SMCMA Physician

CMA Section Focuses on Diversity

“A blank wall of social and professional antagonism faces the woman physician that forms a situation of singular and painful loneliness, leaving her without support, respect, or professional counsel” 

Elizabeth Blackwell, the first woman to receive a medical degree in the United States.

Since her graduation from medical school in 1849, I think we would like to believe that we, as a noble and venerated profession, would have evolved beyond bias to a place where opportunity, equity, and inclusion would be embraced and diversity celebrated. But, as noted in the October 25th New England Journal of Medicine, 50 percent of female medical students still reported experiencing harassment. This regretfully illustrates the continued schism between the aspirational and the hard reality. Additionally, the National Academies, in their 2018 report on Harassment: Climate, Culture and Consequences, chronicled that despite some improvement in the participation of women in medicine, there still exists significant gender bias resulting in substantial gaps and barriers in salary, leadership positions, and career advancement.

The CMA House of Delegates, through Resolution 302-14, prioritized the development and design of a strategic approach to expand diversity and inclusion in the CMA, our constituent Medical Societies and in the House of Medicine in general. The CMA Executive Committee took that as a call to action. They formed a Technical Advisory Committee (TAC)on Diversity and Inclusion to work on this mandate to help our organization in identifying and removing barriers, in helping to set priorities to adjust to the changing demographics of our state, and to focus on the needs of our diverse communities. These efforts have included understanding the role that gender has in our membership and leadership, and to help develop a path forward to address biases and bridge the gender based gaps that have resulted in our current state. But we needed data to understand what our current state actually was. 

The work of the TAC has included a deeper look at our organization, which has led to a better understanding of how the California Physician Workforce is evolving. Using the most up-to-date data available, an examination of the current demographics was undertaken. That deeper dive helped to flesh out our present organizational composition revealing that the CMA and the California Physician Workforce in general is evolving and in fact becoming more female with each generation. As it stands, in the youngest cohort of CMA members, women now constitute more than half of our active members.

CMA leadership, and in particular our current President, Dr. David Aizuss, recognized that in the current political and economic climate, CMA needed to establish itself as an indispensable leader and driver of inclusion, diversity and justice within California’s physician workforce. It became clear that the strategic imperative of equity and opportunity was at its base really acknowledging the realities of the evolving cultural dynamic. It was also clear that buy-in at all levels of the organization was necessary to assure the success of any diversity and inclusion initiatives. As a consequence of that over arching strategy, the Board of Trustees on the recommendation of the TAC, took steps to begin to embrace the realities of the changing membership base and alter the organizational approach by which future leaders are identified and promoted, adding their unique voices to the collective narrative. The Board approved updating the CMA nomination process to include diversity and demographics data to allow applicants to provide information to be used for policy making and increase the number of factors employed in selection. The goal would be to encourage new member involvement and expand the focus of the selection process. The Board also affirmed the need for expanded outreach to underrepresented physicians to help increase awareness of participatory opportunities within regional, component and statewide CMA organizations. Within that directive was also the desire to expand solicitations from component units within the CMA to improve the communication and help identify future leaders who identify with underserved and underrepresented communities within the House of Medicine and the state as a whole. There was also an agreement to reach out to younger physicians and physicians in training to both provide guidance and networking opportunities to help them learn and advance into leadership tracks to help move forward a more inclusive narrative throughout the organization. It was also recognized that other organizations who are also working towards justice and equity would serve as synergistic voices and that the CMA would seek to partner with them and their organizational Diversity Offices to continue to promote the aims of policies of inclusion and opportunity. The goal has always been that while we honor our traditions and values, we also seek to evolve and remain a nimble organization that is reflective of and responsive to our members and the communities we serve. 

And clearly the call to action and the work of the TAC will continue as we have not yet achieved that place where full equity is an assured reality either in the House of Medicine nor in society as a whole. Leaning in as agents of change has never been more important. We all must play a collaborative role in replacing anachronistic gender based attitudes, customs, practices and structure that have failed to honor our mutual training, professionalism and dedication. Respect means admitting that we have all endured the same rigorous journey, paid the same price to practice medicine and should, irrespective of gender, be afforded the same opportunities, value and respect. 

We want to celebrate our diversity and revel in the strength it affords us as an organization. In my mind, I pause and reflect on one of California Medicine’s true pioneers Dr. Charlotte Blake Brown. Dr. Brown upon graduation from Medical School in 1874, returned to her home here in the Bay Area to practice her hard earned craft. As was the practice in those days, she applied to the San Francisco Medical Society in 1875 only to be denied membership because she was a woman - not once but twice. Undeterred, she continued to practice as a as primary physician and surgeon and later on in that same year, with eleven other women, founded the Pacific Dispensary Hospital for Women and Children in San Francisco, the precursor to the Children’s Hospital of San Francisco. She, through her unquestioned skill, compassion and dedication eventually became the first female Chair of a State Medical Society (the California Medical Society) in 1876 and later was one of five women admitted to the San Francisco Medical Society in 1877. What was true then is equally true now: Californias Women Physicians are true innovators and irreplaceable agents of change. 

Donaldo Hernandez, MD is past President of the Santa Cruz County Medical Society and represents Disctrict VII on the CMA Board of Trustees