On a beautiful sunny January day in Foster City, twenty San Francisco Bay Area women anesthesiologists gathered for brunch at the lovely home of Dr. Mona Kotecha, co-hosted by Dr. Kotecha and Dr. Mimi Lee. While dining over a spectacular lunch, we mingled with our peers and discussed the current status of women in anesthesia in our area. Those present came from such diverse practices as Mills-Peninsula Health Services, Summit-Alta Bates Hospital, Kaiser Permanente-Oakland, Marin General Hospital, the anesthesia residency programs at Stanford and UCSF, and independent practice.
As hostess, Dr. Kotecha’s hope was to help inspire women in our professional community to “gather, network, and support each other.” Gracious and positive in her introduction to those present, she mentioned the unique challenges that women anesthesiologists face in the workplace, both physical and interpersonal. “We interact, negotiate, navigate and lead the world differently,” Dr. Kotecha said. “We handle crises differently. [And] we look different to others when we practice anesthesia.”
Dr. Kotecha’s stated goal to, “start a dialogue and get [us] thinking about the ways gender influences the way you practice, interact with your patients, and the way you are perceived by the world around you,” was met with a lively discussion about current barriers to professional self-actualization for women at all stages in their careers. To start the discussion, Dr. Lee opened with a moving account of her recent diagnosis and treatment of breast cancer while simultaneously working to establish her career in private practice. We then heard from members of the audience all who, in turn, echoed a common theme—that often the barriers to successful career advancement for women come from private decisions that seem on the surface to be fair, but are ultimately to the group’s detriment. Examples included a group not accepting a well-qualified female candidate to work part time because the group structure could not design a flexible schedule, and denial of a female partner’s request to broaden her career by shifting to a leadership role in hospital administration while still maintaining some clinical duties. The discussion delved even deeper into anecdotes of gender discrimination and harassment, bullying in the operating room, the existence of the “glass ceiling” in anesthesiology and gender-specific patterns in Bay Area groups’ hiring and advancement.
Of course, much of the discussion also involved the delicate, and often messy, balance between work and family life. We were lucky to have Dr. Patricia Dailey with us, who has indeed “done it all.” We asked her how she did it, and she told us, “In order to keep all the balls up in the air (husband, kids, senior parents, work, ASA, CSA, SOAP, me), I employed the ‘world’ to maintain my sanity.” For her, it was essential to “have a husband who [took] on a lot of the traditional ’mom’ responsibilities.” She stressed that we all need to keep our options open when it comes to career advancement, not to close off opportunities because of family duties, and that one thing will lead to another. In her case, this meant first helping advance the field of obstetric anesthesia (when she first started, all parturients getting C-sectioned received a general anesthetic!), then providing leadership for the CSA, and then accepting the invitation to be director for Norcal Mutual Insurance, all while maintaining a busy schedule in private practice.
And as for us mere mortals? We all agreed, it’s a juggle! Between the job, the kids, the nanny, the nursing, the nights on call, and often, a spouse’s busy schedule, we struggle to maintain that delicate balance. We all expressed the desire for flexibility in the workplace—so that we could continue to keep all those balls in the air while maintaining our clinical skills, learning new techniques, teaching, doing research, and moving into administrative or leadership roles.
We were also fortunate to be able to hear from the residents who attended; for in addition to giving them a chance to socialize outside the operating room, the brunch was in large part designed for them—to help them prepare for life after the relative protection of residency. Their desires for their careers included, maintaining an adequate breadth of practice, receiving and participating in professional support (i.e. ensuring adequate mentoring), and finding a job with some degree of flexibility. Senior resident Dr. Becky Wong said at the conclusion, “The meeting was one of the most eye-opening experiences in all of my residency! I really appreciated the words of wisdom from the women anesthesiologists before us, who were our voices before I knew I needed a voice. It was comforting to know that whatever worries I have, someone else has gone through it and that I am not alone. I believe that women face many challenges in having a strong career and a happy family, but I am confident that things will only get better in the future for all of us.”
We left Dr. Kotecha’s home inspired to continue to network and mentor, to support and coach, to say “yes” to each other when we want to accomplish something that might, on the surface, seem radical or unconventional. We were inspired to help each other to, as Facebook COO Sheryl Sandberg has exhorted, “lean in" to our careers and our lives, as women anesthesiologists.