Female Excellence and Leadership in Pediatrics Subspecialties (FLEXPeds): Creating a Network for Women Across Academic Pediatrics
2023; Elsevier BV; Volume: 263; Linguagem: Inglês
10.1016/j.jpeds.2023.113512
ISSN1097-6833
AutoresChristiane E.L. Dammann, Kathleen Kieran, H. Barrett Fromme, Claudia Espinosa, Celeste Tarantino, Maria Trent, Jenifer R. Lightdale, Katherine Bline, Cristina Alcorta, S Asaki, Sowmya Balasubramanian, Romina Barral, Abbie Bauer, Erica Bernardo, Laura A. Boomer, Jessica Bowman, Tamika Bryant, Jamie K. Capal, Corrie E. Chumpitazi, Jill N. D’Souza, Beth Emrick, Ann Marie Flannery, Dana W. Giel, Theresa Gilbert, M. Gillispie-Taylor, Candace F. Granberg, Heather Haq, Elena B. Hawryluk, Honey Herce, Vivian Hernandez‐Trujillo, Ginger Janow, Mayra Jones-Betancourt, Juliann L. Kim, Catherine Kimball-Eayrs, Hilda A.J. Kriel, Mary Landrigan‐Ossar, May Lau, Kerri Z. Machut, L. Malone, Michelle Mann, Lucy D. Mastrandrea, Agnes Montgomery, Bindi Nalk-Mathuria, Toba N. Niazi, Haleigh Prather, Maria H. Rahmandar, Juliann L. Reardon, Cynthia K. Rigsby, Alyssa A. Riley, Megana Sathe, Renée A. Shellhaas, Nanette B. Silverberg, Kanakadurga Singer, Cynthia Wetmore, Heather Williams, Sylvia H. Yoo,
Tópico(s)Sex and Gender in Healthcare
ResumoAlthough the gender gap for medical school admissions in the US appears to be firmly closed,1Heiser S. More women than men enrolled in U.S. Medical schools in 2017. AAMC; 2017. Press release.https://www.aamc.org/news/press-releases/more-women-men-enrolled-us-medical-schools-2017Date accessed: July 11, 2023Google Scholar female physicians continue to lag behind men in rank and leadership appointments, particularly in academic medicine.2Carr P.L. Raj A. Kaplan S.E. Terrin N. Breeze J.L. Freund K.M. Gender differences in academic medicine: retention, rank, and leadership comparisons from the National Faculty Survey.Acad Med. 2018; 93: 1694-1699Crossref PubMed Scopus (277) Google Scholar,3Richter K.P. Clark L. Wick J.A. Cruvinel E. Durham D. Shaw P. et al.Women physicians and promotion in academic medicine.N Engl J Med. 2020; 383: 2148-2157Crossref PubMed Scopus (217) Google Scholar Although women currently represent 54% of all enrolled medical students,4AAMCDiversity increases at medical schools in 2022.https://www.aamc.org/news/press-releases/diversity-increases-medical-schools-2022#:∼:text=Gender%3A,men%20matriculants%20did%20not%20declineDate accessed: July 11, 2023Google Scholar contemporaneous data show that women also currently represent less than one-third of all full professors and department chairs,5AAMCFaculty roster: U.S. medical school faculty.https://www.aamc.org/data-reports/faculty-institutions/data/2022-us-medical-school-facultyDate: 2022Date accessed: July 11, 2023Google Scholar and receive less funding from the National Institutes of Health.6Oliveira D.F.M. Ma Y. Woodruff T.K. Uzzi B. Comparison of national Institutes of health grant amounts to first-time male and female principal investigators.JAMA. 2019; 321: 898-900Crossref PubMed Scopus (138) Google Scholar Such gender disparities significantly affect physician wellness,7Hoff T. Lee D.R. Burnout and physician gender: what do we know?.Med Care. 2021; 59: 711-720Crossref PubMed Scopus (18) Google Scholar as well as individual career compensation.8Catenaccio E. Rochlin J.M. Simon H.K. Addressing gender-based disparities in earning potential in academic medicine.JAMA Netw Open. 2022; 5: e220067Crossref PubMed Scopus (20) Google Scholar Women physicians in academic medicine have greater rates of burnout, lower rates of professional fulfillment,9Rotenstein L. Harry E. Wickner P. Gupte A. Neville B.A. Lipsitz S. et al.Contributors to gender differences in burnout and professional fulfillment: a survey of physician faculty.Jt Comm J Qual Patient Saf. 2021; 47: 723-730Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar exposure to sexual harassment, experiences of explicit and implicit gender biases,10Jagsi R. Griffith K.A. Jones R. Perumalswami C.R. Ubel P. Stewart A. Sexual harassment and discrimination experiences of academic medical faculty.JAMA. 2016; 315: 2120-2121Crossref PubMed Scopus (286) Google Scholar and a persistent pay gap that translates into an estimated $2 million loss of lifetime earnings per physician. This financial disparity persists even after adjusting for work hours, clinical revenue, practice type, and specialty.11Whaley C.M. Koo T. Arora V.M. Ganguli I. Gross N. Jena A.B. Female physicians earn an estimated $2 million less than male physicians over a simulated 40-year career.Health Aff. 2021; 40: 1856-1864Crossref PubMed Scopus (42) Google Scholar To address gender compensation inequities in academic medicine, the Association of American Medical Colleges (AAMC) has suggested institutional tracking of gender representation and salary equity in hiring, promotion, and leadership appointments, as well as encouraged public transparency for these data.12Dandar V.M. Lautenberger D.M. Exploring faculty salary equity at US medical schools by gender and race/ethnicity. Association of American Medical Colleges, 2021Google Scholar Nevertheless, the compensation gap between women and men in medicine has continued to increase over the last 5 years, reaching 28.2% in 2021 and annually exceeding $122 000,13Doximity 2021 physican compensation Report. Access 2023. https://c8y.doxcdn.com/image/upload/v1/Press%20Blog/Research%20Reports/Doximity-Compensation-Report-2021.pdfGoogle Scholar independent of position or academic rank.14Sullivan B.G. Al-Khouja F. Herre M. Manasa M. Kreger A. Escobar J. et al.Assessment of medical oindustry compensation to US physicians by gender.JAMA Surg. 2022; 157: 1017-1022Crossref PubMed Scopus (9) Google Scholar,15Wang T. Douglas P.S. Reza N. Gender gaps in salary and representation in academic internal medicine specialties in the US.JAMA Intern Med. 2021; 181: 1255-1257Crossref PubMed Scopus (17) Google Scholar This pay inequity has been linked to burnout13Doximity 2021 physican compensation Report. Access 2023. https://c8y.doxcdn.com/image/upload/v1/Press%20Blog/Research%20Reports/Doximity-Compensation-Report-2021.pdfGoogle Scholar and is exacerbated by the fact that leadership positions with greater salaries in US medical systems (eg, division chiefs, department chairs, deans, and senior-level hospital executives) remain dominated by men, whereas lower-level positions in pediatric medicine and other fields are increasingly held by women.16Gottlieb A.S. Jagsi R. Closing the gender pay gap in medicine.N Engl J Med. 2021; 385: 2501-2504Crossref PubMed Scopus (20) Google Scholar Earnings have declined even more precipitously in workforces in which women physicians predominate, such as pediatrics and obstetrics,17Pelley E. Carnes M. When a specialty becomes "women's work": trends in and implications of specialty gender segregation in medicine.Acad Med. 2020; 95: 1499-1506Crossref PubMed Scopus (54) Google Scholar reflecting a phenomenon known as "devaluation and queuing" or "occupational feminization".18Levanon A. England P. Allison P. Occupational feminization and pay: assessing causal dynamics using 1950–2000 U.S. Census data.Soc Forces. 2009; 88: 865-891Crossref Scopus (300) Google Scholar It is critical to recognize that gender pay disparities in these fields reflect specific systemic issues that negatively affect physicians of all genders.19Bravender T. Selkie E. Sturza J. Martin D.M. Griffith K.A. Kaciroti N. et al.Association of salary differences between medical specialties with sex distribution.JAMA Pediatr. 2021; 175: 524-525Crossref PubMed Scopus (19) Google Scholar Improving compensation for all who care for children will require elimination of gender pay gaps and will be critical to attract future graduating medical students of all genders to pediatrics. Perhaps incongruously, pay disparities in pediatrics across all genders are even more pronounced in the pediatric subspecialties, compared with pediatric primary care, family practice, primary care internal medicine, and internal medicine subspecialties.17Pelley E. Carnes M. When a specialty becomes "women's work": trends in and implications of specialty gender segregation in medicine.Acad Med. 2020; 95: 1499-1506Crossref PubMed Scopus (54) Google Scholar,19Bravender T. Selkie E. Sturza J. Martin D.M. Griffith K.A. Kaciroti N. et al.Association of salary differences between medical specialties with sex distribution.JAMA Pediatr. 2021; 175: 524-525Crossref PubMed Scopus (19) Google Scholar Although length of training is generally linked to greater compensation, this is not the case for pediatric subspecialties. Although training programs for pediatric subspecialists are similar in length or even longer than their adult counterparts there is not necessarily an increase in compensation relative to pediatric primary care.20Lakshminrusimha S. Murin S. Lubarsky D.A. Low compensation for academic pediatric medical specialists: role of Medicaid, productivity, work hours, and sex.J Pediatr. 2023; 255: 1-6Abstract Full Text Full Text PDF PubMed Scopus (4) Google Scholar Furthermore, these pay disparities lead to a substantial disadvantage in lifetime earnings for pediatric subspecialists when compared with their peers who care for adults with similar conditions.21Catenaccio E. Rochlin J.M. Simon H.K. Differences in lifetime earning potential between pediatric and adult physicians.Pediatrics. 2021; 148 (e2021051194)Crossref PubMed Scopus (17) Google Scholar Within pediatrics, earnings are lowest in subspecialties with greater proportions of women physicians.22Catenaccio E. Rochlin J.M. Simon H.K. Association between workforce gender distribution and lifetime earning potential in the pediatric subspecialties.Acad Pediatr. 2022; 22: 1153-1157Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar For example, physicians of all genders in adolescent medicine and pediatric endocrinology have lower compensation compared with those in pediatric cardiology, which tends to attract more men to training programs. Most of the published data on gender equity in medicine come from adult specialties, highlighting the need for more research into devaluation of clinical care, including subspecialty areas, across the pediatric workforce. Of course, confronting gender pay inequity is only a first step to reducing gender disparities in career trajectories, as gender differences in professional interactions also must be recognized as major obstacles to advancement. For example, networking practices in academic medicine remain dominated by men, may function as de facto "boys' clubs," and often happen outside the formal work environment to the exclusion of women.23Murphy M. Callander J.K. Dohan D. JR G. Networking practices and gender inequities in academic medicine: women's and men's perspectives.EClinicalMedicine. 2022; 45: 101338Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar Transforming workplace culture for physicians in ways that emphasize inclusion of the workforce majority in networking is now necessary, as is intentionality in sponsorship, defined as public advocacy for the career advancement of others, to avoid gender bias.24Travis E.L. Doty L. Helitzer D.L. Sponsorship: a path to the academic medicine C-suite for women faculty?.Acad Med. 2013; 88: 1414-1417Crossref PubMed Scopus (132) Google Scholar Physicians in leadership positions with the opportunity to name colleagues to committees, lectureships, authorship, eg, invited articles, and awards should be encouraged to do so with an intentional lens that promotes gender equity,25Levine R.B. Ayyala M.S. Skarupski K.A. Bodurtha J.N. Fernández M.G. Ishii L.E. et al."It's a little different for men"—sponsorship and gender in academic medicine: a qualitative study.J Gen Intern Med. 2021; 36: 1-8Crossref PubMed Scopus (28) Google Scholar as well as diversity and inclusion. Other contributing risk factors for persistent gender disparities in medicine include intersectional forces, such as discrimination (eg, racism) and harassment,26Rotenstein L.S. Jena A.B. Lost Taussigs—the consequences of gender discrimination in medicine.N Engl J Med. 2018; 378: 2255-2257Crossref PubMed Scopus (27) Google Scholar as well as the disproportionate roles that women physicians play as primary caregivers when at home.27Jolly S. Griffith K.A. DeCastro R. Stewart A. Ubel P. Jagsi R. Gender differences in time spent on parenting and domestic responsibilities by high-achieving young physician–researchers.Ann Intern Med. 2014; 160: 344-353Crossref PubMed Google Scholar,28Starmer A.J. Frintner M.P. Matos K. Somberg C. Freed G. Byrne B.J. Gender discrepancies related to pediatrician work–life balance and household responsibilities.Pediatrics. 2019; 144: e20182926Crossref PubMed Scopus (72) Google Scholar As was magnified during the height of the COVID-19 pandemic, women physicians face significantly asymmetrical burdens of dependent care and housework. Several contemporaneous studies revealed that women physicians are more likely to be responsible for children engaged in remote learning and for eldercare of family members, when compared with their men colleagues during the shutdown.29Soares A. Thakker P. Deych E. Jain S. Bhayani R.K. The impact of COVID-19 on dual-physician couples: a disproportionate burden on women physicians.J Womens Health (Larchmt). 2021; 30: 665-671Crossref PubMed Scopus (18) Google Scholar,30Machut K.Z. Kushnir A. Oji-Mmuo C.N. Kataria-Hale J. Lingappan K. Kwon S. et al.Effect of coronavirus disease-2019 on the workload of neonatologists.J Pediatr. 2022; 242: 145-151.e1Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar Dated gender stereotypes further disadvantage women by promoting invalid notions that women are less qualified for academic and professional advancement than men.31Grandis J.R. Gender equity in science and medicine: breaking the impasse.Cancer Discov. 2022; 12: 1191-1194Crossref PubMed Scopus (2) Google Scholar Women medical students and resident physicians may be more likely to experience gender-career bias when compared with men at similar training levels.32Kramer M. Heyligers I.C. Könings K.D. Implicit gender-career bias in postgraduate medical training still exists, mainly in residents and in females.BMC Med Educ. 2021; 21: 253Crossref PubMed Scopus (8) Google Scholar Such findings may provide an important educational target for mitigating disparities at higher levels. Nevertheless, and despite all extant explicit and implicit gender-career biases that may be affecting their professional development and satisfaction, there is growing evidence that women physicians provide greater quality of patient care with improved clinical outcomes33Wallis C.D. Jerath A. Coburn N. Klaassen Z. Luckenbaugh A. Magee D. et al.Association of surgeon-patient sex concordance with postoperative outcomes.JAMA Surg. 2022; 157: 146-156Crossref PubMed Scopus (120) Google Scholar,34Tsugawa Y. Jena A. Figueroa J. Orav E.J. Blumenthal D. Jha A. Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs female physicians.JAMA Intern Med. 2017; 177: 206-213Crossref PubMed Scopus (601) Google Scholar and may represent preferable medical providers from both adult34Tsugawa Y. Jena A. Figueroa J. Orav E.J. Blumenthal D. Jha A. Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs female physicians.JAMA Intern Med. 2017; 177: 206-213Crossref PubMed Scopus (601) Google Scholar and pediatric patient stakeholder perspectives.35Bernzweig J. Takayama J.I. Phibbs C. Lewis C. Pantell R.H. Gender differences in physician-patient communication: evidence from pediatric visits.Arch Pediatr Adolesc Med. 1997; 151: 586-591Crossref PubMed Scopus (89) Google Scholar Physician gender disparities within pediatrics may be even more striking at the leadership level, as only one-quarter36Weller E. Jacobs R. Opipari V.P. Wilmott R.W. Fleisher G. Trends in pediatric chair sex distribution and tenure over time: a survey of 714 pediatric chairs from the association of medical school pediatric department chairs.J Pediatr. 2019; 209: 5-8.e2Abstract Full Text Full Text PDF PubMed Scopus (3) Google Scholar to one-third37AAMCTable C: department chairs by department, gender, and race/ethnicity, 2022.https://www.aamc.org/media/41546/download?attachmentDate accessed: July 11, 2023Google Scholar of pediatric department chairs are women, even though women comprise the overwhelming majority of current-day pediatricians. Although the number of full professors in academic pediatrics who are women has increased in recent years, women pediatricians remain less likely to be promoted,38Saboor S. Naveed S. Chaudhary A.M. Jamali M. Hussain M. Siddiqi J. et al.Gender and racial profile of the academic pediatric faculty workforce in the United States.Cureus. 2022; 14: e22518PubMed Google Scholar,39AAMCTable 13: U.S. Medical school faculty by gender, rank, and department, 2020.https://www.aamc.org/media/8866/downloadDate accessed: July 11, 2023Google Scholar and women authors remain under-represented in senior positions in publications across major pediatric journals.40Böhme K. Klingelhöfer D. Groneberg D.A. Bendels M.H.K. Gender disparities in pediatric research: a descriptive bibliometric study on scientific authorships.Pediatr Res. 2022; 92: 80-90Crossref PubMed Scopus (3) Google Scholar,41Fishman M. Williams II, W.A. Goodman D.M. Ross L.F. Gender differences in the authorship of original research in pediatric journals, 2001-2016.J Pediatr. 2017; 191: 244-249.e1Abstract Full Text Full Text PDF PubMed Scopus (131) Google Scholar Within the American Academy of Pediatrics (AAP), membership gender distribution has changed dramatically in recent decades, with women membership increasing from 28% in the 1980s to 67% in 2021. Approximately 35% of current women AAP members are within childbearing ages,42American Academy of PediatricsPediatricians' Practice and Personal Characteristics.https://www.aap.org/en/research/periodic-survey-of-us-aap-members/pediatricians-practice-and-personal-characteristics/Date: 2021Date accessed: July 11, 2023Google Scholar and 70% of current pediatric residents are women.43Boyle P. AAMC news.https://www.aamc.org/news/america-s-medical-residents-numbers-0Date: 2021Date accessed: July 11, 2023Google Scholar Steps must be taken now to ensure that these demographics are reflected at institutional and societal leadership levels. The fact that career advancement and equal pay stagnated or regressed during COVID-19 lends further urgency to this mandate.44Ferns S.J. Gautam S. Hudak M.L. COVID-19 and gender disparities in pediatric cardiologists with dependent care responsibilities.Am J Cardiol. 2021; 147: 137-142Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar Not only is the pediatric workforce rapidly changing, but the nature of pediatric practice is changing as well.45Basco W.T. Rimsza M.E. WORKFORCE COPPediatrician workforce policy statement.Pediatrics. 2013; 132: 390-397Crossref PubMed Scopus (96) Google Scholar If children are to receive state-of-the-art, high-quality medical care, the field of pediatrics and all its subspecialties will need to reduce gender disparities to adequately address most of their workforce needs.46Cuevas Guaman M. Miller E.R. Dammann C.E.L. Bishop C.E. Machut K.Z. Neonatologist staffing models: urgent change is needed.J Perinatol. 2022; 42: 1556-1557Crossref PubMed Scopus (4) Google Scholar,47Lombarts K.M.J. Verghese A. Medicine is not gender-neutral—she is male.N Engl J Med. 2022; 386: 1284-1287Crossref PubMed Scopus (5) Google Scholar Female Excellence and Leadership in Pediatrics Subspecialties (FLEXPeds) is a newly formed community of pediatric subspecialists from 31 AAP sections that aims to explore gender disparity issues. FLEXPeds considers gender, as a construct, to be a social identity that is increasingly recognized to be associated with disparities among physician ranks in both the US health care system and around the world.48Venkat P. Sekaran V.C. Mayya S.S. Ashok L. Kamath V.G. Women faculty in higher education: a social identity lens to gender issues.J Datta Meghe Inst Med. 2022; 17: 915-919Google Scholar,49Kerins J. Smith S.E. Tallentire V.R. 'Us versus them': a social identity perspective of internal medicine trainees.Perspect Med Educ. 2022; 11: 341-349Crossref PubMed Scopus (4) Google Scholar The ultimate intention of FLEXPeds is to develop potential solutions for gender inequities across all pediatrics while providing professional and personal peer mentorship. Currently, FLEXPeds is being led by an executive committee and features monthly virtual meetings, as well as various advocacy and communication initiatives. In 2021, FLEXPeds penned a top 10 resolution at the Annual Leadership Forum on gender pay equity, and members of the group are currently working with the Committee on Pediatric Workforce on an AAP policy statement on Paid Family and Medical Leave. Both AAP leadership and the Friends of Children Fund have supported FLEXPeds in numerous important ways, including in the sponsorship of an inaugural virtual summit in April 2022 that allowed members to meet and network. Over the 2 half-day sessions of the summit, it became clear that challenges and barriers for pediatric career advancement of women are very similar across medical and surgical subspecialties. As a result, the FLEXPeds community has called for further opportunities to define and promote equity for women pediatricians across sociodemographic and training backgrounds, as well as to generate an environment that fosters inclusion, respect, success, and vitality. A central tenet of this vision is that only by seeking solutions for closing gender gaps in promotion, leadership roles, physician wellness, and compensation can women and all pediatricians hope to fully develop their individual professional potential. The mission of FLEXPed is to achieve workforce gender equity through effective advocacy, education, scholarship, leadership development, policy oversight, and connection within the AAP. For practical purposes, achieving gender equity has been defined as achieving equity in professional development and physician pay, as well as in representation of women in leadership roles that is proportionally reflective of the workforce. As discussed at the summit, FLEXPeds aims to accomplish its mission by acting as a resource for the Academy, by amplifying the Academy's work to address gender equity issues, as well as by fostering environments that promote workforce vitality. FLEXPeds is also committed to building mentorship, sponsorship, scholarship, networking, and professional development opportunities for women and professional allies in both general pediatrics and pediatric subspecialties. Finally, the FLEXPeds mission emphasizes intersectionality, diversity, and inclusion to ensure alignment with the AAP's current equity agenda.50American Academy of Pediatrics equity agenda.https://www.aap.org/en/about-the-aap/american-academy-of-pediatrics-equity-and-inclusion-efforts/aap-equity-agenda/Date: 2023Date accessed: July 11, 2023Google Scholar Moving forward, the FLEXPeds community intends to build on existing initiatives that promote women in leadership roles across all aspects of pediatric medicine. In particular, we are focused on capitalizing on opportunities for structural change that reduces gender-associated disparities throughout a pediatric physician's career. Our short-term goals over the next 1-3 years are to (1) promote gender pay equity across all pediatric fields, with the goal of reducing the devaluation of pediatrics in the US health care system; (2) support women pediatricians across their professional lifespan through mentorship and sponsorship; and (3) improve the pediatric workplace environment to be more transparent and supportive of women and parents.51Bline K. Dammann C.E.L. Improving workplace culture by increasing financial transparency.Pediatr Res. 2022; 92: 1492-1493Crossref PubMed Scopus (2) Google Scholar Finally, our long-term goal is to promote gender equity and reduce barriers to promotion across all spheres of health care so that all women in pediatrics have equal opportunities to reach their full career potential. We believe that by having members from all AAP clinical subspecialty sections, FLEXPeds will be ideally situated to gather granular data on trends in gender-related career advancement and leadership achievements. Through FLEXPeds, all sections can be encouraged to explore ways that they can act to mitigate gender disparities in their area. Although many have already engaged in exceptional work to reduce gaps in leadership,52Allan J.M. Kim J.L. Ralston S.L. Black N.M.P. Blankenburg R. Shaughnessy E.E. et al.Gender distribution in pediatric hospital medicine leadership.J Hosp Med. 2021; 16: 31-33Crossref PubMed Scopus (12) Google Scholar,53Singer K. Burns C.J. Griffith K.A. Opipari V.C. Martin D.M. Shellhaas R.A. et al.Gender differences in endowed chairs in pediatrics.J Pediatr. 2022; 251: 38-39.e1Abstract Full Text Full Text PDF PubMed Scopus (2) Google Scholar career development,54Chumpitazi C.E. Allister L. Cho C. Hoffmann J.A. Hsu D. Iyer M. et al.Career development in pediatric emergency medicine: what do we need?.Pediatr Emerg Care. 2022; 38: e1552-e1556Crossref PubMed Scopus (1) Google Scholar scholarship,55Kim J.L. Allan J.M. Fromme H.B. Forster C.S. Shaughnessy E. Ralston S. Gender distribution of scholarship and measures of national recognition in hospital medicine.Hosp Pediatr. 2022; 12: 117-124Crossref PubMed Scopus (1) Google Scholar mentorship, advocacy,30Machut K.Z. Kushnir A. Oji-Mmuo C.N. Kataria-Hale J. Lingappan K. Kwon S. et al.Effect of coronavirus disease-2019 on the workload of neonatologists.J Pediatr. 2022; 242: 145-151.e1Abstract Full Text Full Text PDF PubMed Scopus (6) Google Scholar,56Gold J.M. Allan J.M. Ralston S.L. Fromme H.B. Desai A.D. Collective action and effective dialogue to address gender bias in medicine.J Hosp Med. 2019; 14: 630-632Crossref PubMed Scopus (2) Google Scholar, 57Kim J.L. Allan J.M. Fromme H.B. Gender Equity in Pediatric Hospital Medicine: What History Tells Us.Hosp Pediatr. 2021; : e422-e425https://doi.org/10.1542/hpeds.2021-006144Crossref PubMed Google Scholar, 58Machut K.Z. Bhombal S. Escobedo M. Kataria-Hale J. Kushnir A. Lingappan K. et al.Call to action: gender equity in neonatology.J Perinatol. 2022; 42: 982-983Crossref PubMed Scopus (2) Google Scholar, 59Machut K. Hubbard D. Kataria-Hale J. Kushnir A. Lingappan K. Owens L. et al.WiNei toolkit for gender equity.https://downloads.aap.org/DOSP/SONPMWiNeiGenderEquityToolkit.pdf?_ga=2.52200873.1088674672.1682335445-270431901.1682335445Date accessed: July 11, 2023Google Scholar benefits,60Arnautovic T.I. Dammann C.E.L. The neonatal perspective of paid family medical leave (PFML).J Perinatol. 2022; : 1-4https://doi.org/10.1038/s41372-021-01300-6Crossref Scopus (4) Google Scholar and wellness, other sections may need support to implement first initiatives. FLEXPeds will offer opportunities across the AAP to share and collaborate on advocacy initiatives (eg, AAP policy statements and commentaries). In addition, FLEXPeds intends to work collaboratively with various other professional organizations, including the Association of Medical School Pediatric Department Chairs, the American Pediatric Association, the Society for Pediatric Research, and the American Pediatric Society, as well as the Children's Hospital Association, and the AAMC. A major goal will be to disseminate evidence-based, best-practice recommendations for reducing gender–career disparities to ensure a best future for healthcare in general. Moreover, stakeholder support will be sought for implementing urgently needed systems-level changes to reach gender equity across the pediatric workforce. For example, we support the national request from the AAMC and the National Institutes of Health for transparency and accountability of institutional gender equity12Dandar V.M. Lautenberger D.M. Exploring faculty salary equity at US medical schools by gender and race/ethnicity. Association of American Medical Colleges, 2021Google Scholar,16Gottlieb A.S. Jagsi R. Closing the gender pay gap in medicine.N Engl J Med. 2021; 385: 2501-2504Crossref PubMed Scopus (20) Google Scholar,61Spector N.D. Asante P.A. Marcelin J.R. Poorman J.A. Larson A.R. Salles A. et al.Women in pediatrics: progress, barriers, and opportunities for equity, diversity, and inclusion.Pediatrics. 2019; 144: e20192149Crossref PubMed Scopus (80) Google Scholar using clear metrics of inclusion, diversity, and equity.11Whaley C.M. Koo T. Arora V.M. Ganguli I. Gross N. Jena A.B. Female physicians earn an estimated $2 million less than male physicians over a simulated 40-year career.Health Aff. 2021; 40: 1856-1864Crossref PubMed Scopus (42) Google Scholar In short, FLEPed believes that public reporting of such data is vital to enact systemwide changes that will benefit all.12Dandar V.M. Lautenberger D.M. Exploring faculty salary equity at US medical schools by gender and race/ethnicity. Association of American Medical Colleges, 2021Google Scholar Despite significant strides over the past several decades to close the gender gap in academic medicine, there is still much work to do. The COVID-19 pandemic created significant new barriers for the career advancement of women physicians and magnified existing systemic problems that remain unaddressed. As a new network of pediatric primary care and subspecialty clinicians, FLEXPeds will work to achieve gender equity in academia, leadership, and compensation for the benefit of all current and future members of the pediatric workforce, as well as for the children of America for whom we collectively care. This group has received funding from the AAP Friends of Children Fund. The authors declare no conflicts of interest. We have received administrative support from the AAP and would like to thank Lauren Barone for her help and passion. We have received funding from the AAP Friends of the Children's Fund and support from Drs Anne Edwards and Fan Tate. FLEXPeds includes the following collaborators: Cristina E. Alcorta, MD (Pediatric Trainees, Brown University, RI), Sarah Yukiko Asaki, MD, CEPS-P (Minority Health, University of Utah, Salt Lake City, UT), Sowmya Balasubramanian, MD (Cardiology, University of Michigan, Ann Arbor, MI), Romina L. Barral, MD, MSCR (Minority Health, Children's Mercy, Kansas City, MO), Abbie R. Bauer, MD, MS (Nephrology, Oregon Health & Science University, Portland, OR), Erica Bernardo, MD (Critical Care, Baylor College of Medicine, Houston, TX), Laura A. Boomer, MD (Surgery, Children's Hospital of Richmond, Richmond, VA), Jessica L. Bowman, MD (Cardiology, Nationwide Children's Hospital, Columbus, OH), Tamika J. Bryant, MD (Child Abuse, Emory University, Atlanta, GA), Jamie K. Capal, MD (Neurology, University of North Carolina, Chapel Hill, NC), Corrie E. Chumpitazi, MD, MS (Emergency Medicine, Baylor College of Medicine, Houston, TX), Jill D'Souza, MD (Otolaryngology, School of Medicine, New Orleans, LA), Beth B. Emrick, MD (Developmental Behavioral, Marshall University, Huntington, WV), Ann Marie Flannery, MD (Neurosurgery, Our Lady of Lourdes Women's & Children's Hospital, Lafayette, LA), Dana W. Giel, MD (Urology, University of Tennessee, Memphis, TN), Theresa W. Guilbert, MD, MS (Pulmonology, Cincinnati Children's Hospital, Cincinnati, OH), Miriah C. Gillispie-Taylor, MD (Rheumatology, Baylor College of Medicine, Houston, TX), Candace F. Granberg, MD (Urology, Mayo Clinic, Rochester, MN), Heather A. Haq, MD, MHS (Global Health, Baylor College of Medicine, Houston, TX), Elena B. Hawryluk, MD, PhD (Dermatology, Boston Children's Hospital, Boston, MA), Honey H.H. Herce, MD (Ophthalmology, Baylor College of Medicine, Houston, TX), Vivian P. Hernandez-Trujillo, MD (Allergy and Immunology, Allergy and Immunology Care Center of South Florida, Miami Lakes, FL), Ginger L. Janow, MD (Rheumatology, Hackensack Meridian Health, Hackensack, NJ), Mayra A. Jones-Betancourt, MD (Minority Health, University of Nevada, Las Vegas, NV), Juliann L. Kim, MD (Hospital Medicine, Palo Alto Medical Foundation, Palo Alto, CA), Catherine A. Kimball-Eayrs, MD (Uniformed Service University, Bethesda, MD), Hilda H. Kriel, MD (Orthopedic Surgery, Baylor Scott and White Health, Temple, TX), Mary F. Landrigan-Ossar, MD, PhD (Anesthesiology, Boston Children's Hospital, Boston, MA), May C. Lau, MD, MPH (Adolescent, UT Southwestern, Dallas, TX), Kerri Z. Machut, MD (Neonatology, Lurie Children's Hospital, Chicago, IL), LaDonna J. Malone, MD (Radiology, Children's Hospital Colorado, Denver, CO), Michelle C. Mann, MD (Pulmonology, Baylor College of Medicine, Houston, TX), Lucy D. Mastrandrea, MD, PhD (Endocrinology, Jacobs School of Medicine, University at Buffalo, Buffalo, NY), Agnes S. Montgomery, MD (Pediatric Trainees, Children's National Hospital, Washington DC), Bindi J. Nalk-Mathuria, MD, MPH (Surgery, Baylor College of Medicine, Houston, TX), Toba N. Niazi, MD (Neurosurgery, Nicklaus Children's Hospital, Miami, FL), Haleigh Prather, MD, MHS (Pediatric Trainees, Oregon Health & Science University, Portland, OR), Maria H. Rahmandar, MD (Adolescent, Lurie Children's Hospital, Chicago, IL), Juliann L. Reardon, MD, MHS (Nephrology, Connecticut Children's Hospital, Hartford, CT), Cynthia K. Rigsby, MD (Radiology, Lurie Children's Hospital, Chicago, IL), Alyssa A. Riley, MD, MEd (Nephrology, Ascension Medical Group, Austin, TX), Megana N. Sathe, MD (Gastroenterology, UT Southwestern, Dallas, TX), Renee A. Shellhaas, MD, MS (Neurology, Washington University School of Medicine, St Louis, MO), Nanette B. Silverberg, MD, MPHc (Dermatology, Boston Children's Hospital, Boston, MA), Kanakadurga V.N.L. Singer, MD, MA (Endocrinology, University of Michigan, Ann Arbor, MI), Cynthia J. Wetmore, MD, PhD (Hematology Oncology, Mississippi Center for Advanced Medicine, Oxford, MS), Heather N. Williams, MD (Child Abuse, Vanderbilt, Nashville, TN), Sylvia H. Yoo, MD (Ophthalmology, Tufts Medical Center, Boston, MA).
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