Showing posts with label anesthesiology. Show all posts
Showing posts with label anesthesiology. Show all posts

Monday, April 3, 2023

Implicit Bias and the Motherhood Penalty – Opting Out vs. Helping Out

From the March 31, 2023 issue of the Transformational TImes - Women's History Month



Implicit Bias and the Motherhood Penalty – Opting Out vs. Helping Out 

 

 

Elizabeth “Libby” Ellinas, MD, and Adina Kalet, MD, MPH  


 

In this Director’s Corner, Drs. Libby Ellinas and Adina Kalet call for ongoing, proactive attention to the subtle and mostly unconscious gender bias in the workplace that lowers career expectations for women and parental engagement for men and deprives all of us a more equitable world. If you would like to explore ways to mitigate gender stereotypes and second-generation gender bias, please consider making an IWill Pledge... 


 

Dr. Kalet’s story (1993) 


When I gave birth to our first child in 1992, my husband and I had parallel jobs -- same hours, same salary, same responsibilities, and we even had offices side by side. Except for the fact our colleagues, students, and staff acted as if my door was “always open” and his was “always closed,” we pretty much had the same daily routines. I took a six-month, mostly unpaid leave, because there were no formal maternity leave benefits at the time. He took two weeks paternity leave and returned to paid work. 


As the end of my leave approached, we discussed each returning to work four days a week so we could have a family life that included each of us having a full weekday with our child and -- along with a creative mixture of other childcare arrangements -- two meaningful work lives. When I went to my boss to discuss this, he said, “Sounds exactly right; we will support you in being part-time.’” When my husband went to his boss, he said,Don’t do it! You will ruin your career!”  

 

Two facts about this experience perplexed me. First, neither of us requested part-time work, given the demands of our clinical schedules, which included mandatory evening clinical hours. We proposed more than full-time hours, confined to four weekdays.  


Second, we worked for the same man.  



Dr. Ellinas’s story (circa 2003): 


As a young faculty member, and then as program director for the Obstetric Anesthesiology Fellowship, I had many opportunities to discuss fellowship opportunities with anesthesiology residents. 


When I spoke to women residents, I would sometimes encounter “interest if...” This would occur when someone was a great practitioner, and expressed interest in perhaps pursuing a fellowship “if…” That would be followed by a statement indicating she was putting her career second; usually second to her partner’s career: I will consider a fellowship if my partner gets his fellowship where there happens to also be space for me. Many were also feeling the time pressure to have children. I have not had that same conversation with a man.  


Maybe the woman’s answer was just a polite way of saying she really was not that interested in the fellowship. If not, I wondered whether a prioritization of the husband’s career would extend beyond the fellowship. Those fellowships would benefit both their careers and were open to both equally. What pressure was there – and coming from what direction – that resulted in the husband’s fellowship being prioritized over the wife’s fellowship? 



Now (2023) 


Second-generation gender bias refers to practices that may appear neutral or even favorable to women, but that discriminate against a gender because they reflect hidden, subtle, or silent bias.


The motherhood penalty is part of that bias: 


Mothers suffer a penalty relative to non-mothers and men in the form of lower perceived competence and commitment, higher professional expectations, lower likelihood of hiring and promotion, and lower recommended salaries.” (“Mothers suffer a penalty relative to non-mothers and men in the form ...”) This evidence implies that being a mother leads to discrimination in the workplace.


For men, on the other hand, having a child benefits their careers. They are seen as more stable, worthy of higher salary and more competent. So, when it comes to the differences between mothers and fathers at work, “the disparity is not because mothers… become less productive employees and fathers work harder when they become parents — but because employers expect them to. 


Dr. Kalet and her husband’s boss had two children. He regularly talked about his home life as a means of relating to the women who worked for him, although he did not do this with the men. It was obvious he viewed himself as a feminist and a great supporter of women in medicine.


However, his own wife did not work outside the home, and took care of almost all the daily needs of making a home and caring for the family. This probably contributed to his blindness or insensitivity to the challenges of being a working parent in a dual-career family. This manifested as having unrealistic expectations of his team for time flexibility in clinical coverage, calling last-minute, early morning or late afternoon meetings, and expecting writing tasks to be done evenings and weekends.  


Because he himself was not forced to be organized and planful when opportunities arose, he waited until the last minute to recruit help from more junior members of the faculty so that only those with few responsibilities, other than work, could take advantage. Parents who might have been interested would have needed more notice to engage in the work. In these ways, he created inequities for leadership and academic opportunities. Had our institution had policies and incentives for him to be a more equitable leader, he would have embraced them readily.  


If we want to help women be successful in the workplace -- and reach what they perceive as their full potential -- we need to be aware of subtle (and not so subtle) biases that persist in the ways we work and think about our workplace and ourselves.  

 


The authors encourage everyone to: 

  • Educate ourselves about second-generation gender bias and maternal bias. Both are often implicit, so we will not know about them unless we look for them.
  • Encourage everyone to take full parental leave. Make it both straightforward and possible for the birthing parent.  
  • Encourage fathers to take full leave. Discourage work productivity during this time to incentivize parent-child bonding and build other skills critical to equality in the home sphere. 


We encourage MCW to: 

  • Continue to support salary equity efforts.  
  • Address known and emerging second-generation gender bias in hiring and salary equity.  
  • Consider more generous paid leave policies for parents.  
  • Consider creative scheduling options for parent flexibility as the needs of families rapidly evolve. 
  • Support lactation spaces and develop a culture that assists lactating persons toward success.
  • Continue to offer equal parental leave, regardless of gender.  


See Info scope for details about MCW’s parental leave for faculty and staff. 

 


Dr. Kalet’s status update:  


My husband continues to have his “Daddy Day” long after our children have left home, his colleagues have adjusted to the fact he doesn’t attend routine meetings or teach on Fridays. As a result, as the needs of the family evolved, he was able to “protect” time for other work and personal pursuits. In fact, we both have had long satisfying careers, albeit with many difficult bumps along the way. Being a “good worker” has required remaining sensitive and responsible to institutional needs, learning to advocate for ourselves and others effectively when needed, and a willingness to compromise. All of this has been a continual negotiation and renegotiation around our work and with our bosses and supervisors, each other, and our kids.  

 

No careers have been ruined. 

 



Libby Ellinas, MD, is Director, Center for Advancement of Women in Science and Medicine and Associate Dean, Women's Leadership, Professor, Anesthesiology and a member of the Medical Education Data Science Laboratory at the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education at the Medical College of Wisconsin. 

 

Adina Kalet, MD, MPH, is Director of the Robert D. and Patricia E. Kern Institute for the Transformation of Medical Education and holder of the Stephen and Shelagh Roell Endowed Chair at the Medical College of Wisconsin.