Women, Take the Stage!

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Increasing the number of women speaking at educational conferences is low lying fruit for addressing some of the gender gap in emergency medicine. Here are some concrete tips to get us started.

Close your eyes and channel your mind to the last big CME event that you attended. You’ve braved the crowded coffee lines and the awkward waves to old colleagues whose names you’ve forgotten, and now you’re sitting in a blue lecture hall listening to a presenter. Got an image? Now, is the speaker in your image a man or a woman? Be honest.

It’s 2016 and the “Mad Men” days of overt gender discrimination are mostly a memory. What we are left with is a bias that is much more elusive. I bet if you were to ask most working women today if they had ever personally experienced a situation in which they were not given a professional opportunity simply because of their gender they would likely say “no.” Similarly, I’d wager that most men (and the occasional woman) who are making hiring and advancement decisions are not purposefully trying to screw over women and truly believe their decisions are gender blinded. The resounding gestalt is “yeah, there may still be a problem, but it’s not with us.”

That’s exactly where popular critical care podcaster Scott Weingart found himself earlier this winter. Weingart, who commands a sizeable social media presence with almost 25,000 Twitter followers, was called out for the lack of women presenters at his popular NYC Resuscitation conference. In response, rather than running from the hot seat Weingart partnered up with UK EM researcher Simon Carley and Dara Kass, co-founder of Feminem.org, to participate in a moderated online discussion about the dearth of national EM female speakers.

The conversation – which can be viewed on FemInEM – was candid, educational and thought provoking. For instance, according to Carley, only about 25% of speakers at the big emergency medicine conferences are women, despite the fact that at least 38% of emergency physicians are women (according to a 2014 study published in Journal of the American College of Surgeons).

Now gender gaps in public speaking may seem relatively inconsequential considering there are still much bigger fish to fry in areas like compensation and advancement. For example, a 2011 Health Affairs Study which factored in specialty, practice type and predicted hours showed an almost 17,000 dollar unexplained difference in the starting salaries of more than 8000 male and female graduating NY state resident physicians (the difference in EM was about 12,500). And a 2014 AAMC report showed that the vast majority (85%) of professors in EM are still men. Really fixing these bigger issues, however, is incredibly complicated and will require a dedicated long term multi-faceted approach. In comparison, achieving gender balance in public speaking is relatively low lying fruit and as a specialty we can facilitate change right now.

So why is targeting CME lecturing actually important? Well, for several reasons. Public speaking comes with a few obvious tangible financial perks such as travel reimbursement, waived conference fees and a possible stipend. But the real advantages arise from the intangible perks. Speakers often have unique access to networking with other well known EM experts and this can lead to future collaborations, increased citations of their work (as name recognition increases) and additional speaking opportunities. All of these things can help a speaker springboard their career and advance professionally.

As members of the EM community, we can easily increase the number of women speaking in high profile EM events. Here are 15 concrete suggestions to start moving the needle.

Strategies for women who want to become public speakers:

  • Demystify the qualities that it takes to be a speaker. Tony Robbins and Oprah were not born at the podium. Like putting in a central line, high quality public speaking is an obtainable skill through intentional practice. If you want to become a better speaker, own the process and get started reminding yourself that the goal is continued improvement not initial perfection.
  • Pick your passion. Become an expert in an area in which you want to be a life long learner. It is much easier to lecture when you are confident that you know more about your topic than 90% of the room. If skeptical listen to Amal Mattu’s interview on Rob Orman’s podcast (blog.ercast.org) in which he talks about how his interest in EKGs segued into national speaking.
  • Study the art of public speaking. Read, listen, analyze and then copy. A good place to start is a Science Of People study that analyzed why some Ted Talks went viral while others fell flat.
  • Practice and seek out feedback. Ask effective speakers who’s style you would like to emulate, for coaching tips. Of note, recognize that actively seeking feedback from a legitimate source is slightly different than overanalyzing unsolicited comments about a given talk. As Simon Carley brought up in the FemInEM discussion, if you want to be a high profile female speaker, expect that as a woman you are more likely to receive superficial or inappropriate critiques about your appearance or possibly even your educational content than your male peers. Although this is unfortunate (it can suck) understand that at least for now this is part of the territory. Scan for comments on how to be more effective in future presentations, and then consciously move on.
  • Stretch your networks. Traditionally women tend to have very small and intimate networks compared to men whose networks are broad and diverse. If you want to get to the national speaking circuit you will likely need to move beyond your natural comfort zone. Get to know your regional educational didactic coordinators and residency directors, go to national meetings and join committees that focus on your area of interest. Let people know that you are interested in public speaking.
  • Invest in social media. Use social media to educate and connect with your audience and as a vehicle to network with other source experts.

For residency program directors:

  • Reinforce that public speaking is an attainable skill that is not gender specific.
  • Provide formalized feedback. Give residents structured evaluations of their required educational talks. As physicians, most of us are occasionally asked to give some type of presentation, teaching residents the basics of how to give an effective presentation and how to use background material appropriately is an important skill regardless of whether they give 10 or 100 lectures post residency.
  • Facilitate additional opportunities. When a resident has identified that they want to become a better speaker help them gain access to additional coaching and speaking opportunities.
  • Support diverse grand rounds speakers. Whether it’s gender or race, residents need living, breathing access to successful people who look like themselves so that they can subtly reframe abstract possibilities into realistic aspirations.

For CME program directors:

  • Examine your current track record. Sometimes the simple process of consciously recognizing patterns can in itself facilitate real change. If historically the vast majority of your conference speakers have been men, decide to include gender diversity as a variable in your next planning session.
  • Include women in your planning committee. From research in other science and technology fields we know planning committees that include both men and women (versus all men) are more likely to produce programs with higher numbers of female presenters.
  • Evaluate your speaker selection process. During the Feminem discussion, Kass was clear that planners need not “dumb” down their standards or jeopardize the quality of a conference by including a speaker who may not be ready for prime time, just because they are female. Rather, she asks that planners consciously expand the current pool from which they solicit speakers, so that it includes additional qualified candidates who just happen to be female. The poster child of an EM program that has done this successfully is the international acclaimed Social Media and Critical Care (SMACC) conference. Their planning committee made speaker diversity a priority and developed innovative techniques to expand their selection process and consequently identify new speakers.

For senior male and female speakers:

  • Be mindful of coaching opportunities. If you are a big name in emergency medicine you also have a bigger responsibility because you likely have the ability to catapult the careers of individuals behind you. Use this power thoughtfully, consciously identify motivated women to coach, mentor and sponsor.
  • Have a handy list of qualified female speakers. When invited to speak, ask the program committee if they still need additional speakers and if declining an invitation yourself, share contact information for a qualified woman as an alternative.

Thanks Scott, Simon, Dara (and moderator Jenny Beck-Esmay) for starting this discussion.

ABOUT THE AUTHOR

EXECUTIVE EDITOR
Dr. Wolfe is an Associate Professor of Emergency Medicine at Tufts School of Medicine’s Baystate campus.

9 Comments

  1. Thank you for writing this article, and generating this important discussion. As one of the course directors for the Resuscitation conference, I can tell you that speaker diversity has been an integral part of our planning for over 12 years. We plan for gender, practice, and regional diversity. I think we have the best faculty in the country as a result of this planning and shared vision.

    We believe having representative faculty is vital to providing the right educational experience and context for our equally diverse attendees.

  2. These are all great suggestions, Jeanette. Thanks!

    I had such mentoring and “hands up” guidance from the likes of Bernadine Healy (Hopkins, NIH and ARC), Janet Bickel (AAMC) and Ellen Taliaferro of ACEP. I hope that I have also passed some wisdom and opportunities down. I’ll never forget Bernie’s ultimately feminine analogy “It is not a zero sum game; we are all a part of an ever expanding ‘power pie”!, Janet’s “mentor receptor deficiency” affliction description, and Ellen’s spellbinding stories “Oh my god, it IS a gun in my hand and I was going to blow you all away if you didn’t listen to my problem!”. AND, “when you are ready to learn, the teacher is there”. Bless them all.

    I would add that it certainly helps to “encourage” our professional associations to name women to chair (not just sit on) the conference organizing committees, and not to allow staff to make decisions on speakers based solely on left brained criteria. There are certain subjects that will just “feel” better coming from the mouth of a woman, and of course some that will “feel” worse—because women remind people of mothers.
    When in doubt, let the audience get over the mother complex and on with the business of learning from wisdom.

    One of my MANY mentee/mentors was Steve Stack. He had the wherewithal as a teenager to enroll himself in the local Toastmasters, where he was taken under wing by a couple of older women…which should illustrate to everyone how anyone can become a “silver tongued orator”. There is also the National Storyteller’s Association, the National Speakers’ Association, and I recently was introduced to a person whose job title is “Chief storytelling officer” for TedMed. Now THAT sounds like a fun job!

    • John Dale Dunn MD JD on

      Could i pour a little cold water on this gender oriented whine? Well maybe it isn’t a whine, but it is a gender based bit of nonsense.

      I have never found that women in emergency medicine were neglected out of proportion to their acco0mplaishments or their efforts.

      In fact the complaints about this and that, when diseected, are directly related to what women personally and professionally think are important things, that don’t translate into the “status” or “accomplsihments” and “rewards’ that some female writers seem to think should be doled out on a quota.

      I reject quotas, don’t you. I don’t think Tintinalli, or Rivers or so many other recognized female performers were tamped down by misogynist fellow male physicians anymore than I accept the idea that accomplishment and achievment shoulc ever be saddled with the nonsense of “gender” politics.

      I have never, ever, worked in a place where females were treated with less respect or relegated to a lesser salary/income status because of gender, in fact, chivalry and accomodation appeared to be in play much of the time, so that women could pursue obejctcives outside the profession, concerns about motherhood that obviously shouldn’t be considered a negativ–quite the contrary.

      We now have an increasingly female physician profession with the inevitable decline in productivity created by “values” and “priorities” of females that have nothing to do with contributing to professional effort.

      Are the noise females willing to tell us how that inequity and special consideration will be properly addressed?

      I would say that the recent continuing concern about physician workload and productivity is impaired by many things, silly computer excess usage, among other things,, but when half of a professional becomes half time workers looking for convientient hours and shifts and high priority time for children and family–we will need to at least double or triple the total number of physicians in all the specialties to pull up the slack created.

      I have lived through the angry female physician times, women in medicine with a gigantic chip on their shoulder, put there by politics, and now i find female physicians competent, professional, easy to work with the hard working. HOWEVER, they can’t help themselves and they will be looking for part time work, special considerations for their domestic priorites. and the result will be another med school/residency grad who is part time or less than full time.

      Don’t pretend that what I say isn’t true–just learn to live with it, since female physicians are a real asset, but they will, in many if not most cases, always be lesser players, not carrying the big loads, with few exceptions.

      It’s like any of these identity politics things–get a grip–accept the realities. Stop pretending.

      John Dale Dunn MD JD

      • Sandy Oestreich, ARNP on

        Dr. Dunn, WOW! 4 8 2016
        As a working mom carrying my load at work, I at first reading your comment, got defensive. Then, I realized and resonated from DrDunn’s cultural point of view.
        From his values, he has a right to be angry seeing himself as being abused at work. After all, to him, Work is Everything. To many in medicine and elsewhere, work IS everything. Especially if you are male, tho it happens to the rest of us sometimes.

        We’ve been taught from little on that the Man is the Provider of Everything and has real needs to be sustained (by hot meals at home, kids quiet, all things centered on R & R for Dad when he comes home, etc.). AFTER ALL, the Job is Everything to his inner soul. Everything else comes Second.

        I exaggerate, but this seems mostly True.

        On the other hand, women workers share the importance of work with the More Important (to us) and Primary Calling is to provide All That for kids and Dad at home, TOO.

        Kinda’ impossible to balance, right? Yes, it is. We females actually try to balance 2 bosses–home life and work life–equally trying jobs.

        Going to say something now that is True but won’t be spoken out loud. Because we females are trying so hard to balance our Calling (home and hearth) with our Secondary level life , Employment, we are dancing on the head of a pin:

        THERE IS NO SUCH THING AS WORK-LIFE BALANCE for a woman, unless your family recognizes the above quandry and pitches in BigTime at home, Or you are wealthy enuf to hire nannys , constant restaurant-ing, home managers who clean house, too, etc.

        Having had a career I took too seriously, pretending to value meeting all the criteria of a committed, brilliant employee, I must say now..that I regret it on the family-side.

        UNTIL the USA joins ALL the industrialized nations that supply Quality Paid Daycare, we Women do not have a Chance to have Real Life Balance.
        Do you know that Nordic countries recognize the benefits of a working woman/working mom to the GDP (one noted a rise in GDP by 9% when politicians THERE did recognize it!!!) by providing nannies, home workers who manage all those doctor appointments, even walk the dog!

        Tough stuff for couples who also need romance and just plain golden togetherness.

        [I’m a Nurse Practitioner of 35 yrs, Prof. Emerita, pharmacology author, former elected official just now recognizing the above Truths. So, am now working on The Problem for working Women, Men, Families:

        I AM AN UNPAID LOBBYIST for the “Fix”. I have worked for You,Dr Dunn and all of us, for more than 16 years (going back to the 1970s as a feminist) To Get the intransigent Republican pols to PASS THE EQUAL RIGHTS AMENDMENT, now waiting for 93 years!
        ERA will help set things right in America as it has elsewhere.

        Did you know that the USA mandated that all nations created right after WWII had to codify womens’ equal treatment ?…BUT THEN CAME HOME TO DENY IT HERE IN USA?

        Ladies, Watch WHO you vote for, and read the Platforms of all political parties–all of the platform.

        http://www.2passERA.org, click “ERA for Women” (yes, there’s ERA for Men, too, as males have needs too) for eye-openers to prove America is not “exceptional” except in the negative sense. If you want to get in touch, email the editors here, who can give you my / our address.
        FORGIN’ ON now.

  3. The hardest thing to address is the bias that is stated anonymously, or with condescending kindness, or whispered down hallways or behind closed doors. Therefore, I am so pleased with John Dale Dunn’s openly biased and hateful comments.

    Dunn’s post is also a wonderful demonstration of several phenomena that tend to kick in when gender bias comes up in conversation:

    1. Over-reliance on one’s personal take, rather than the facts. The logic goes like this: “I have been personally put out due to a colleague’s maternity leave / child care needs / etc. Therefore, all women exist to make men bear more than their share of the ‘load.’” A good way to test whether one’s personal impression represents truth is to look at the data. A large body of evidence now supports that women in medicine are paid less, given less opportunity for advancement, and face systematic biases even after controlling for their level of experience, part-time work, choice of specialty, and accomplishments. The so-called whining is not, actually, unjustified.

    2. Defensiveness in the face of an implied wrong. Gender bias is a societal problem. We all – both men and women – perpetuate it, are affected by it, and have a stake in finding solutions. Nevertheless, the conversation often is perceived as being men bashing. The men I’ve spoken with about gender bias have one of two polarized reactions: A) They go into super-over-drive defensiveness and denial (“I have never, ever, worked in a place where females were treated with less respect or relegated to a lesser salary/income status because of gender” = statistically impossible unless you have had no jobs) and chalk the whole issue up to whining, laziness, and entitlement, or B) They start looking at the problem thoughtfully and introspectively and want to be part of the solution. I’ve been lucky to witness the latter quite often, but the former is probably more common. Speaking of solutions, it has been observed that high achieving men have significantly fewer domestic responsibilities than similarly high achieving women. I wonder if John Dunn has ever stopped to consider what his career might be like without a SAHM carrying the load at home?

    3. Inability to take the long view. Many of the senior chairs I’ve spoken with about the work cycles of women have told me that women are their most valuable long-term employees. They are generous, tend to think of what is best for the whole team, including their nurse and physician colleagues and their patients. Focus only on the downside of needing to usher women through their child-bearing years, and you miss the fact that the relatively fallow career years are followed by years of accelerated professional productivity (this is also supported in the literature). Women – who are increasingly making up 50% of EM residency programs – are occupying a critical portion of the emergency care workforce. Despite this, their uteri continue to serve that pesky function of reproduction. Learn to live with it.

    Since Dunn mentions Dr. Tintinalli, one of my cherished role models, I will quote a wonderful piece she wrote recently on the role of sex and gender in medicine:

    “Women like Ellen Johnson Sirleaf, Christine Lagarde, Angela Merkel, Janet Yellen… Women are steadily, confidently, and appropriately occupying positions of national and international power in government, business, and academia. But most of the 3.5 billion women in the world do not have the opportunity, resources, or social supports to reach such commanding heights. Worldwide, women have been consigned to narrow roles and behaviors, subject to oppressive cultural values, and forced to accept economic, educational, social and health care disparities that have limited their potential.”

    Yes. Even the giantesses in our field have experienced gender disparities, and are committed to fighting them. Let us make no mistake: this is not an issue of women wanting to skate by with less effort. This is women recognizing that as a group, we are not rewarded commensurate to our efforts and abilities.

    I am an EM physician, faculty member, wife, and mother of four children 8 years old and under. My values and priorities? To make the world a better place, both at work and at home. I see Dunn’s “big load” and raise him an unmeasurable, weighty load that I and my peers must bear to overcome the barriers inherent to being a woman in the workforce. And by the way – I am also a federally funded researcher. So Dunn’s tax dollars are paying for this lesser player. I hope he can accept that reality.

  4. I had written a reply almost identical to my giantess Esther Choo, but it might have gotten lost in the web-esphere. I applaud the article by Dr Wolfe and the response by Dr. Choo, in addition to any other thoughtful and engaging commentary on this subject.

    I would encourage Dr. Dunn or anyone else who questions the need for such articles to read Anne-Marie Slaughter’s recent book Unfinished Business: Men, Women, Work Family, which really helps spell out our perceptions on gender, bias, work and family.

    Having been mentioned in the article, I will say that we at FemInEM are trying to highlight all the voices and perspectives on topics related to gender and EM. We encourage contributions from Dr. Dunn and the rest of the EM community. Feel free to contact me directly for any other issues.

  5. Hard to properly respond to all the topics raised above, but what typically strikes me when topics around gender are raised is this:

    Why do we frame the topic as if men have no stake in the game?

    Dr. Choo points out, I think correctly, that Dr. Dunn’s comments draw directly from his personal experience. And the lived experience of many female EPs just isn’t accessible to him. Data points on salaries and promotion can never truly bridge that divide, but it’s a start. Dr. Dunn’s comments apparently also stem from a feeling of inequity that “allowances” are made for women in EM regarding schedules or time off.

    You may certainly argue that having seen none of the drawbacks in salary and advancement that women have, men shouldn’t be complaining about the “special considerations” Dr. Dunn is concerned about. But aren’t there men who want these considerations? Why are women having an impossible time reconciling family and career while men devote themselves to their calling as Physicians without a qualm?

    Well of course, men don’t do that. Societally and culturally they enjoy the career advancement and the same expectations make it unusual to see men ask for or get the family time or set schedules Dr. Dunn cites.

    And so I do a job at work (not as well as I’m perhaps capable) and a job at home (not as well as I’d like). I’ve grown to be somewhat okay with that. Perhaps the tradeoffs I’ve made arent nearly what female EPs have had to deal with. But the third response from men should likely be: I’d better help out here- because it’s in my best interests.

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