina Schaffer
Danoff A. Female Physicians and the Future of Endocrinology. Presented at: AACE Annual Scientific and Clinical Congress; May 3-7, 2017; Austin, Texas.
: Danoff reports no relevant financial disclosures.