My Own Bias

If you had told me I would be writing someday on women’s issues I would have grabbed a pulse oximeter and placed it on your finger and checked your oxygen level. As a physician scientist I have spent the majority of my career reading, studying, and writing on clinical medicine. Then something changed.


For years I have had the pleasure of working with and for some pretty phenomenal men in medicine. These men are #heforshes; they invite me to speak on panels and collaborate on research studies and publish manuscripts. They have nominated me for committees and leadership positions and I count each of them a friend. I believe they promote me not because I am a woman; they promote me simply because they know I will deliver. And they see me as their equal; as I see them.


So why would I, who has had a successful career thus far, speak out on women’s issues? Wouldn’t I be smarter to just keep working in the current culture and stay mum? What changed?


Two things:


1.     Recognition of my own biases

2.     Realization that my success significantly changed with the simple yet powerful action of two women physicians who couldn’t even pronounce my name right.


There was a time where I was an academic nobody. I had no publications, no national presentations, no street cred. I was still me; I had passion, drive, and decent speaking skills. I could write, albeit not as well as now, and was full of ideas on how to improve my area of medicine. What I lacked was a mentor, a sponsor, or anyone to take a chance on me.


My department was in a transition period and I began to realize that if I was going to start making a difference, I needed mentorship. And I had to do it outside of my institution. I decided to get involved in my national medical society, the Society of Cardiovascular Anesthesiologists, which proved to be one of the smartest career decisions I’ve made. What I received was not mentorship, but something even more important in my opinion: sponsorship.


I entered a contest where a junior person had the ability to stand on stage for 8 minutes and present a medically challenging case. My submission was selected. I stood up in front of hundreds of people (8 months pregnant - not my most graceful appearance) and presented a great case. Those 8 minutes drastically changed my career trajectory. Afterward, the two women in the society who organized it approached me. Those two women, in many ways, changed my career.


Why? They weren’t intimidated by me or threatened by me or thinking of themselves. They saw potential in me. And they quickly introduced me to several leaders in the society, important men who were in positions to make decisions. These women basically said this: “Watch for Sasha. Pick Sasha. Sasha has potential. Give Sasha a chance.” 


And they did.


Now here’s the thing: I had to show up. I had to deliver. I couldn’t shy away from responsibilities or big talks or grunt work. I did it. And now I am one of three physicians who run the very same national meeting, after years of putting in hard work and showing up. Many physicians do what I did; they depend on medical societies for academic promotion, education, networking, and career advancement. That’s why I am writing this blog today: medical societies are important pathways that must present fair opportunities and advancement for ALL physicians.


If you look at the current facts, most society leadership positions are held by men. A recent study by Paloma Toledo, MD and colleagues shows that in the American Society of Anesthesiology (the largest group of anesthesiologists in the world) inclusion of women and minorities in society leadership is lacking and lags behind the representation of women and minorities in the general workforce and in medicine.1 This is disheartening, and we must change it. Like the two women who sponsored me, we MUST sponsor others.


If you are up to speed on women’s issues in medicine, you will know the name Julie Silver, MD. Dr. Silver is an Associate Professor and Associate Chair of the Department of Physical Medicine and Rehabilitation at Harvard Medical School and leads two Harvard Leadership Courses. She is brilliant, well-spoken, well read and well, she’s plain fabulous. Besides being someone I greatly admire, Julie is a friend.


Julie and her colleagues recently published an incredibly brave study on her own medical society, AAPM&R, one of which she is also very involved.2 She noticed that while the society was made up of a fair amount of women (34%), most of the awards, lectureships and recognition within the society were given to males (84% males vs 16% to females).


Do you think Julie did this research to be popular? Heck no.  Yet she was very forthcoming with her society in her desire to study this issue. According to Julie, when she published her findings that showed that the majority of recognition awards were given to men, her society was thankful. They responded with formal action plans to how to improve this and work to change their own unconscious biases.


Why did they respond so favorably to a physician pointing out a bias? Because Julie’s work wasn’t meant to bring anyone down; it was to bring others up.


So why am I writing about women’s issues?  To do the same. And it starts with me, and why I changed what I write about. Because I had to. Let me tell you about my own bias.


Last year as I was planning a large national meeting. I sat down with a spreadsheet and a pot of coffee to select physician speakers for a large meeting. I started filling in spaces and linking topics with experts and spent several hours looking at about 100 names. I was so pleased with my finished product. Wow, if we were able to get all these speakers, this was going to be one amazing program.


Then I looked again. And my heart stopped.


Sasha Shillcutt herself had filled in those blocks with 90% male speakers in an organization where approximately 35% of the expert pool to pick from were women.


Why had I done this? I realized I had my own bias, because I only heard the men speak. I thought of women, of equal expertise, rank and experience who I could have filled in a spot instead of a male counterpart. But why hadn’t I? Because I had never heard the women speak and I didn’t know if they were good speakers. But why was that? Because like the person before me filling out the speaker assignments, we all have an unconscious bias. And we hadn’t sponsored those women TO speak. We don’t know it, we don’t mean it, but it is there.


I thought of Dr. Kathy Glas from Emory and Dr. Wanda Popescu from Yale who took a chance on the girl from nowhere Nebraska and I decided right then and there I was going to do the same. I was going to be a #sheforshe and change MYSELF.  I was going to give women a chance, and do my part to change the culture.


I challenge all of you, to look deep inside yourself and practice mindfulness when you think about promoting and sponsoring others. Do you sponsor people based on name alone, or are you promoting others who need someone to give them a chance? Do you actively support and challenge deserving women to nominate themselves for recognition awards? If you serve on a committee, do you nominate them?


After reflecting on my own biases, I realized I had often sponsored men because I knew they would say yes without a moment’s hesitation (there have been several studies to validate this point). I now purposefully sponsor the person I know who can do it, not just men who I know will say yes. I sponsor women and tell them what I know they often need to hear: you CAN do this, and I will help you. The truth is, women need both male and female sponsors; and they need sponsors who will instill the confidence in them they may be lacking to succeed.


We need our medical societies to advance and grow. And since WE make up our medical societies, and we ARE the societies, we need to look deep in our own biases and recognize them. What I have learned is I had my own bias; which left out women, and left out minorities. As a leader, I am changing me. I encourage you to do the same!


Look inside yourself. You may be surprised what you find there. Be #heforshe. Be a #sheforshe.


Note: Thank you Dr. Stan Shernan. Thank you Dr. Madhav Swaminathan. Thank you Dr. Christopher Troianos. Thank you Dr. Linda Shore-Lesserson. Thank you Dr. Doug Shook. Thank you Dr. Andy Shaw. Thank you Dr. Amanda Fox and Dr. Mike Eaton. Thank you to so many of you who took a chance on me!


And thank you Dr. Mark Taylor, Dr. Gregg Janelle, Dr. Roman Sniecinski and Dr. J Ho who have all reached out and encouraged me to be #braveenough. Words of support from smart and successful men like you mean more than you know!


1.     Toledo P et al. Diversity in the American society of anesthesiology leadership. Anesth Analg, May 2017 124:1611-1616.

2.     Silver J et al. Female physicians are underrepresented in recognition awards from the American academic of physical medicine and rehabilitation. PM R, Published online: March 21 2017; 1-9.