For the second year in a row (and the second time since 2004), more women than men applied to U.S. medical schools, and the majority of new enrollees to medical school are women (51.6% versus 50.7% in 2017). CSA’s current active membership is 30% women (953 members), and our resident members are 38% women (290 members). Women make up 27% of the active ASA membership and 28% of total ASA membership. Neither the CSA nor ASA have much data on how many women are practicing full-time or part-time, nor in what practice models.
At the recent CSA Annual Meeting in San Diego, Christine Doyle, MD, FASA, Linda Hertzberg, MD, FASA, and I asked women attendees to join us for an exploratory session to hear about their challenges and needs as women physicians. Many issues were identified, both expected and unexpected. These included, mentoring, practice management skills (contracting, negotiation skills, valuing your worth), dealing with disruptive and aggressive personalities in the workplace while maintaining professionalism, resiliency, work life balance, and flexible work hours. Many of you may be wondering why it is important to know these things.
According to the Association of American Medical Colleges report of 2015, women residents were proportionately underrepresented in anesthesiology along with surgery, emergency medicine, and radiology. We want to recruit the best and brightest to anesthesiology, so we need to be able to compete and attract more women to our field.
We are already in the midst of a physician anesthesiologist shortage which will worsen if we cannot successfully fill our programs. Both CSA and ASA need to have significant resources to advocate for our profession successfully - and that requires everyone’s participation as a member of both societies.
Corporate America expects an employee turnover rate of 12-15% per year, which includes retirement. Poor retention translates to significant economic losses irrespective of the practice model. Significant costs are incurred for repeated recruitment, on-boarding, site training, and paying premiums to locums to cover shortages. The cost to replace a single physician is estimated to range from $200,000 to $1,000,000. One medium sized corporate entity reported a 27% turnover rate which cost an additional $15 million dollars in production losses over the expected amount.
The benefits of creating a welcoming work environment with financial and practice management education, mentoring, flexible hours, family time, and transitional work tracks will promote stability and loyalty to the practice of anesthesiology, and not just for women. We need more data on a national and state level by practice model, gender, flexibility, payor mix, leadership structure, and location to see what factors make a positive impact and where we can advocate for improvement.
The ASA recognized how this gender shift will affect the long-term strength of our specialty and established an ad-hoc committee on Women in Anesthesiology, chaired by Dr. Hertzberg to better understand the issues and roadblocks affecting women anesthesiologists and how to address these issues during the various stages of their career. The committee’s work was presented to the ASA Board in March 2019 with the recommendation that it be made a standing committee by a vote of the House of Delegates meeting in October 2019. ASA has asked the state component societies to help discover issues peculiar to their state or practice models and explore solutions. Common themes may be championed by the ASA on the national level as more data is obtained.
By supporting the needs of women physicians, providing targeted practice resources, and creating new flexible work models, we will improve wellness, satisfaction, longevity and loyalty to our sites and to the profession of anesthesiology. Please join in the conversation within the CSA on how we can best serve our women members by sharing your thoughts and ideas by emailing firstname.lastname@example.org.