Leaders in Imaging: A conversation with Dr. Marcia Javitt

2012 01 16 15 19 02 267 Javitt Marcia 70

AuntMinnie.com is pleased to present the next installment of Leaders in Imaging, a series of interviews with individuals who are shaping the radiology landscape. This month, the American Journal of Roentgenology published a Masters of Radiology panel discussion on the topic of women in radiology. We spoke with Dr. Marcia Javitt, section editor for women's imaging at AJR and adjunct professor of radiology at Uniformed Services University of the Health Sciences, who participated in the panel discussion.

AuntMinnie: Masters of Radiology panel moderator Dr. Howard Forman began the discussion with the following question: "Should we care that women are grossly underrepresented in radiology?" What's your response?

Javitt: The answer to that question is complicated for me. First, I don't consider myself so much a feminist as a humanist. That is, someone committed to supporting all people regardless of gender, race, ethnicity, religion, etc. Obviously that includes both men and women. The selection, mentorship, and support of candidates going into radiology ought to be based on merit. For me, it's not about gender but rather about encouraging capable people to enter a field that offers them an opportunity to marry cognitive abilities with patient care.

Do women bring unique skills to the practice of radiology?

Women do have a special niche. Because of gender differences in our culture, women radiologists may sometimes interact differently with patients and approach women's healthcare differently than men radiologists. Women may tend to build consensus and may avoid conflict more than men. This has little to do with a woman radiologist's cognitive processing when she's interpreting images. It's just that there are culturally based patterns that can be additive, especially for patient care. The fact is that women bear and raise children, which requires that they subordinate their needs to those of others.

How can women be supported to pursue careers in radiology?

The one factor that may most influence career choice is mentorship. I often ask my female peers in the field who are successful today -- serving on prominent committees, holding professorships, performing research -- "who mentored you?" And many of them say that men were their mentors.

Dr. Marcia JavittDr. Marcia Javitt
Dr. Marcia Javitt
There's been an evolutionary process over the past two or three decades wherein forward-thinking men encouraged bright men and women to enter the field of radiology. Women are underrepresented in radiology; women are 48% of medical students, but only about 24% go into radiology. Over the past two decades, there has been some progress, as more and more women have successful careers and assume positions of authority.

Women can make great leaders, but the career development and advancement of women who have leadership abilities are contingent on career opportunities, mentorship, and support. These potential leaders must have strength of character, magnanimity, honesty, dedication, intelligence, innovation, and charisma. In these qualities, they are no different from their male counterparts. However, to develop into tomorrow's leaders, these women require a level playing field.

Career advancement of capable women, whether within an academic institution or a clinical practice, contributes to the success of the entire enterprise. If women are excluded or overlooked for promotion, tenure, or research funding (the currency by which we might judge success in the field), then they will become disenfranchised and disillusioned -- an undesirable result for these women and their institutions.

What is the role of mentorship in women's radiology careers?

Mentorship is part of the continuum of training. Those of us who are leaders now have the opportunity to interact with students, who then become residents, fellows, and junior and then senior faculty, all of whom, in turn, mentor those behind them at every step of the way. Students and residents look for role models to emulate. They seek guidance about the nature of the work and the advantages and disadvantages of the subspecialty to decide whether to go forward with their career choice in radiology.

We need to let those whom we mentor into our personal space, behind our defense mechanisms, and actually show them what we find gratifying in the work, and tell them how we manage our life issues and how we balance work with family. Doing this makes a mentor human and offers students and residents an algorithm that they can apply to their own lives when they're making career decisions. We're not going to get smart people if they come to the department for training and are confronted by a cold, unsympathetic, uninspiring attitude.

I think being a mentor is a huge personal commitment, and it's incredibly worthwhile. When it comes to mentorship, you can't turn someone on and off at will by telling them, "I'll mentor you, but only on Tuesday afternoons." It doesn't work like that. There are similarities to parenting, which is a full-time job. In my experience, mentorship is a two-way street. Mentees make me want to do a better job, to offer my best, and to strive for excellence. I am very proud of my trainees, and I learned as much from teaching them as they did from being taught.

What kind of work patterns do you see among female radiologists? Has the radiology workplace changed to support these patterns?

The biological reality is that women bear children. Women tend to be in their childbearing years at the same time that they're in training or are very young faculty. There is an intrinsic conflict between childbearing and rearing, and being dedicated to your training program to become an excellent radiologist. It is a fundamental work-life balance issue that is hard to juggle. The good news is that there are now improvements in some services in the workplace.

For example, some facilities, both academic and community hospitals, have childcare available onsite. Maternity leave is more widely accepted than ever before. Some women are doing job sharing or teleradiology work at home while they're in this season of their lives.

But the fact of the matter is that young female radiologists who are parenting children have a difficult time being academically productive and/or providing extended service to their clinical practice with committee work or practice development. Let's face it: It's hard to go to work all day, come home to care for your kids, and then after the kids are down late at night, to go back to work writing papers and doing research. The net result is that women are very challenged to be productive in the early part of their careers, and they tend not to advance as quickly up the academic ladder. Of course, theoretically, men should be equally sharing childcare responsibilities, but that's still not always the norm.

How can women enrich the practice of radiology in the current fiscal and regulatory climate?

There are big challenges to our specialty related to healthcare reform, the faltering economy, and the debt crisis. Threats include but are not limited to the commoditization of the field and the exclusion of radiologists from decision-making processes that affect patient care, policy, and reimbursement.

We as radiologists have to add value to the patient care enterprise. Women can make strong contributions. Our ability to communicate as physicians tends to be honed by the fact that we manage a family, parent our children, deal with our spouses, and multitask 24/7. This same skill set will be useful in developing successful collaborations with our clinical colleagues to practice safe and effective patient-centric medical care going forward.

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