Category Archives: Family Medicine Stories

The Same Old Problems That Each Generation of Women Face in Medicine

Written by the Women in Family Medicine Collaborative

Recent survey data shows that many of the problems faced by members of the Women in Family Medicine Collaborative are the same old problems that recur for each generation.

Members of the collaborative report that their top concern is addressing disparities for women in medicine, followed by negotiations and salaries, and power and control in the workplace. These self-reported concerns are backed up by numbers. The Association of American Medical Colleges reports that 47% of entering medical students are women, but just 16% of women are in dean positions, 15% are in department chair positions, and 21% are in full professor positions. Only 32% of full-time women faculty are associate professors or higher, compared with 52% of full-time men faculty. Issues of control and negotiation naturally follow from these kinds of power differentials.

The STFM Women’s Collaborative took this information and presented a multigenerational panel at the STFM 50th Annual Spring Conference. The panel helped to frame, contextualize, and put perspective on the problems we encounter today and have been encountering for years.

Dr Candib found a clipping from the late 1980s addressing concerns about negotiation specific to physicians practicing part-time. The concerns highlighted—how to get recognized for call and how to negotiate benefits—would be very familiar to part-time doctors today. One 1989 panel addressed women’s leadership styles, and another spoke to role conflict and empowerment issues for women in academic family medicine. Even after years of working on these problems, we still face them.

It became clear from the discussion that these issues are not unique to the Women’s Collaborative. Dr Candib showed a 6-minute interview with Dr Jeannette South-Paul recollecting her early experiences as a black woman in family medicine and detailing the different choices that women of color may make in their work within STFM. Racism, elitism, and homophobia were the key topics in that same STFM annual conference in 1989. Audience members and panelists connected content from the panel discussion this year to other talks they had attended. Other groups share the struggles of the Women’s Collaborative: struggles for equality, against bias, and for representation in leadership.  

Though we have a feminist perspective on these struggles, we do not own the solutions to them. Too many of the annual conference discussions happened as ours did: in a conference room big enough for 40, with another discussion about a similar struggle happening 90 minutes later in another conference room with 40 different people.

Incoming STFM President Stephen Wilson encouraged us to put aside our labels at the closing plenary session. Many of us embrace our labels, but we acknowledge that we share common goals. The Women’s Collaborative had good success at collaborating internally to produce the panel, and next, we hope to collaborate externally. We would like to join efforts with other groups doing mutual work to promote common goals. 

The Women’s Collaborative will work to address the leadership needs of women in STFM and within academic family medicine during this academic year. We will actively seek out other STFM collaborations or individuals who share these goals. Where one voice or one face experiences less bias, we all benefit.

Family Medicine Residents Are Underutilized Resources for Quality Improvement

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Dan Nguyen, MD

I think it’s time for family medicine to rock the boat. Family physicians, and especially family medicine residents, are uniquely qualified to promote quality improvement by standardizing patient care processes.

As a family medicine intern at an urban academic institution, these past 6 months have been a blur of rotations. Every 4 weeks, we start a new service and drink from a fire-hose of learning the intricacies of “how-to-be-a resident.” Our intern training is the most diverse; we rotate through inpatient services in OBGYN, pediatrics, family medicine, internal medicine, general surgery, intensive care, and the emergency department.

For inpatient services, there are common tasks that all residents perform. We answer pages, place admission orders, write progress notes, discharge patients, sign-out the patient lists, etc. We have access to the same electronic medical record, the same resources, and are unified by an academic institution.

What dawned on me is that every service seems to coordinate patient care completely differently. Every 4 weeks, I would re-learn how to do the same types of tasks but with different methodology. The most glaring disparities I noticed were in how different services handle transitions of care, especially patient sign-out.

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The Energy and Courage to Try New Things: My Memories of STFM Conferences Over the Years

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John Frey, MD

I have been attending STFM meetings since 1972, when I went to my first meeting as a resident, and have missed only three since that time. Those first meetings are all a jumble in my memory but mostly I remember feeling as if, somehow, I had found sanctuary, at least for a few days each year. Everyone was busy with the work of starting a career without a roadmap, making it up as we went along and comparing notes at the annual meeting. I suppose I had the idea that STFM meetings would have “the answers” but as one of my early residents said, it took me a few years to realize that there were no “answers”, just more questions and that was as it should be.  I would go home with my head full of possibilities. Fortunately, that feeling has never left me.

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