Dr. Madeleine “Maddie” Lee had moments—plenty of moments—in her early career as a general surgeon when she wasn’t sure she would make it. She wasn’t always certain what she meant by “making it,” but her concern usually took the form of worry that at some point medicine would prove to just be too much for her.
Of course, there was the natural self-doubt that people feel from time to time when they are pursuing a highly demanding profession. And there were multiple pressures in contemporary medicine.
But there was another big factor: simply being female.
Dr. Lee wasn’t always accorded the respect she had earned through years and years of education and experience. She had to struggle to be paid what she was worth. There were days when balancing her roles as a physician and a mother nearly did her in. At the leadership level, there was a deficit of understanding the needs of female physicians who had decided to be mothers.
More than once her peer coach, Dr. Alice Egonu, helped her down off a metaphorical ledge, and Dr. Lee was so impressed by the positive impacts, that she became an internal Well-Being Advocate. In fact, she decided that showing up for her fellow female physicians would become her pathway to leadership at Methodist Hospital.
Dr. Lee turned her attention to women in her organization—most of them young practitioners—whom she gained firsthand knowledge from about what they needed and what was missing in their work and how it affected their professional well-being. Through this experience, she felt she was making a substantial contribution to their well-being in the organization and a real impact. Not every concern she heard was female-specific either—issues such as the crushing weight of electronic record-keeping, rushed scheduling and productivity demands were ones she heard universally. Work-life balance was an issue for men too—especially the younger ones, for whom the old model of the work-obsessed doctor wasn’t working any more.
So she signed up for Methodist’s well-being committee, which was easy enough, as it usually was short of volunteer members, and became determined to give it new life. From the beginning, she let it be known she was serious about making changes.
Not that committee work was easy. One member of the body, Dr. Larry Carey sometimes decided to play devil’s advocate and make statements such as, “I totally understand we need to get docs to take care of their physical health—sometimes we let ourselves go more than our patients do, right? But this mental-emotional well-being bit sounds like people are becoming too soft. ‘This profession is making me tired and depressed.’ But, it’s a profession that can make you tired and depressed sometimes—they need to deal with it!”
Dr. Lee would politely counter with statistics on burnout, plummeting patient satisfaction scores and the crazy costs of replacing a physician who quit because of “this mental-emotional well-being bit.”
She made well-researched pitches for more flexible scheduling for physicians, greater awareness of the small and large acts of disrespect directed at female physicians and the crazy demands motherhood could put upon them. The committee got used to her way of making her points, which were vivid, personal and full of detail.
“I remember it so well,” she said at one meeting. “I had finished a difficult cholecystectomy and I got a call from the nanny that Micah was running a fever. I was over-scheduled and there was no way I could get away, even for an hour. A senior surgeon was passing by—a guy I was scheduled to assist in the Number Four OR. He saw me on my phone and barked, ‘Wrap it up, sweetie, we need you in Four right now.’ I can’t believe I didn’t throw the phone at him.”
There was laughter, but also a vigorous nod from Dr. Virginia Beale, the other woman on the committee.
Pretty soon Dr. Lee had developed a reputation at Methodist as a Well-Being Advocate who was in it for the long haul and this reputation filtered up into the hospital’s c-suite. She started being invited to top-level meetings with the CFO. When leadership decided to expand their well-being program to other hospitals in the system—one centered on confidential peer counseling, confidential referrals to psychotherapy when needed, with guardrails in place so that licensing issues would not come up—Dr. Lee was made its administrator.
Dr. Lee understood that just having a program in place wasn’t enough if it wasn’t well-communicated, and if seeking help addressing concerns or growth opportunities wasn’t normalized. She worked closely with internal teams to promote the well-being resources and help their clinical team members understand the many ways these resources could be used to support both their well-being and improve their work-life balance—whether male or female.
Realizing the well-being program could not address all of the root causes of gender inequity within the organization, Dr. Lee immediately began expanding the initiative in the direction of deep culture change.
- She established a bag-lunch program where she and the other Well-Being Advocates brought in guests from VITAL WorkLife who spoke about a culture of care for
- She had posters made and put them up in work areas to address the issue of implicit bias—and even sexism. One said: “I’m Kathy at home and after our shift. On rounds, remember, I’m Doctor Smith.”
- She volunteered to help the newly launched DEI&B program get off the ground.
All of this service didn’t solve Dr. Lee’s personal work-life balance problem and advocating for herself in a male-dominated profession. She still struggled to spend enough time with her kids to be a “real mom” as well as a “good doc.” And she still had to use sharp negotiating skills at salary-review time. Patients’ families still sometimes said things like, “I’m sorry, but we would be, ah, a little more confident with a…man surgeon.”
But Dr. Lee knew for sure now that she was making it. And what she was making was a difference.
Download our article How the Rise of Women Physicians Impacts Your Healthcare Organization to learn more about this rising demographic of practitioners and how your organization can best support their greatest barriers.
