Article In Brief
Women neurologists who have participated in leadership training programs with others have found that the ability to connect with others sharing some of the same challenges helps address burnout and promotes a sense of well-being.
Elisabeth B. Marsh, MD, director of the Johns Hopkins Bayview Comprehensive Stroke Center, applied for the Academy's Women Leading in Neurology Program because she wanted to hone her leadership skills. She came away with new skillsets, she said, but also with an unexpected bonus: a sense of camaraderie with the other women in the group.
“From the very first get-together we had, we have been able to hold one another up as leaders and provide support,” she said. “To share experiences with people who have similar backgrounds and challenges—we are trying to raise families and to navigate the political and social situations in our work and in our private lives—I find to be very, very valuable.”
So do other women neurologists. In groups small and large, online and in-person, women neurologists are finding ways to build meaningful connections with professional peers who, without being told, understand their experiences. The connections reduce isolation that can contribute to burnout and improve career satisfaction.
Stephanie Vertrees, MD, director of the headache clinic at Baylor Scott & White–Austin Round Rock region, serves on the planning team for her health system's Women Leaders in Medicine (WLiM) summits and the planning team for WLiM programming in Baylor's Austin-Round Rock region.
“It's been exceedingly positive for me and I think for a lot of other women too,” Dr. Vertrees said.
WLiM events brings women physicians, psychologists, and audiologists in the BSWH system together for peer-networking, leadership skill-building, and mentoring/sponsorship relationships. An April 2019 survey found 85 percent of participants said the programming reduced burnout.
“We hear: ‘This is keeping me in practice,’” said WLiM founder Dawn Sears, MD, division director of gastroenterology at Baylor Scott & White Medical Center-Temple. “And ‘I was thinking about quitting or going part-time or changing professions and now I feel I can do this’ and ‘You guys have inspired me and together we can make it through.’”
Why Women Only?
A National Academy of Medicine discussion paper, “Gender-based differences in burnout: Issues faced by women physicians,” published in May reported what the women physicians interviewed by Neurology Today said they already knew: They experience the same burnout drivers—frustrating electronic medical record systems, administrative burdens, and insufficient staff support—that their male colleagues do, but they face other issues that are unique to, or more common for, women in medicine.
“There are incredible pressures, which are different than my male colleagues, of keeping the house and home running, as well as doing everything here, and answering the nurse's questions, and being fashionable, and never being grumpy,” Dr. Sears said. “And then, of course, there's the sexual harassment and the gender discrimination we endure.”
She started the WLiM, in part, because she saw female colleagues in the prime years of their career moving to part-time hours or leaving medical practice entirely.
“And I would ask, ‘Why are you doing this?’ and hear: ‘Well, I can't do it all. I feel like I have to do it all and I have to do it perfectly,’” she said.
In many neurology settings, there are few women physicians to serve as role models for traversing gender-specific challenges. Dr. Vertrees started her neurology residency as one of three women—one attending, two residents—in a relatively large neurology department. She experienced situations her male colleagues would never face.
“Completely unprompted, a male resident asked me if I was planning on getting pregnant because that would ruin the call schedule,” she said. “That was really inappropriate but I felt I had no one to talk to about it and no recourse because there were mostly men in my department.”
An online survey of members of the Women Neurologists Group Facebook members in 2016 found that 77 percent of 181 respondents reported gender-based discrimination in their current workplace. The most common sources of perceived discrimination were patients, followed by higher-ranking physicians. In free-text responses, women neurologists cited discrimination related to medical expertise/professionalism; work expectations and administrative support; pay inequality; lack of support for advancement to leadership positions; and pregnancy/maternity leave.
The WLiM planning team typically invites a few men—regional chief medical officers, division directors, the CEO—to attend the twice-annual summits so they can learn about the issues that their female colleagues are concerned about. But the events are designed to create a safe environment for women to discuss their challenges, their fears and their bragging points, trusting they will be supported by the other participants.
WLiM leaders model the civility and respect they expect to receive in their professional interactions.
“There is no man-bashing at any of these events, and if anyone starts to go down that road, the rest of us shut them down immediately,” Dr. Sears said. “This is not a zero-sum game. We all win when we promote women, so we strongly protect that environment of safety for women but with complete respect for both genders.”
Connecting Points Proliferate
The second Women Neurologists Group (WNG) conference, scheduled in March, will bring together more than 100 participants for learning and mutual support. One conference track will focus on the new maintenance-of-certification pilot program; the other will focus on leadership development and practice-building.
Kathrin LaFaver, MD, FAAN, a movement disorders specialist and associate professor of neurology at Northwestern Feinberg School of Medicine, is one of the facilitators of the popular WNG social media network, which has grown to include more than 2,700 women neurologists. She expects this year's conference to sell out just like the inaugural event in 2019 did.
“It was an amazing experience to get to meet other women in other systems and other subspecialties, and talk about work struggles, leadership, family, and everyday life as well,” said Cristina M.Cabret-Aymat, MD, director of headache medicine at Baylor Scott & White Medical Center-Temple.
She uses the WNG Facebook group to share her clinical expertise when other neurologists post questions about headache, to seek advice on clinical or professional issues, and to be in community with supportive colleagues around the country.
“When we're busy everyday working all the time, being responsible for our patients and family, we sometimes need to just talk with other women in the same position,” Dr. Cabret-Aymat said. “It does help me to not get burned out. I can go there and see, ‘OK, this is what other women neurologists who are successful are doing. Let's start incorporating some of these recommendations in my daily life and see how I can make things better for me and my team as well.’”
In Texas, local WLiM programming has emerged to compliment the twice-annual all-day statewide summits. In the Austin-Round Rock region, for example, Dr. Vertrees helps organize a WLIM group that meets once a quarter for dinner and activities ranging from a Zumba class to a discussion of a leadership topic. That group spawned a WLiM book club; members read a book—typically a female-centric novel—and meet over dinner to discuss it. Both groups help participants get to know other women physicians in their own communities.
“A big problem, not just for women but for neurologists in general, is that we tend to congregate in our own departments because we are in clinic all day,” she said. “So this is a nice form of fellowship and we are learning interesting things together.”
In the Temple region, Dr. Cabret-Aymat attended a WLiM dinner in which the main highlight was mutual support.
“We just talked about families and kids not sleeping at night and how we manage,” she said. “We talked about referrals and how do we divide our time between personal and work responsibilities.”
At her table, several women expressed their concerns about taking maternity leave. Dr. Cabret-Aymat shared her experience with a pregnancy that had complications and returning to work as a breast-feeding mother.
“I described how I was able to come back full-time with the full support of my department,” she said. “That gives other women confidence to speak up and say, ‘I'm going to take the amount of maternity leave I need.”
The Academy's Women Leading in Neurology program trains participants to negotiate for what they want, manage and lead others with confidence, and develop their own leadership style. During the six-month program, each participant develops a plan to achieve a personal leadership goal, such as getting involving with a professional committee, board, or task force; acquiring or improving a community or subspecialty neurology leadership position; or changing or improving a behavior that will have a positive impact on career success.
Vivien Lee, MD, FAAN, associate professor of neurology at The Ohio State University (OSU), is one of 12 neurologists chosen for the current Women Leading in Neurology Program. A key benefit of the program is being paired with a female mentor who has achieved a top leadership position. Because women are under-represented in the senior ranks of academic medicine, that opportunity is not available to many women neurologists who aspire to leadership positions.
“Gender equity in the workplace, pay equity, childcare issues—these are things that you want to talk to people about who have the same kind of shared experiences with you and have common goals for their careers,” said Dr. Lee, medical director of the Comprehensive Stroke Center at OSU Wexner Medical Center. “It's hard to be introduced to committees or leadership positions outside your institution if you don't have somebody to help you get your foot in the door and this program recognizes that.”
Ariane Soldatos, MD, MPH, director of the pediatric neurology consultation services at the National Institute of Neurological Disorders and Stroke, sought—and received—a slot in the Women Leading in Neurology Program so she can be an agent of positive change.
“What's very important for me to mitigate burnout is professional and personal development,” she said. “In the world of medicine nowadays, there are a lot of things you can see as problems. But being in leadership positions gives you more agency to actually implement changes in your daily practice.”
Seeing the AAN invest in the program is, in and of itself, a signal that professional life for women neurologists can improve, Dr. Soldatos said.
“Sometimes when you look at the disparities and lack of diversity in leadership roles, it can be a bit discouraging,” she said. “But it's really empowering and encouraging to know that the organization really puts their money and their time in this issue. This has made me much more enthusiastic and hopeful of getting more involved in the organization. This program is good for the younger physicians coming up to see.”