Category Archives: Women in Family Medicine Collaborative

Breastfeeding Behind a Bookshelf

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Laura Bujold, DO, MEd

The office is about to open when my office manager—I’ll call her Sally—walks up to me and says, “Did you see the pumping space I made for you?”

“No,” I respond. Sally and I walk in the door to an office that holds two nurse triage personnel. There is a rod with a shower curtain hanging that exposes a 3 x 21/2-foot area at best. One of the “walls” is the bookshelf and the other two walls are the corner of the office. The fourth “wall” is the shower curtain. Sally says she bought the supplies herself, smiles, and then leaves.

I run to grab my pump and pumping bag while panic consumes my confusion. There is no room for my pump. Even in a true office space, I could barely manage enough room for the pump, tubing, flanges, bottles, paper towels, water, and nursing bra, let alone the cooler for the milk.

I move quickly—my first patient will be here soon. I search the office for a small table and I find one in the bathroom; I put it immediately outside the homemade cubicle. I put my pump on the table. The electrical cord to my breast pump doesn’t reach any of the outlets. My heart skips a beat. My patient will be here any minute. I move the table toward the closest outlet. With the breast pump’s electrical cord completely extended and the tubing stretched, my pump is plugged in but it is sitting about 1 foot outside of the cubicle.

In order to breastfeed and meet patient access demands, I am dividing my lunchtime throughout the office day to pump. However, this dedicated pumping time frequently gets booked with patients. When I ask for the patients booked in my pumping times to be rescheduled, I am told “Oh, you can’t see them?” or “Are you sure?” or “But there isn’t another time available in your schedule.”

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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.

Staying Present in Chaos

Sarina Schrager, MD, MS

Sarina Schrager, MD, MS

My house is full of 7th graders; it’s a big party to say goodbye to my son’s friend who is moving away. As I begin to fall asleep over my computer in the home office, I think about the chaotic nature of my job.

Earlier that day I was awoken at 1 am with the news that an obstetrics patient was ruptured, and the resident was going to start Pitocin. Great, I thought, now I won’t have to worry about her anymore and stress out about the planned induction for next week that I probably was not going to be able to go to because of clinic and after-school activities.

I couldn’t sleep after that call, so I went to the hospital at 5 am and worked in the call room until I had to come home to prepare for the 19 children coming to my house after school—all before my patient delivered.

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