Australian doctors are calling for transformative policy changes and a cultural shift to help dismantle the systemic barriers impeding gender equity in cardiology.
Writing in the European Heart Journal [link here], Dr Gabrielle Freedman and Associate Professor Tugba Kemaloglu Oz from the cardiology department at Alice Springs Hospital in the NT said the path forward included establishing mentorship programs for women and fostering an inclusive culture that valued diverse voices.
The authors pointed out that despite equal numbers of women completing medical school, women only made up 15% of cardiologists and only 5% of interventional cardiologists. Women were also less likely to be department heads, be involved in academia or receive senior academic posts, even after adjusting for confounders.
A lack of gender diversity in leadership impacted all facets of the specialty from patient outcomes, to physician wellbeing and workplace culture and productivity, they said.
“We know that gender plays a role in our interests, communication style, and ability to connect with patients, and research in healthcare demonstrates specific advantages when female physicians manage female patients, with greater reports of patient-centred care and improved patient satisfaction,” the authors wrote.
“However, the skewed and predominantly male workforce in clinical cardiology is a disadvantage for many female patients. For example, female patients treated by male physicians after myocardial infarction have worse outcomes than male patients, which is not the case when they are cared for by female clinicians.”
The underdiagnosis and undertreatment of women with cardiovascular disease could also be attributed to a lack of women in academic research and a history of recruitment bias which left “salient” research gaps in women’s health, they added.
Promoting gender equality in medical leadership would not only have a positive impact on the professional advancement of female cardiologists, but also on physician wellbeing in a male-dominated industry where sexual harassment was not uncommon, allowing for a much needed “transformative culture shift”.
The authors highlighted that current barriers for women advancing to leadership positions included the imbalance of parental leave and caregiving responsibilities and inflexible training requirements, along with gender-based discrimination.
“Often this discrimination is subtle, giving rise to the term ‘micro-inequities’ or ‘micro- aggressions’. For example, female doctors are less likely to be introduced as ‘Doctor’ during grand rounds, are given less autonomy in the procedure room, and are less likely to receive referrals from male surgical colleagues due to cognitive biases. These interactions and patterns of behaviour culminate over time, shaping a healthcare culture that continues to devalue women as leaders,” they said.
However, the authors also acknowledged a movement in cardiology towards gender inclusivity, adding that policies that were not just symbolic but transformative would be essential to dismantling systemic barriers.