Reviewed by: Mrinalini Kulkarni-Date MD, Yvette Williams-Brown MD and Kimberly Brown MD
Written by: Abbi Havens
At UT Health Austin, we know the importance of a diverse staff and patient base to increase mutual understanding and deliver the most informed care possible to our community. When we listen and learn from each other, we all grow. In the Women in Medicine panel discussion recently hosted by the Dell Medical Health Apprentice (HLA) Program, we had the privilege of listening to UT Health Austin doctors Kimberly Brown, MD, FACS, Yvette Williams-Brown, MD, MMS, FACOG, and Mrinalini Kulkarni-Date, MD, discuss gender-based issues in medicine and have a frank discussion about what it’s really like to be a woman in medicine. Here’s what they had to say on the subjects of family, bias and change.
Can you tell us a little bit about yourselves and what led to you to enter medicine?
Dr. Williams-Brown: I was drawn to my field because I was fascinated by babies. I thought reproduction was amazing and I’ve always been interested in science and biology. Once I actually began ob-gyn residency, delivering babies was exciting, but I was more drawn to the complexity of the surgery involved in taking care of women with gynecological cancers. I decided to sub-specialize and became a gynecologic oncologist.
Dr. Kulkarni-Data: I knew I wanted to do medicine at an early age. I tried to do other things, but I was always drawn back to medicine. I was drawn to the complexity. There are a lot of puzzles to put together to be a great diagnostician. I chose endocrinology for many reasons. It’s fascinating because it combines multiple organs, and it’s mostly outpatient, so I like the lifestyle that it also allows me to have.
Dr. Brown: I’m a surgical oncologist. I chose surgical oncology because I love my patients and I am honored to help them in their acute time of need. Additionally, I love surgical oncology for the problem solving. Between surgery, chemo, or radiation, what’s best for the patient and in what order? Discovering what’s best for patients is intellectual and hands on, which I find incredibly satisfying. My husband even noticed when I’m spending a lot of time in the OR, my mood is better. When I haven’t operated in a while, I’m cranky.
A common question that women entering medicine receive is ‘How will you manage a family and children?’ What are your thoughts on this, and is this a valid question?
Dr. Kulkarni-Date: I made the decision to enter this field before I was married and had kids, but I knew that I wanted a family. You have to discover who you are and what’s important to you. I have two boys and my career has been a very positive experience for them. They think it’s really cool their mom is a doctor and it teaches them a lot of life lessons.
Dr. Williams-Brown: I always wanted a family and I always wanted to be a doctor, and I never felt I had to choose between the two. I’m surrounded by friends who are female physicians, and they are constantly around my house and know my kids. So when my twin boys recently met a male doctor, they said, ‘Wow, daddy’s can be doctors too?’ So yes, my boys are beginning to realize that even they can be doctors if they put their minds to it.
Cue the crowd’s laughter.
Dr. Brown: I’ve realized that even when you work outside of medicine, it’s not that much easier to have kids in any field. In any context, when you have a career you are trading time with your kids, but you’re gaining the opportunity to build your own sense of identity and satisfaction from that. My kids know I love them very much. It is possible. It’s challenging, but it’s possible.
What are some examples of discrimination you’ve faced as a woman in medicine whether from patients, intentional or unintentional, or from colleagues?
Dr. Williams-Brown: The biggest barrier I face is people don’t think I’m a doctor, period. I can walk into a space and not even be acknowledged. Once I was rounding in between surgeries with my residents, and a nurse asked me who I was there to pick up. I said, ‘Excuse me?’ She repeated, ‘Are you here picking up or dropping off?’ I said neither and she asked, ‘Well are you just hanging out on the ‘floor?’ Finally, I said ‘No, I’m a physician.’ It seemed I couldn’t have been anything else other than the patient transporter because she was just wracking her brain trying to figure out what else I could possibly be doing there. I can name countless examples of that as a woman of color. It’s little microaggressions, as they call it. I don’t know if they’re really microaggressions or a slap in the face, but those things happen all the time. They add up and can be overwhelming if you let them.
Dr. Kulkarni-Date: There’s always been one patient who says ‘I prefer to be seen by a man,’ or ‘I prefer to be seen by someone Caucasian.’ When people talk about their own health, there’s a lot of fear, so my response was always, ‘I’ll see what I can do.’ Now, when I see that happening to my residents, I have a talk with my patients. I say, ‘This is your doctor and they’re capable and competent.’ It can be alienating to speak up if you are around people who are used to a particular environment and you’re one of the only women. It can be an isolating experience, but I always try to do what’s right understanding I won’t always be the most popular person, and frankly may be sacrificing opportunities, but I personally feel like we have to do that. We have to stand up, we have to speak up and support each other, and take more women with us as we move up in the world.
Dr. Brown: What’s been most challenging in my career is the currency of opportunities and how those are distributed. In academia you need grants, to publish research, and to be in leadership roles and those opportunities are often doled out by the people already in positions of influence. Statistically speaking, those people are often white men. I recently attended a talk by a surgeon about disparities in education and leadership. He said that whenever he is asked to provide a name for an opportunity, whoever comes to mind might be the person he recently had a beer with, and that person will most often be someone like him. He now tries to think a little deeper and ask himself, ‘Who else do I know that is also qualified for this opportunity?’ in order to extend opportunities more equally to people from diverse backgrounds.
Moving forward, what would you like to see change?
Dr. Brown: I think it’s important to make education about microaggressions a part of the culture and teach people appropriate responses to address that.
Dr. Kulkarni-Date: We have to be very careful that our actions and words are not alienating to our male counterparts. We are not going to move forward without the support of men in leadership positions. That is the reality, and there are many peers and men in leadership who are really supportive. One thing I’ve found really helpful is mentorship. I didn’t know what I was getting into as a woman in medicine. I found many mentors and every single one of them has been profoundly influential on where I am today. Mentorship programs should be actively supported in this regard. It’s all about setting the culture and that takes time. It starts with us.
Dr. Williams-Brown: I think just having women and people of color in positions of power will ultimately change things. Having representation certainly matters and people who are conscious of others’ interests will actually create change for other people.
Creating change. That is how we work here at UT Health Austin. By welcoming a diverse range of voices to the table, we constantly strive to give you the best and most informed care possible, and we couldn’t do it without our own inspiring women in medicine.