Published October 11, 2022
By Dirk Hoffman
Women in medicine were celebrated and strategies to overcome underrepresentation in leadership positions were discussed during the UB DoctHERS Annual Symposium.
At the Jacobs School of Medicine and Biomedical Sciences, UB DoctHERS is a network of female physicians, scientists, faculty, health care professionals, residents and students who address current issues in the medical and scientific fields in order to foster advancement, mentorship and equal opportunities for future generations of women in medicine and science.
This year’s event, conducted on Sept. 29 in the M&T Auditorium in the Jacobs School building, marked the network’s first in-person symposium since the emergence of COVID-19.
The event featured a keynote speech titled “Developing Women Leaders in Health Care,” delivered by Allison Brashear, MD, MBA, UB’s vice president for health sciences and dean of the Jacobs School.
Her speech was preceded by short presentations from three UB DoctHERS members who highlighted some of the work being done in the community.
Lauren M. Kuwik, MD ’08, clinical instructor of medicine and chair of UB DoctHERS, served as the event moderator.
In her introduction of Brashear, she noted “she is an internationally recognized neurologist, accomplished researcher and health sciences administrator.”
“Dean Brashear is a visionary leader whose work demonstrates her enduring commitment to serve the greater good,” Kuwik added. “She is responsible for setting the strategic direction of UB’s health sciences schools while directly leading the Jacobs School.”
“She is a powerful advocate for creating diverse leaders in medicine and was instrumental in creating one of the first national leadership programs in neurology for women and is a lifelong champion of advancing women’s leadership in medicine.”
Brashear began her presentation by highlighting what she called “Allison’s 4 P’s to Building More Equitable and Inclusive Career Pathways” — purpose, pathway, promotion and pay it forward.
“Each of us have a unique path to leadership,” said Brashear, noting she earned her medical degree from the Indiana University School of Medicine and went into internal medicine before switching to the specialty of neurology.
“There were no women on the tenure track at IU at that time,” she noted. “Later, I was the only female department chair at the Wake Forest School of Medicine for a time.”
Brashear pointed out that nearly 80 percent of all the health care and social assistance professionals in the United States are women — over 16 million — and yet there are very few women leaders.
“The pipeline has been full for some time with more than 50 percent women in medical school classes for the past 20 years,” she said. “The only reason we do not have more women professors, or chairs or deans is because we do not have programs to support women in academic medicine.”
Brashear noted that it is not lost on her that she is the first woman dean at the Jacobs School (Margaret Paroski, MD, previously served as interim dean) — pointing out that is only two women leaders at a medical school that has been open since 1846.
Brashear said she is very proud that the Jacobs School has had a significant increase in women in its medical student classes and praised the work of Dori R. Marshall, MD, as associate dean and director of medical admissions.
“She has done an amazing job. Not only has she changed the gender makeup of the school, she has also made a significant impact in the racial makeup of our classes,” she said. “She deserves a huge amount of credit for making sure we move in that direction.”
Brashear said she has been meeting with Jacobs School department chairs and asking them about their plans for diversity and inclusion, their number of women professors, the makeup of their residency classes and their plans for hiring more diverse faculty.
“As for the status of women in the Jacobs School, most of our numbers are a bit better than nationally, but I found the number of women as tenured faculty at 18 percent to be very, very low,” she said. “And we only have 38 percent that are professors.”
“I want to make sure that women see themselves as leaders, see themselves as having any opportunity possible,” Brashear added.
Brashear said the idea of “paying it forward” and focusing on women really came to light in 2019 when the Association of American Medical Colleges (AAMC) issued a statement that read in part “academic medicine has suffered as a result of systemic discrimination and can no longer ignore the large impact that gender inequities have created.”
“We need to neutralize biases,” Brashear said, noting examples such as biased assumptions that women don’t have enough time to be mothers and leaders, and biased actions such as lower pay.
“Women are often treated less formally. How often are you introduced by your first name rather than your professional title?” Brashear asked, before remarking “it happened to me today, actually.”
Brashear also noted resident gender and race discrimination contribute to high burnout rates.
“We need to fix this in medicine because our students see this. They soak everything in,” she said.
Brashear listed examining one’s own biases, improving mentorship opportunities and facilitating sponsorship as ways to close the leadership gap.
“I am a huge fan of mentorship,” she said. “That‘s really important, but I am really passionate about sponsorship. Without sponsors women are less likely to be promoted. Sponsorship is key.”
Brashear said one of the most powerful examples she could provide was her experience at Indiana University when she was in clinic and was told the senior executive dean needed to talk to her right away.
“She talked about this strategic planning initiative and told me she and the dean wanted me to chair it,” she said. “Then she tells me there will be 30 people and you will be one of only a few women and one of the most junior.”
“But she not only gave me that opportunity, she met with me and she made sure I got it done, she made sure I had support to do all the financial analysis. She ran interference when there were people who were not going to be cooperative,” Brashear added. “And that ended up being the clinical strategic plan at Indiana University School of Medicine in 2005. That is an example of sponsorship.”
Brashear said more attention also needs to be paid to recruitment efforts.
“This is an amazing statistic that I have repeated many times,” she said. “When you have only one woman on your final list, the statistical chances of her being hired are zero. It is the same for underrepresented minorities.”
”It is because the people making the decision do not want to select that person who is different,” Brashear noted. “We need to make sure the short lists are diverse.”
“The most important is about paying it forward — mentoring and sponsoring — that is what has made a big difference in my life,” she said.
“And with that I would like to announce the formation of a Jacobs School task force to promote women’s leadership,” Brashear said.
Its charge is “helping to ensure that women advance and have productive lives in academic medicine.” The task force will be chaired by Nancy H. Nielsen, MD, PhD, senior associate dean for health policy.
“My hope is that we will begin to have much more of a focus on advancing women leadership in medicine in the Jacobs School,” Brashear said. “That we will begin to develop programs and move toward having more professors, senior leaders and chairs. This is a first step.”
Kenyani Davis, MD, MPH ’16, an internal medicine specialist who is chief medical officer of the Community Health Center of Buffalo, Inc., was the first of three UB DoctHERS members who gave brief presentations as community panelists.
Davis said she wanted to speak about two topics: access vs. connectivity, and leadership in medicine.
She spoke about caring for community members in the aftermath of the racially motivated mass shooting May 14 at a Tops market on Jefferson Avenue in Buffalo that killed 10 Black people and injured three others.
“How do you care for a community that is already traumatized?” Davis asked.
“When one individual comes into your office you can treat them for high blood pressure or diabetes, but what happens when an entire community is asking us to show up as leaders in health care?”
Davis said the answer was to simply show up and be available for people in need.
“That is the difference between access versus connectivity,” she said. “Access is ‘build a building and they will come,’ you put in beautiful tile and entryways.”
“But when you have a mass shooting like that, how do you show up?”
“It was connectivity to the community. It wasn’t just the physicians that came out. Our CEO and CFO came out,” Davis said. “I stood next to the mental health providers and asked ‘how can we be of service to you?’ That is how you show up.”
“When you are dealing with community medicine it looks and feels different. There are things I have to deal with that I don’t have to deal with in my practice in my office,” she added. “You are so important as female leaders because not only are you powerful and strong, but you are also nurturing.”
“I encourage you all to define how you want to show up in medicine.”
Davis closed by saying she wanted to share something she tells all her mentees.
“I am your moon, not your sun. I’ve had my day in the sun,” she said. “My job is to guide you and the next generation into this and there is enough room for all of us to win. Just because you shine, my light does not dim.”
Katharine V. Morrison, MD ’84, an obstetrician-gynecologist, practiced as a generalist for 10 years before she went to work at Buffalo Women Services in 1998 — just two months before another provider there, Barnett Slepian, MD, was murdered by an anti-choice activist.
She continued working there and eventually bought the facility in 2004. In 2014, Morrison opened a free-standing birth center — The Birthing Center of Buffalo — offering natural out-of-hospital birth. It became the first facility in the country to offer both birthing and abortion services.
Morrison said she wanted to share how the recent Dobbs decision which overturned Roe V. Wade has played a role in women’s health and reproductive options for women in the future.
She said her facility provides first- and second-trimester abortions to Western New Yorkers, reaching clients from a 200-mile radius and is now welcoming patients from Ohio and other newly anti-choice states.
“We are an independent facility and by that, I mean we are not Planned Parenthood and we receive no funding,” Morrison said.
There is absolutely no doubt removing the right to an abortion will increase maternal mortality — the risk of dying during pregnancy in the United States, Morrison said.
“How do we know that? Because maternal mortality in the United States dropped in 1973 with the legalization of abortion through Roe,” she added. “Countries with restrictive abortion laws have higher numbers of women who die from abortions, largely illegal abortions, than those with laws supportive of women’s abortion rights.”
Morrison noted that worldwide, 68,000 women a year die from unsafe, illegal abortions.
“Restrictive abortion laws never stop abortion. They stop safe abortion,” she said.
Morrison said it’s currently safer to have a baby in over 60 other countries than in the U.S., largely because of a Caesarean section rate that is at least three times what is recommended by the World Health Organization.
“A woman is three times more likely to die from a Caesarean section than a vaginal delivery and yet we tolerate a Caesarean section rate of 32 to 40 percent.”
She also noted “the laws in the anti-choice states were written by politicians intent on election, not by physicians intent on care.”
Morrison said that adding women to medicine unfortunately did not make medical care safer for women.
“Women obstetricians are no more responsible for the increase in maternal mortality than their male counterparts, but we have not yet done anything to reverse it,” she said. “We were educated to unconsciously value the fetus over its mother, objectify the laboring patient and acquiesce to brutal, unscientific, unkind and dangerous protocols.”
“In order to correct these horrible inequities, we women physicians have to examine our own misogyny, racism and class bias.”
She is also a champion athlete who gives back to her local high school in Grand Island by encouraging students to consider careers in health care professions with her Amelia Earhart program.
Watt said she has served on many panels where she was the only female.
“People tell me not to worry, that half of medical school classes are women now and women are now on panels, the fight is over, it is done,” she said. “And I can’t stop from laughing and saying ‘Are you kidding me? It is far from over.’ The fight is to all of us, but it didn’t hit home until I had children.”
Watt relayed a story about sitting at a parent-teacher conference with her two daughters, listening to the teacher telling her they were wonderful because they were kind, empathetic and smiled and laughed a lot.
“I said, ‘great, how are they doing in math?’ and the teacher said, ‘well, math is not for everyone.’”
Watt said she was concerned because she knew her daughters were strong in science and loved math.
“It got to me. Because what was celebrated in my daughters — they are kind, personalities, they smile,” she said. “No, I want a tiger. I want my child to lead, to be an example and I want them in front.”
Watt says that’s when she started talking to Grand Island school officials about bringing a panel of experts to talk to students about careers in STEM — science, technology, engineering and math.
“I did it in congruency with Zonta International,” she said, noting the global women’s organization that was founded in 1919 in Buffalo and now boasts more than 27,000 members in more than 60 countries.
“Amelia Earhart did a lot of work in STEM. She’s best known as a pilot, but she was someone who said it’s OK for girls to like aviation, to be good in math. She served as a great beacon of hope.”
The panels Watt puts together for the Amelia Earhart program consist solely of women.
“I have been doing this for six years and every single year one of the students will ask ‘why are all the panelists women?’ and I will say ‘oh my God, are they? I just brought the best in the areas of STEM. They just happen to be all female.”
“You would be amazed at the impact that has. All the moms in the room are applauding. It’s nice to see they understand,” she said.
Watt said her next goal is to bring the program to Buffalo City Schools.
“We can travel to any school district. We can make it a traveling roadshow — women in STEM.”
The UB DoctHERS symposium is made possible by funds from the DW Harrington Lectureship Endowment and the following sponsors: