Should Female Emergency Physicians Embrace their Femininity?

A new generation of female physicians is reshaping perceptions of our profession: what it takes to succeed, and therefore what sorts of skills, temperaments, and character types belong in our field. The changing demographics of emergency medicine physicians begs a consequential question: should female emergency physicians embrace their femininity on the job?

There is the nascent #ILookLikeaSurgeon campaign that started on Twitter and grew to its own domain aimed at breaking down the stereotype that surgeons are all of the Caucasian, male, alpha-types of old. What will the equivalent movement be for emergency medicine? And what obligation do female EM residents and attendings have to represent our profession on the job and when we negotiate for new jobs?

I must confess, I am a reluctant warrior at best when it comes to reinforcing or breaking down gender stereotypes in the ED. My ultimate goal is to do what is best for my patients, and if that means playing up my femininity, then I’ll consider that tactic. But not every female physician feels this way, and opinions on the subject are passionate and varied.

I can imagine the two extremes on this matter. There is a very girly emergency physician who has no qualms about being feminine at work, and she will use it to her advantage if need be. There is the other female emergency physician, however, who rejects using her femininity on the job and, in fact, views it as a borderline betrayal of the cause.

Dr. Sandra Scott Simons, known on Twitter as @ERGoddessMD, argued in a recent EMN column that female physicians should embrace their inner “Dr. Barbie.” Dr. Simons embraces her rhinestone-adorned stethoscope, and she is delighted when the EMS guys raced to deliver her coffee piping hot. She wrote about how she “purred” to a hospitalist to smooth an admission and leveraged the inevitable flirtations of an octogenarian male patient to coax him into being more cooperative.

Dr. Simons is clearly at the girly end of the spectrum.

Her article sparked an interesting conversation among my fellow female emergency physicians when I posted it on social media. One colleague of mine wholeheartedly said, “Women should stand in their own truth and be who they want to be and be doctors,” but in the next sentence said she would get her own coffee and say, “No, thank you,” to turning on the charm at work.

Another colleague said she agreed a little more with Dr. Simons, who she envisioned as “some badass version of Elle Woods,” the main character in the film “Legally Blonde.”

“[Dr. Simons] is making the point that she can be pretty, and she can exploit that to her advantage. I am certain that the [male] ER docs who flirt with the nurses are doing the same. So — I agree with her on this — I actually also want respect and rhinestones!”

Keep in mind both of these women are senior physicians in important leadership positions. Neither of them has to prove anything to anyone.

I get the idea of wanting to have both. What woman doesn’t? I saw a cartoon recently of a woman juggling everything: her husband, her kids, the housework, and her career, and under it was a caption wryly observing thatonly a woman would want to do all of this at once.

As I’ve grown into my career and also into motherhood, I’ve increasingly realized that it really is impossible to do everything perfectly. If you are searching for a new job or considering going part-time to achieve a perfect balance, keep dreaming. Society still expects women to be perfect at everything — the perfect mother, the ideal wife, the ambitious career woman — but it’s not society’s expectations with which I’ve needed to come to peace. It’s my own.

Women who choose to become EPs, like men who choose that career path, probably do not need instructions on how to channel ambition, achieve success, or otherwise lean in. Dr. Simons wrote, “Beauty is power, and beautiful people succeed.” My first reaction to this statement is what a bummer that we are still stuck there. I would like to think that charming and warm and friendly people, not just attractive people, succeed.

My message to fellow women in medicine is to hold on to the qualities that make you good physicians, whether or not these are viewed as more feminine qualities. But most of all, seek some sort of peace within yourselves about the idea of having it all. You can’t juggle all the balls in your life perfectly all of the time. Invest your energy into the aspects your life that really matter, so that when that ball falls, it will bounce right back up.

Editor’s note: this post first published in EM News, where Dr. Fowler writes a monthly column.