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Women in rheumatology. the event at the american college of rheumatology annual scientific meeting in october 1992

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SPECIAL ARTICLE
WOMEN IN RHEUMATOLOGY
The Event at the American College of Rheumatology
Annual Scientific Meeting in October 1992
BEVRA H. HAHN
The need
One of every 6 current members of the American College of Rheumatology (ACR) is a woman
(based on my survey of the 1992 ACR Membership
Directory). None of the 5 officers and none of the 3
council “chairpersons” are women. One of the 20
members of the Board of Directors is a woman (again,
figures based on the 1992 Membership Directory). I
estimate the number of women trainees in rheumatology to be 1 in 3. According to a program entitled “The
Glass Ceiling” telecast on Cable News Network recently, 1 of 2 employees in the workplace is a woman,
compared with 1 of 20 in the boardroom. The need
seems clear. Women in the ACR, as in other workbased organizations, are looking for evidence that they
belong to the entire group-not just in the trenches.
Women struggle with multiple issues, and the
struggle can be quite lonely. Some needs are obvious.
Affordable and accessible day care for our children
near our workplace is essential. A work schedule that
provides meaningful off-time to share with all family
members-parents,
spouses, siblings, children-is
needed. Equal pay for equal work seems obvious, but
it still eludes many women. Sexual harrassment is a
common experience, and few women believe that
there is any true redress. Beyond these eminently
reasonable needs, we wonder if we should have additional, special, considerations that allow us to fulfill
our roles at home as well as in medicine and science.
If we ask for special programs (mainly, reduced work
schedules), do we deserve to ascend the power ladder?
Bevra H. Hahn. MD, FACR: Professor of Medicine and
Chief of Rheumatology, University of California Los Angeles, and
Member, American College of Rheumatology Planning Group.
Arthritis and Rheumatism, Vol. 36, No. 7 (July 1993)
Do professional women really want to be Chief Executive Officer, Dean, Head of a Group Practice, Chairman of a Department? Or is the work of the leader not
important enough, compared with raising children or
making a home, or giving personal service to someone
in need, to be desirable?
In our current setting of rapid societal change
(we women are doubtless here to stay in medicine and
science), there is a need for a group that allows
important issues to be addressed. A first step toward
addressing this need was provided by the ACR during
its 56th Annual Scientific Meeting in Atlanta last
October.
The planning
The idea of a session specifically for the women
of the ACR was born in the mind of Gale McCartyFarid, MD, FACR, who is currently Chief of the
Division of Rheumatology at King Faisal Specialist
Hospital and Research Center in Riyadh, Saudi Arabia. She approached the leaders of the ACR and asked
for a designated meeting time at the 1992 meeting. A
breakfast hour was set aside on the first day of full
meetings, in the Georgia World Congress Center,
where attendance could be maximized. Several other
Fellows of the ACR contributed to the planning,
including Drs. Evelyn Hess, Naomi Rothfield, Mary
Betty Stevens, Deborah Kredich, Marilyn Pike, Lee
Simon, Herb Kaplan, and the author. Ms. Sherrie
Cathcart, Director of Education for the ACR, was
instrumental in making all the arrangements.
We asked for an honorarium for a speaker, long
after monies had been designated for other parts of the
program. Again, the leadership was enthusiastic, and
WOMEN IN RHEUMATOLOGY
the honorarium was provided. The planned theme for
the program was “Time Management,” and we would
feature a guest speaker and a panel of ACR members
(all physicians). We balanced the panel to represent
women in practice and in academics, women with
children and without, women who are their own or
their family’s sole support and women who are married to a working spouse, as well as women who are
young and those who were once young. All of the
panelists we selected had served or were then serving
on an ACR committee, and/or were consultants to the
federal government on women’s issues in science and
medicine. Thus, each woman had successfully combined career, extra-career duties, and working for the
ACR or the National Institutes of Health (NIH). Every
person invited to be on the panel accepted with
enthusiasm: Interest in this activity was high.
So, the program was assembled. All that remained was the concern that no one would come,
given the unattractive hour of 7 AM on the first full day
(Monday) of the annual meeting.
The event
People came. We counted 403, of whom 396
were women-mostly trainees and members of the
ACR and the Arthritis Health Professions Association
(AHPA). The rolls ran out at 7:06 A M ; the coffee ran
out at 7:10 AM. We sent for more.
Dr. McCarty chaired. Lucy Davidson, MD,
was our speaker. She is a psychiatrist in private
practice in Atlanta who specializes in problems of
adolescents and women. She is on the faculty at
Emory University Medical School, consults for the
NIH, and publishes on such problems as suicide in
adolescents. Her topic was “Time Management: Problems and Solutions for Women in Medicine.” The
panelists were Drs. McCarty (academic medicine),
Elizabeth A. “Betsy” Tindall (private practice of
rheumatology), Mary Betty Stevens (academic medicine), Patience H. White (academic pediatrics), Robin
K. Dore (private practice of rheumatology), and the
author (academic medicine).
Here is a summary of some of the suggestions
gleaned from the program.
We are Physicians, Scientists, Researchers, Business Persons, Educators, and Leaders-Not “One Of
The Girls.” Be in charge of your office, of the subgroup of your practice in which you specialize, of your
research laboratory, of your clinic. Be in charge of the
professional and personal aspects of your life. Learn
89 1
to negotiate. Look and act like a professional. The fact
that our numbers are increasing is no guarantee that
our influence, especially in traditional leadership roles,
will increase. There are many countries in which most
physicians are women, but very few of the leaders in
the medical profession are women.
Designate time for each activity you need and
want to do, and stay with the plan as much as possible.
The plan should not be interrupted for things that are
not important to you. Feel free to say “No” to things
outside the plan-no excuses needed, just “No.” The
medical community should make accommodation for
part-time training, practice, or research to allow for
time at home. If you need such a program, ask for it.
Don’t let work pile up and overwhelm you: Do
the necessary things promptly. Dr. Davidson recommended that we open our journals over the wastebasket, tear out only articles we really want to read, and
throw the rest away. And, read the tear-outs within 2
or 3 days, or throw them away also.
Make your time off work truly off. This is
particularly important if you have children, who need
help with homework, carpooling them to activities,
etc. You need time to be available to them when you
are not also available to patients. Plan leisure time that
belongs just to you.
Your time at work can usually be made more
efficient, allowing time for your other activities. Panelists’ suggestions included computer programs that
provide quick access to patient data and allow recording of notes during the visit (or promptly after). When
you leave the office, you need not take paperwork
home. Talented, reliable office and business managers
are essential to maximizing office efficiency, thereby
allowing you more time away.
Choose a work situation that allows you to maximize productivity in the time spent with professional
activities. If beginning a research career, it is easiest at
a large, research-oriented institution that is rich in
well-funded scientists and is dedicated to protected
time for young investigators. If beginning a practice, a
group that is large enough to provide cross-coverage
for the protected time out of the office may be better
than staking out an individual practice, unless you
have excellent office management and support in the
physician community that will allow you protected
time from a solo practice.
Be at peace with your roles. We cannot do
everything to the best of our abilities at all times.
Abandon that idea. We should do what we can do in
the 24 hours allotted to each day. Be satisfied with
892
achievements; grieve briefly over defeats. Move
ahead.
The future
Open discussion followed the formal program.
This portion ran beyond the allotted time. I had the
strong sense that this type of forum was needed. There
is a widespread sense of frustration, of anger, of being
overwhelmed by demands. Many women at all levels
feel they are neither treated fairly nor credited appropriately for their talents and work. There are many
impediments to our success. Some are peculiar to
women; others are experienced by both men and
women.
The following suggestions grew from the discussion.
1. An organized activity of this sort should be
considered for future ACR meetings. The focus for the
next program might be “How to Negotiate.”
HAHN
2. There is a need for interaction with role
models and for counseling by appropriate experts to
deal with individual problems among the women
members.
3. Consider establishment of an organization
akin to the Council on Rheumatologic Care (CORC),
which would address the concerns of women in the
ACNAHPA. Perhaps the ACR should establish a
network of local ACR women-again, using the CORC
model. The purposes of the network would be to (a)
provide a resource that directs women to supportive
local medical practices, academic programs, financial
organizations, health maintenance organizations, biotechnical companies, etc., and (b) provide information
regarding appropriate responses to such issues as
harassment, unequal pay, and impediments to promotion. Our numbers may presently be too small to
sustain such a program, but are not too small to begin
discussing the options.
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