On Their Own Terms: Women in Medicine
Four Alums Explore What It Means to Be a Woman in Medicine
By Elisa Ludwig
Patrice Weiss '92
"I was lucky to live in an interesting time," says distinguished pediatric oncologist and researcher Anna Meadows '69, referring to the opportunities she created for herself in an era when women doctors were rare. Arguably, these are still very interesting times for women and especially in the field of medicine, where women now outnumber men in medical school. Meadows and three other alumnae — ob/gyn and Carilion Clinic Chief Medical Officer Patrice Weiss '92; cosmetic and laser physician Lisa Cheley Espinoza '04; and emergency physician Kraftin Schreyer '13 — recently shared their challenges and successes, and what they'd like to see shift for women doctors of the future.
Dreams, Breakthroughs and Stumbling Blocks
It's hard to believe that there was a time when women were simply discouraged from entering the field, full stop. Yet an early college experience quashed Anna Meadows' goals for a time. "I took a chemistry course and I really aced it, and the TA thought I must have cheated, so he gave me a C in the course. This will surprise people who know me now, but back then I just said, Well, there's nothing I can do and I'll never get into medical school. So I changed my tack and majored in psychology."
After she got her master's degree in psychology and moved to Ohio with her first husband, Meadows taught at Lake Erie College and had three children, yet she still felt dissatisfied with her career choice. In 1962, Benjamin Spock came to the school to speak, and when she asked his advice, he told her to follow her dream. Meadows applied to Harvard Medical School, only to be told that she would be taking the place of a man who wouldn't have children and therefore would have a much more productive career. That "poison pen" letter only lit the fire for her, and she applied to as many East Coast schools as she could find. She was accepted at Woman's Medical College, where she enrolled in 1965, one of 62 women in her class.
Some 30 years later, Patrice Weiss found the path to medical school to be much smoother, partially because she had actively-engaged parents who had already helped her break down social barriers — in 1974, they petitioned local organizers to allow her to be one of the first girls in Pennsylvania, if not the first, to play Little League baseball. It was Weiss's involvement in sports and the injuries she sustained as a result of playing them that piqued her interest in anatomy and medicine.
Lisa Cheley Espinoza '04 and Kraftin Schreyer '13
"But I never told anyone I wanted to be a doctor, not because I was a girl, but because I was a jock and focused on other things. I started college as a business major but by sophomore year I told my father I wanted to switch to pre-med. He told me to go for it. I was in awe — I just held physicians, nurses and the medical field in such high regard, and I never thought I could do what I really loved," she says.
Drawing on a Legacy of Women's Medical Education
Even with women comprising the majority of medical students today, it's still poignant to consider that Woman's Medical College privileged women's careers when that was a radical idea. Lisa Cheley Espinoza came to medical school later than the traditional student, having spent many years as a professional ballet dancer. Drexel University College of Medicine enticed her because of its culturally diverse student body and its reputation for educating underserved populations.
"I was a little older, my parents never went to college and I'm Hispanic, so it was important for me to choose a school that embraced different kinds of students," she says. "As someone who always felt like an underdog, I very much appreciated that Drexel was built on the history of Woman's Medical College."
While enrolled, she found that Drexel's ratio of female faculty lecturers, administrators and leaders was important to her academically, and formative in her vision of what her life could look like. "These were amazing women who were teaching and practicing medicine and having families. They did everything, and they showed me how you could be a powerhouse as a woman in medicine, that I could go into whatever specialty I chose."
Anna Meadows '69
Another key influence is Espinoza's mother, an immigrant from Colombia, who advised her to work at least 5 percent harder than everyone else, and Espinoza took this to heart. In medical school she was named class president, and she later served as chief resident.
Well into the 21st century, Kraftin Schreyer was encouraged to follow her interest in medicine from childhood and, having plenty of doctor role models, never once considered that she would encounter any obstacles due to gender. She was drawn to Drexel for its progressive pedagogy, but she was equally enamored with its tradition of teaching women. "There were many men and women in my family involved in medicine, and my parents both attended Hahnemann Medical College — my mother for her PhD — so there were several reasons for me to choose Drexel, but I liked knowing that history was there."
From School to Specialty
Choosing a specialty can raise important considerations for women in medicine. Historically, of course, many specialties were simply seen as unfit for women doctors, and some continue to demand hours that could be incompatible with traditional household arrangements. Yet these four graduates were undeterred by naysayers and focused on their passions above all else.
With a fascination for the visual — the pathologies she could see in a microscope — Meadows decided to go into pediatric oncology, one of the specialties that had lots of women then. As a resident at St. Christopher's Hospital for Children, she found that women in the hospital setting were often ignored, so she made it a point to befriend the nurses.
"The women doctors realized the nurses knew everything and they were our allies. That helped us get through," Meadows says. As a student at Hahnemann University School of Medicine, the one thing Weiss was certain she didn't want to be was an ob/gyn — which, even in the late 1980s, was a fairly male-dominated field — but a rotation changed her mind.
"I discovered how amazing pregnancy is. How can our bodies reject kidney transplants, yet when it comes to pregnancy, you have 50 percent foreign proteins and DNA in your body that doesn't get rejected?" Weiss says. "People thought I was crazy for going into a specialty that would take me away from home at all hours of the night. They told me I couldn't have a family life and I would be hit with malpractice cases. All I ever said back was 'but I like it.'"
Espinoza found her specialty even before attending medical school: Her own history of acne and an undergraduate job at a UCLA clinic exposed her to the field of cosmetic dermatology. She soon fell in love with laser medicine and its applications for a range of skin conditions. At the time this modality was in its infancy and just coming into vogue on the West Coast, and she saw a valuable business and career opportunity to bring the technology east.
Likewise, Schreyer has always known she wanted to go into emergency medicine. She finds the spontaneity of the work, the constant improvisation and hustle, exciting. She also had a sense that shift work would actually allow her to more easily manage parenting and family life, when the time came. "I think the field in general attracts strong women, and I see that in the women who take on leadership roles," she says.
Forging a Career Path
Leadership, entrepreneurship, education — finding a niche and using it to make a difference distinguishes these women in their careers, whether it's a platform to share their expertise or a seat at the table with key decision makers. Along the way, they've sought help from mentors and mentored younger women in turn.
In 1972, Meadows was recruited for a fellowship at the Children's Hospital of Philadelphia, where she worked with her mentor Audrey Evans, a pioneer in the field. After realizing that there was very little research that followed up on the outcomes for childhood cancer survivors, Meadows got involved in clinical research. Her groundbreaking work made her an international leader in the field and helped evolve treatment methods to protect patient health. "In a small way I was able to change the outlook for kids, from not just surviving cancer to being able to live lives free from some of the untoward consequences that the treatment created for patients."
Meadows served as chief of pediatric oncology at CHOP for 10 years. She also was the first director of the National Cancer Institute's Office of Cancer Survivorship.
Weiss took on leadership roles as early as residency and won several resident research awards. Later she became director of the residency program and medical director of risk management for the Lehigh Valley Physician Group. Throughout her career, even as she was named vice chair and medical director of the Breast Care Center at Carilion Clinic, became chair of ob/gyn, and was promoted to her current role as CMO, she says she didn't encounter any gender-based obstacles, and she is thankful for that.
Despite her expanded responsibilities, Weiss remains clinically active as a professor of ob/gyn at Virginia Tech Carilion School of Medicine.
"I have a vested interest in women's health because I'm a woman, too. I've had difficult pregnancies. And I'm now almost 53 years old, so I'm looking toward issues like menopause and osteoporosis management. I don't think you need to be female to take great care of pregnant women. But you can definitely relate to what patients are going through," Weiss says.
With the support of her husband, a Drexel Cardiology Fellowship alum, Espinoza decided to follow her dream of essentially creating a subspecialty, starting with opening her own practice.
"I always knew I loved the entrepreneurial side of medicine, but I also realized it was harder to break into business as a woman. I bought my first laser in 2005 and built my own private practice of cosmetic and laser medicine while working at a wellness center, seeking additional training opportunities to combine dermatology, cosmetic surgery and laser medicine."
The multidisciplinary La Chelé Medical Aesthetics clinic opened in 2008 in Bucks County, Pennsylvania. Espinoza works seven days a week, but loves every minute of it. In addition to running her business, she teaches medical students, conducts clinical research, consults with multiple pharmaceutical and laser companies and travels the world speaking about the future of the field. It hasn't always been easy, she says, and challenges remain.
"Clinical research is still hugely male-dominated, as are a lot of specialties in medicine. My hybrid specialty didn't even exist when I started out so it's been a rough road getting to where I am, breaking down barriers, and I couldn't have done it without my mentors, many of whom have been women in business."
Espinoza says she has seen huge changes in her field. She's proud of the fact that she employs 25 women, and that she has been invited to speak at international conferences, join pharmaceutical advisory boards and donate services to more than 270 nonprofit organizations. La Chelé will soon be in its third phase of expansion, adding another 5,000 square feet.
Now an assistant professor of emergency medicine at Temple University's Lewis Katz School of Medicine, Schreyer works in the emergency room and conducts research. As a young faculty member, she has taken on a host of leadership roles, including quality officer for the Department of Emergency Medicine, director of the Emergency Medicine Administrative Fellowship (which she developed), and co-director of the Quality and Patient Safety Curriculum for the medical school. She also serves as a mentor for residents, medical students and academic associates.
All of these roles feel natural to Schreyer, who hopes to continue to hold leadership positions. "I've never felt that I should be sitting on the sideline listening. When I'm in a meeting, I speak up if I have something to say. I like to take initiative instead of waiting for things to happen."
"Women are different from men. When women go into medicine their drive for power is not going to be as great as it is for men with their testosterone. But women should be listened to and respected."
The Side Job
For accomplished physicians in their respective fields, multitasking is key. Yet, even if they delegate tasks like childcare and cleaning, women often find they are still responsible for much of the "emotional" labor of their households: keeping the schedules, planning events, organizing the home, attending school meetings and shopping for their children.
"If they have a family, in most cases women are still the ones who are going to remember to buy the milk, to buy the toilet paper, to decorate the house," Meadows says. "It's not easy." For her part, Weiss doesn't like the term "work-life balance" because it tends to induce guilt in anyone trying to achieve what could ultimately be an impossible feat. The point, she says, is to establish priorities and make decisions accordingly, without letting social norms dictate the rules of the house.
"What works for me may not work for someone else," she says. "I have been fortunate to be married to my best friend for 26 years. He is also a physician, and he worked in primary care. We never had roles based on gender. He could cook dinner and I could mow the lawn. He could cut his hours back for our family when I couldn't. In 1999, people were asking us how the man could possibly cut his hours for the woman's career. We faced a lot of those stereotypes from his patients and others, but I like to think that has changed by now."
Having a strong support system, inside the household and beyond, can help to weather the stressors of "having it all." Schreyer doesn't currently have children but she hopes to someday. "I see that when women at the hospital go on maternity leave, everyone rallies around them to fill in the coverage — not just women, but men, too. It's still a struggle in medicine to balance a full workload and a family. A lot of women go part time when they have kids. I'm not sure if that's in my future, but I do know that I love what I do and would have a tough time cutting back. Thankfully, I have an incredible fiancé and family that support me in all of my endeavors, and I know they will continue to do so."
Conditions have evolved, yes, but there is work to be done in evening the playing field for women doctors. Espinoza would like to see the gender pay gap close. She works hard in her own professional life to advocate for equal pay for women. She'd also like to see more resources devoted toward women entrepreneurs in medicine, more mentorships and business education.
"When you're a young doctor coming out of medical school and opening up your practice, you're dewy-eyed and you're going to make mistakes. We need to go out into the world with more business acumen," she says.
In the wake of the #MeToo movement, women in medicine may be more aware of gender dynamics in the workplace. Schreyer has heard rumors about inappropriate conduct from male counterparts, especially during training, but she personally has not experienced anything along those lines. "Perhaps I'm mistaken, but I don't think it's as prevalent in medicine as it might be in other fields."
Weiss does see more women in high-powered positions relying on their male partners for childrearing support they might not have gotten even a decade ago. Though she still encounters more men than women in health care leadership, she believes that will change.
"We'll see the shift — over time there will be more candidates. And these roles aren't for everyone. To a young woman in the field I would say, ‘Follow your passion and don't let anyone dissuade you.' I'd rather wake up every day and do something I'm passionate about for 60 hours a week than work 30 hours at something I don't care about. But you also have to punch your ticket with each experience along the way, and take the skillsets and develop your coping mechanisms so that you're ready for the opportunities when they come."
At 87, Meadows is helping to organize her 50-year reunion from medical school. She also takes care of her mentor, Audrey Evans, who lives nearby in Center City. But for all of the advances she's witnessed in her lifetime, she still recognizes the need for improvements. Meadows notes that in just about any conference or group setting, formal or informal, the speaker typically calls on a man first when answering questions.
"That's always an issue and I am forever pointing it out. But right now I see the obstacles for women as being essentially the same for men. It's about greed dominating the field of medicine — greed and power. Women are different from men. When women go into medicine their drive for power is not going to be as great as it is for men with their testosterone. But women should be listened to and respected."
She idly wonders if she would have gotten where she did if she'd had less determination to break through gender barriers or a different style of interacting with colleagues. "I frankly didn't have any problems once my career at CHOP began, not in terms of gender. Partly that's because I have a big mouth and if I saw injustice, I spoke out. Who knows — maybe I would have gotten further in my career if I'd kept my mouth shut. But I did what I wanted to do and I had a glorious 40-year career in medicine."
From her vantage point, Espinoza feels encouraged about women in the medical workplace. "From what I see we're doing it all and we're doing it well. We should be really proud of how far we've already come."
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