By Kristen Barnhardt

Only 19% of surgeons are women, but change is coming

As I walked onto my college’s campus for freshman orientation, I wanted to be either a physician assistant or nurse anesthetist.

But being surrounded by men in a “What it takes to be in medicine” seminar gave me an uneasy feeling. Where are all the women?

It made me think of all the times I visited the doctor when I was younger.

Growing up in rural North Carolina – I’m 28 – every doctor I saw was male. Granted, there were only three family doctors serving a town of less than 2,000 people. Maybe big cities had lots of doctors who were women, but I didn’t see them.

When I had two rhinoplasties to fix my nose and deviated septum (a crooked bone inside the nose), I had a male surgeon. I would come to have three other procedures and all those surgeons were men as well. I’m grateful for their impeccable care and treatment that improved my quality of life.

But there were moments where I could not help but notice: no women.

Feeling empowered

As part of my public relations job with Novant Health, I work for our storytelling site, Healthy Headlines, where I write about patients’ experiences and interview doctors and other providers to pass along the latest in health advice and information.

I reached out to Dr. Patricia Mattingly of Novant Health Pelvic Health & Surgery to ask if I could observe her performing surgery. Her swift reply: sure!

When the morning came, I walked down the hall of a surgical floor as men in scrubs and white coats streamed by. Then I passed through the doors of Mattingly’s OR. And there they stood: an entire surgical team composed of women.

From the surgeon to nurse anesthetist to surgical technologists – all women.

I was shocked. And to be honest, I’m embarrassed to admit I was shocked.

For a few minutes I tried to figure out why. Then it hit me. In all of my experiences in the operating room as both an observer and a patient, I’ve never been surrounded by only women.

And I’ve never seen an image or read a news story where all the team members were women. I’ll admit to consuming my fair share of medical TV shows and I never recall seeing an all-women team.

There’s a reason why: Even in 2019, just 19 percent of American surgeons are women. But I have hope this is changing because for the first time since 2004, more women than men applied to medical schools in the United States.

While women account for 62 percent of registered nurse anesthetists and 80 percent of surgical technologist positions, to have all the women in one operating room together felt like a rarity.

And as I watched the team work, my initial impressions of wonder slowly turned to empowerment. It was amazing to witness these women break what I thought was the “norm” in medicine – men behind the surgical masks.

As each member of the team flawlessly demonstrated her years of experience, I was enamored by the thought of how much work it took for them to stand where they were.

For her part, Mattingly has spent years perfecting her technique for minimally invasive procedures that shorten recovery time and reduce risks.

‘There’s still a very real bias with women in medicine’

As I sat there and reflected on the training these women went through, I couldn’t help but wonder what obstacles they faced to get where they are today.

During peer reviews, rather than gauging Mattingly’s professional acumen, some focused on her emotions.

In some instances, she said, female nurses were quicker to question her decisions and authority compared to her male counterparts. There are studies that support her experience.

As an intern, Mattingly still remembers one comment in particular that was meant to be a joke: “Women in surgery are either women who shouldn’t be surgeons or surgeons who shouldn’t be women.”

The thinking: women couldn’t be surgeons because they supposedly couldn’t power through the fatigue like men. They’d burn out, the thinking went, far faster than the guys.

Initially, Mattingly admitted that she thought the joke was amusing and repeated it a time or two. But over time, it lost its humor.

“I’m ashamed I ever thought it was funny,” Mattingly said. “While it’s great to see more and more women entering medicine, there’s still a very real bias,” Mattingly said.

Multiple studies confirm that bias. One found that at a medical center where physicians were introduced for presentations, women introduced by men were less likely to be addressed as “doctor” than were men introduced by men.

Another study revealed women were more likely to be described as “compassionate,” “sensitive” and “enthusiastic” while men were more likely to be labeled as “quick learners” in medical student performance evaluations.

The bias is evident in the gap in pay. Women physicians and surgeons made $0.63 to every $1 earned by their male counterparts.

Women forging ahead

And yet, women continue to move forward.

• At Novant Health, Dr. Erin Kiehna is chief of neurosurgery at Novant Health Presbyterian Medical Center.
• Earlier this year, Dr. Pam Oliver was promoted to the organization’s executive team as executive vice president of Novant Health and president of Novant Health Physician Network.
• Dr. Snow Daws, an orthopedic surgeon in the North Carolina Triad, has spent her life in places dominated by men. Only 14% of orthopedic surgeons are women. She got her start in high school, where she was the only girl on the football team.

For Mattingly, the first step to overcome gender bias is to reflect on and recognize our own.

“It’s painful to acknowledge that I perpetuated gender bias by repeating that joke,” Mattingly said. “But in addition to shame, it makes me hopeful and empowered. I am part of the problem, therefore, I can be a part of the solution.”

Mattingly, who is the minimally invasive gynecologic surgery program director in Charlotte, acknowledges the progress and is looking forward to more in the future.

As for me, I’m looking forward to the day when the idea of an OR team of women would surprise no one.