Are More Women Physicians Leaving Medicine as Pandemic Surges?

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

For mid-career oncologist Tanya Wildes, MD, the pandemic was the last straw. In late September, she tweeted: “I have done the academically unfathomable: I am resigning my faculty position without another job lined up.”

She wasn’t burned out, she insisted. She loved her patients and her research. But she was also “100% confident” in her decision and “also 100% sad. This did not have to happen,” she lamented, asking not to disclose her workplace for fear of retribution.

Dr Tanya Wildes and family

Being a woman in medicine “is a hard life to start with,” Wildes told Medscape Medical News. “We all have that tenuous balance going on and the pandemic made everything just a little bit harder.”

She describes her pre-pandemic work-life balance as a “Jenga tower, with everything only just in place.” But she realized that the balance had tipped, when after a difficult clinic she felt emotionally wrung-out. Her 11-year-old son had asked her to help him fly his model airplane. “I told him, ‘Honey, I can’t do it because if it crashes or gets stuck in a tree…you’re going to be devastated and I have nothing left for you.’ “

This was a eureka moment, as “I realized, this is not who I want to be,” she says, holding back tears. “Seventy years from now my son is going to tell his grandchildren about the pandemic and I don’t want his memory of his mom to be that she couldn’t be there for him because she was too spent.”

When Wildes shared her story on Twitter, other women oncologists and physicians responded that they too have felt they’re under increased pressure this year, with the extra stress of the pandemic leading others to quit as well.

The trend of doctors leaving medicine has been noticeable. A July survey from the Physicians Foundation found that roughly 16,000 medical practices had already closed during the pandemic, with another 8000 predicted to close within the next year.

“Similar patterns” were evident in another analysis by the Larry A. Green Center and the Primary Care Collaborative, as reported by The New York Times. In that survey, nearly one fifth of primary care clinicians said “someone in their practice plans to retire early or has already retired because of COVID-19,” and 15% say “someone has left or plans to leave the practice.” About half said their mental exhaustion was at an all-time high, the survey found.

Dr Monica Bertagnolli

“COVID-19 is a burden, and that added burden has tipped people over the edge of many things,” acknowledges Monica Bertagnolli, MD, chief of the Division of Surgical Oncology at Brigham and Women’s Hospital in Boston and former president of the American Society of Clinical Oncology (ASCO).

“It has illustrated that we do have a lot of people who are working kind of on the edge of not being able to handle everything,” she says.

While many

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CDC: Pregnant women with COVID-19 have higher risk for preterm birth

Nov. 2 (UPI) — Pregnant women infected with COVID-19 are about 25% more likely to deliver their babies preterm, according to data released Monday by the U.S. Centers for Disease Control and Prevention.

About 13% of babies born to mothers with the disease were delivered preterm, or at less than 37 weeks, the data showed.

Just over 10% of babies in the United States are born preterm, according to the CDC.

“The proportion of preterm live births among women with [COVID-19] infection during pregnancy was higher than that in the general population in 2019, suggesting that pregnant women with [the disease] infection might be at risk for preterm delivery,” agency researchers wrote.

Still, the findings are “preliminary and describe primarily women with second and third trimester infection, and … subject to change pending completion of pregnancy for all women in the cohort,” they said.

For the analysis, the CDC researchers reviewed data on pregnancy and infant outcomes among 5,252 women with laboratory-confirmed COVID-19 from 15 states and Puerto Rico reported between March 29 and Oct. 14.

Among 3,912 live births with known gestational age, 12.9% were preterm, the agency said.

However, fewer than 3% of infants for whom test results were available had evidence of the virus, and most of them were born to mothers who had been infected within one week of delivery, the agency said.

Among 610 infants with reported test results, 2.6% tested positive for COVID-19, the data showed.

Previous studies have shown that pregnant women are unlikely to pass the disease on to their children.

However, data released by the CDC in June indicated that expecting mothers may be at increased risk for severe illness from the virus.

These concerns appear to have been confirmed in a separate analysis the agency released Monday, which found that pregnant women infected with COVID-19 were more than twice as likely to require treatment in a hospital intensive care unit and nearly three times as likely to need mechanical ventilation than “non-pregnant” women.

However, “the absolute risks for severe outcomes for women were low,” according to the CDC.

“Pregnant women were at increased risk for severe COVID-19-associated illness,” the CDC researchers said.

“To reduce the risk for severe illness and death from COVID-19, pregnant women should be counseled about the importance of seeking prompt medical care if they have symptom sand measures to prevent [coronavirus] infection should be strongly emphasized for pregnant women and their families,” they said.

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Pregnant Women Should Be Extra Careful Against COVID-19 | Healthiest Communities

A recent story in The Washington Post reported on the more than 700 women who’d tested positive for the novel coronavirus and given birth at the BYL Nair Charity Hospital in Mumbai, India. The hospital is a part of a group called PregCovid, which collects data regarding pregnancy and COVID-19.

Here in the United States, health departments reporting cases of COVID-19 during pregnancy to the Centers for Disease Control and Prevention can provide additional information to help us understand its effects during this critical period in a woman’s – and her child’s – life. Yet despite the growing pool of data about the coronavirus, our understanding of the effects of COVID-19 on pregnant women remains limited, which is troubling given that many states are struggling with the pandemic and the high stakes involved for mothers.

While researchers continue to collect and interpret available data, it is important that pregnant women be especially vigilant to protect themselves and their babies, including by – at minimum – taking basic precautions such as practicing social distancing and wearing masks.

As an infectious disease physician who recently gave birth to my new daughter, being pregnant during the coronavirus pandemic posed significant challenges both physically and intellectually. In my field, we practice evidence-based medicine, but with the novel coronavirus, we continue to learn more each day and to update our recommendations based on new information. For now, the evidence indicates that the best tools to help contain the spread of COVID-19 are social distancing and mask-wearing.

As states have opened up and restrictions have been relaxed, however, people may believe that the risks posed by the coronavirus are diminished and go about their lives without taking these precautions. Doing so may be particularly dangerous for pregnant women: Data published in a CDC report just this week found that expectant mothers with symptomatic COVID-19 were more likely than other infected women to end up in the ICU, to require invasive ventilation and to die.

In addition, the coronavirus may cause poor pregnancy outcomes such as preterm birth. While the CDC may update its information as more becomes available, these possibilities are concerning.

Meanwhile, one of the growing hopes to prevent the coronavirus’ spread is a vaccine. Yet the release of one may not be a panacea for pregnant women, who have been excluded from clinical trials. Given this, it will take some time before we understand if these vaccines are safe for mothers and their babies, so pregnant women may be advised against getting a vaccine should one otherwise become available.

Expectant mothers who previously had COVID-19 also aren’t necessarily in the clear, as the current science is still evolving regarding immunity from COVID-19 once a person has recovered from the disease. Though rare, there have been cases of people reportedly becoming reinfected, and even a recent reported case of someone who died after reinfection.

Given the potential risk associated with the virus, some health care professionals have separated moms from their newborns

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Social Isolation Tied to High Blood Pressure in Women

Women who are socially isolated have an increased risk for high blood pressure, researchers report. But men, not so much.

Scientists used data on 28,238 Canadian men and women aged 45 to 85 who are participating in a large continuing study on aging.

The researchers found that compared with married women, single women had a 28 percent higher risk of hypertension, divorced women a 21 percent higher risk, and widowed women a 33 percent higher risk.

Social connections were also significant. Compared with the one-quarter of women with the largest social networks — which ranged from 220 to 573 people — those in the lowest one-quarter, with fewer than 85 connections, were 15 percent more likely to have high blood pressure.

The associations were different, and generally weaker, in men. Men who lived alone had a lower risk of hypertension than men with partners, but the size of men’s social networks, or their participation in social activity, was not significantly associated with high blood pressure.

The study, in the Journal of Hypertension, controlled for many factors that affect blood pressure, including age, education, smoking, alcohol use and depression.

The senior author, Annalijn I. Conklin, an assistant professor at the University of British Columbia, said that the most important finding is that social ties seem to be more meaningful for women than for men. “Social ties matter for cardiovascular health,” she said, “and they matter more for women.”

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Four Black Women – All CEOs

For 20 years, Carol Fleming has lived with diabetes. In 2016, Fleming, who is now 66, joined  Change Your Lifestyle, Change Your Life, a health-improvement program. Located in Fleming’s hometown of Detroit, Mich., the program was run by the Black Women’s Health Imperative, a nonprofit organization created by and geared toward Black women to help protect and advance their health.

This program, among others at the Black Women’s Health Imperative, is used to help Black women get healthy and address the underlying reasons for health disparities impacting their communities in America. Through advocacy on a federal level, the organization fights stereotypes about why diabetes, maternal mortality, breast cancer, and other often deadly, chronic health issues seem to plague the Black community.

“It’s not in genes; it’s due to systemic racism and bias that has created and still creates structural barriers for Black people in America to receive proper health care. Four hundred years of oppression, and what that has done to the way our bodies function brings us to where we are today,” said Linda Goler Blount, the president, and CEO of Black Women’s Health Imperative. 

“These health disparities are what we should have expected based on the way people are treated and have been treated in this society, and where resources go and where they don’t go and who has access and who doesn’t.” 

Goler Blount and three other Black female CEOs for nonprofits in the health space are signaling a ‘call to action’ to address the health gaps for Black Americans. Currently, the health disparities impacting Black Americans, specifically Black women, are startling and have resulted in alarming statistics: 

-Black women have three to four times higher rates of maternal mortality compared to white women. In New York City, it’s up to 12 times higher.

-Black Americans are 50 percent more likely to have diabetes and two and a half times more likely to die from the disease. 

– Black women have a seven to eight times higher rate of diabetes, according to Goler Blount, and higher rates of mortality from diabetes, cardiovascular disease, and hypertension. 

-Black women have 40 percent higher breast cancer mortality rates. 

-Black women have, on average, about 15 percent more cortisol in their bloodstream than white women. Cortisol is a stress hormone. Elevated cortisol is associated with inflammatory and metabolic changes and raises the risk of diabetes, hypertension, and cardiovascular disease. The high cortisol in Black women is because of chronic racial and gender discrimination.

“These health disparities are unconscionable, and there is absolutely no reason for us to live this kind of reality,” Goler Blount said. “It’s going to take all of us to come together to speak truth to power about our lived experiences, and the impact of racism and gender discrimination on our health, and to

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Polish Pro-choice Campaigner Helps Women Bypass Abortion Law

Seven years ago, Natalia Broniarczyk had an abortion despite stringent Polish legislation against it.

Now, she is helping other women do the same and taking part in mass protests against a further tightening of an already highly restrictive law.

“I’m angry,” the 36-year-old campaigner told AFP as she prepared for the latest demonstration in Warsaw.

Protests have been raging nationwide since a ruling from the Constitutional Court on October 22 that would allow abortions only in cases of rape, incest and when the mother’s life is at risk.

Until then, terminations had also been allowed in case of severe foetal anomalies but the court ruled that was “incompatible” with the constitution.

“The verdict made me feel like my country was spitting in my face. I broke down in tears, powerless,” Broniarczyk said.

Natalia Broniarczyk had an abortion seven years ago Natalia Broniarczyk had an abortion seven years ago Photo: AFP / Wojtek RADWANSKI

The campaigner adds she was surprised by the timing of the verdict, as well as by the government’s warnings to stop people taking to the streets in protest.

“We expected a more restrictive law, but we did not expect it to happen right in the middle of a pandemic.

“Or that they would treat us and our lives and problems like objects. That they would ask us to stay home, to make decisions for us without us,” she said.

Broniarczyk had her abortion seven years ago because she was not ready to start a family.

“I didn’t feel financially secure and didn’t think it was the right time,” she said.

Warsaw's streets flooded with pro-choice demonstrators Warsaw’s streets flooded with pro-choice demonstrators Photo: AFPTV / Jaap ARRIENS

She did not qualify for a surgical abortion under the law and could not afford to go abroad for the procedure.

She tried to order abortion pills abroad but Polish customs blocked her order from going through.

Medical abortion is in a grey zone in Poland, neither authorised nor banned by law.

In the end, a Polish organisation helped her obtain the pills required.

“The woman I talked to had also had a medical abortion and told me how it had gone for her. She helped me prepare for it,” Broniarczyk said.

Today she is giving back by providing support to other women as a member of the organisation “Abortion Dream Team” — whose number is one of the ones being displayed prominently by protesters at demonstrations.

In the case of women seeking medical abortions, Broniarczyk provides them with the information required to obtain pills.

She also helps women who decide to terminate their pregnancies abroad, in countries such as Britain, Germany and the Netherlands.

Poland sees fewer than 2,000 legal abortions every year. Women’s groups estimate that an additional 200,000 women abort either illegally or abroad.

It took Broniarczyk a few years to be able to discuss the abortion.

But she does not regret it, saying that over time she has come to see it as a “liberating experience”.

“I understood that I could decide for myself about my life, even while living

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Study: Postpartum depression can linger for years for some women

Many women have depression symptoms after giving birth, but for some postpartum depression hangs on for years, a U.S. government study finds.

Of nearly 4,900 new mothers researchers followed, one-quarter had depression symptoms at some point in their child’s first three years. And for about half of them, the symptoms either started early on and never improved, or took time to emerge.

It all suggests women should be screened for postpartum depression over a longer period, said lead researcher Diane Putnick.

“Based on our data, I’d say screening could continue for two years,” said Putnick, a staff scientist at the U.S. National Institute of Child Health and Human Development, in Bethesda, Md.

Right now, the American Academy of Pediatrics recommends pediatricians take on the task of postpartum depression screening. It says they should screen mothers for symptoms at their baby’s routine check-ups during the first six months of life.

That’s both because postpartum depression usually arises in that period, and because babies have frequent check-ups during those months, according to Putnick. So pediatricians are, in a sense, best positioned to catch moms’ depression symptoms, she said.

On the other hand, pediatricians are also limited in what they can do. Mothers are not their patients, so they do not have access to medical records to get the bigger picture — including whether a woman has a history of clinical depression. And they can only suggest that mothers follow-up with their own provider.

“What happens after women are screened?” said Dr. Rahul Gupta, chief medical and health officer for the nonprofit March of Dimes.

“The recommendation is excellent,” he said, referring to the AAP advice to pediatricians. “It’s a great starting point.”

But women’s primary care doctors need to be involved, Gupta said, particularly since postpartum depression can persist, or surface relatively later after childbirth.

For the new study, published online this week in Pediatrics, Putnick’s team used data on 4,866 women in New York state. All took part in a research project on infertility treatment and its impact on child development.

During the study, mothers completed a five-question survey on depression symptoms when their baby was 4 months old, and then again when their child was 1, 2 and 3 years of age.

The study was done before the AAP recommendations came out, Putnick said, and it’s not clear what kind of screening or follow-up women might have gotten from their own providers.

Based on the study screening, new mothers followed four different trajectories: Three-quarters had few depressive symptoms throughout the three-year period; almost 13% had symptoms when their baby was 4 months old, but improved afterward; 8% initially had few symptoms, but developed more as their child grew older; and 4.5% had persistent depression symptoms.

Putnick stressed that the women only screened positive for symptoms. They were not diagnosed with clinical depression, and it’s unclear how many would need treatment, such as talk therapy or medication.

But the findings show that postpartum depression symptoms can be long-lasting, or arise relatively

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Women in medicine make about $116,000 less than men, and the pandemic could be making things worse

a person holding a baby: HRAUN/Getty Images

© HRAUN/Getty Images
HRAUN/Getty Images

  • Medical networking site Doximity released its fourth annual Physician Compensation Report on Thursday.
  • In addition to compensation differences across US cities, the report highlights that women make less than men in all medical specialties. 
  • According to the report, the wage gap is largest for otolaryngology — or the specialty related to ears, noses, and throats — where women make 77.9% of men or a gap of 22.1%.
  • Overall, the gender wage gap in 2020 for doctors is 28%, about three percentage points higher than last year’s report.
  • Visit Business Insider’s homepage for more stories.

The coronavirus recession has disproportionately hurt working women, and the pressures of balancing work with parenting and household responsibilities amid the pandemic have also affected female doctors.

Medical networking site Doximity just released its fourth annual Physician Compensation Report, and one of the main findings is that the gender wage gap for doctors has widened this year.

The report describes compensation for physicians in various US cities and in different medical specialties. The figures are based on self-reported compensation surveys from 2019 and 2020 that were completed by around 44,000 US physicians.

One notable finding is the various gender wage gaps among medical specialties. Last year’s report showed a declining gap in pay between male and female physicians. However, this year the overall wage gap was 28%, 2.8 percentage points higher than last year’s figure. Women in medicine made about $116,000 less than men, where women make an average salary of around $299,000 compared to the average salary among male doctors of about $415,000. 

“It’s likely that the widening gender pay gap represents another financial consequence of the pandemic. This is a troubling trend economists have previously reported on in other industry sectors,” the company wrote in the report. 

The latest report shows that the pandemic’s effects on working women extends to healthcare, even though the industry is considered essential during the pandemic.  

“What we are thinking is that women have more responsibilities at home and therefore have had to cut back on their hours,” Dr. Peter Alperin, vice president at Doximity, told Business Insider. He also said that overall there’s been a slowing of increases in compensation this year which has especially affected compensation for women in the medical field.

Overall 865,000 women left the workforce in September alone. That is about four times higher than the number of men who dropped out of the workforce that month. NPR reports that more demand within households may be contributing to this large decline of women in the workplace. 

The following chart highlights the medical specialties with the largest gender wage gaps, according to the Doximity report. Otolaryngology, or treating ear, nose, and throat issues, has the largest gap. Women make 77.9% of men’s average annual salaries or is a wage gap of 22.1%. Women in this medical specialty make around $109,000 less than men.  

The following chart highlights the medical specialties with the smallest wage gaps, based on the report.

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Will kids or pregnant women be able to get a COVID-19 vaccine?

A vaccine against COVID-19 has been heralded, almost since the pandemic began, as the only way society will ever return to life as it was. In reality, though, challenges to widely distributing the vaccine, mistrust over how quickly it is being produced and limitations on who can receive it could mean the road to normalcy may actually be much longer.

Right now, there are four major U.S. pharmaceutical companies — Moderna, AstraZeneca, Johnson & Johnson and Pfizer — in late-stage clinical trials, where the vaccine is tested in tens of thousands of participants to assess both its efficacy and potential to cause adverse reactions. One of these vaccines, or more, could be available to high-risk populations by the end of the year, NBC News reported.

But in large part, these trials, the main process for assessing a vaccine’s safety, have left out two crucial groups that must be vaccinated to keep the coronavirus fully at bay: pregnant people and children.

So far, only Pfizer has received permission from the Food and Drug Administration to test on children. In September it started with those 16 and older; in October, it added kids as young as 12. There are, however, no plans to test any COVID-19 vaccines in pregnant women, who are more likely to get severely ill from COVID-19 than their non-pregnant counterparts, research shows.

“The sooner we can get a vaccine out to everybody, you can reduce transmission to everyone,” Dr. Yvonne Maldonado, a professor of pediatric infectious disease at Stanford University and member of the American Academy of Pediatrics’ Committee on Infectious Diseases, told TODAY. “As long as there are people out there who can spread it, we’re just not going to get rid of this pandemic.”

When will there be a COVID-19 vaccine for kids?

Nationwide, Pfizer has enrolled 100 kids between 12 and 15 and 200 between 16 and 17, Dr. Robert Frenck, director of the Vaccine Research Center at trial site Cincinnati Children’s, told TODAY via email. A Pfizer spokesperson said “several sites are now enrolling participants between the ages of 12 and 15,” as well.

In these trials, half of participants receive a placebo, and the other half receive the actual vaccine. The patients, doctors and nurses don’t know who received which in what’s called a double-blind study.

The plan is to recruit 2,000 kids between 12 and 15 for the Pfizer trial, and 600 total 16 to 17-year-olds, Frenck said, adding that researchers are looking for the same safety and immune response outcomes in kids as in adults. “If the immune response in kids is the same or better than in adults and if the vaccine is shown (to be) protective in adults, we will make the extrapolation that the vaccine should be protective in kids,” he explained.

Right now, the trial is in a “planned pause to review safety after the first dose of vaccine,” Frenck continued. Then researchers will decide on the timeline for bringing in more 12 to 15-year-olds.

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Mary J. Blige and other women touched by breast cancer talk importance of screening

The nine-time Grammy Award-winning singer said in an interview with “Good Morning America” that highlighting the illness is important to her because of the racial disparity in breast cancer death rates.

Higher death rates from the disease for Black women are due to several factors, according to the American Cancer Society’s biennial update on female breast cancer statistics in the U.S.

Some include “later stage at diagnosis and other unfavorable tumor characteristics, higher prevalence of obesity and comorbidities, as well as less access to timely and high‐quality prevention, early detection, and treatment services.”

Blige partnered with the Black Women’s Health Imperative (BWHI), RAD-AID and Hologic, Inc. for the P.O.W.E.R. of Sure campaign in hopes of giving women necessary information about breast cancer screening and why it’s so important.

Women who have battled the disease or who are currently battling the disease are also sharing more about their cancer journeys in the campaign.

The importance of getting screened: ‘Do it even when you’re scared’

Blige said she feels “a lot of fears and barriers” affect whether or not a woman will prioritize getting screened. After losing an aunt to breast cancer, the singer says she now believes a lack of awareness toward screening played
a role in her loved one’s battle with cancer.

“I believe if she had this information that she would be here today — the importance of a mammogram,” the singer said. “When we were growing up, no one spoke about a mammogram, breast cancer — anything like that.”

The singer recalled having many fears going into her first mammogram after losing her aunt and wondering whether it was going to hurt or if she was going to be diagnosed.

“Once I went into the office and went to the procedure, I realized that it was nothing to it,” she said. “It wasn’t painful, it was just a little discomfort on each breast for a second or two, and then it was over.”

She emphasized how she received early results following her Genius 3D Mammography exam and even called the screening “enlightening.” She also said it made her want to know more about her health.

Kimberly Wortham-Macon, a mother of three, is fighting breast cancer and is featured in the campaign along with Blige. She is also adamant about emphasizing the importance of getting checked.

She said she had been considering putting off her mammogram because of the pandemic but quickly took action and went in for a screening after feeling a lump in her right breast. She was diagnosed with breast cancer in July at the age of 40.

PHOTO: Kimberly Wortham-Macon opened up on her battle with breast cancer for the P.O.W.E.R. of Sure campaign.

Kimberly Wortham-Macon

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