SGEM Xtra: I’m in a FIX State of Mind

Date: September 18th, 2019 I had the honour of presenting at FIX19 conference in New York City. Thank you to Dr. Dara Kass and the organizing committee for giving me the opportunity to present at this amazing conference. FIX stands for FeminEM Idea Exchange and is part of FeminEM. While attending FIX19, I had the opportunity to interview a couple of fantastic women. One of them was Dara Kass. She is an Assistant Professor, Emergency Medicine, Columbia University Medical Center. Dara has been on the SGEM before (FIX You Up and FeminEM-Stronger Together). Barb Lubell, Jen Gunter and Ken Milne I also interview Dr. Jennifer Gunter who is a super hero of science wielding the lasso of truth. When she was back in London, Ontario for Western's Homecoming she too made an appearance on the SGEM (Super Hero of Science). Dr. Gunter has written a new book called The Vagina Bible that has been on the New York Times bestseller list. She also has her own TV show on CBC called Jensplaining. You can listen to the brief conversation with Drs. Kass and Gunter on iTunes. From Evidence-Based Medicine to Feminist-Based Medicine. My talk at FIX19 was called from Evidence-Based Medicine to Feminist-Based Medicine. Over the last few years Dara and others have opened my eyes to some of the other limitations to EBM. You can get copies of my slides at this LINK. Evidence-based medicine was originally defined by Dr. David Sackett over 20 years ago. He defined EBM as: “The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”   I would add the word SHARED to this definition.  The modified version would be “The conscientious, explicit and judicious use of current best evidence in making SHARED decisions about the care of individual patients.”  There is a Venn diagram used to represents the EBM definition. Many people think that EBM is just about the scientific literature. This is not true. The evidence informs and guides our care but it should not dictate our care. EBM also needs your clinical judgement based on your experience. We also need to engage with patients and ask them about their preferences and values. These three components make up EBM: The literature, our clinical judgement and the patient's values. If you do that, you will be giving patients the best care, based on the best evidence and engaging in a shared decision making model, or so I thought. My eyes have been opened to the inequities in medicine by Dara Kass and other. I cannot look away any longer or stay silent These are the inequities I see in EBM. The Medical Literature: Who gets most of the grant money in medicine? Men Who rises to the top academic positions at universities? Men Who rises to the top academic positions in medicine? Men Who rises to the top academic positions in Emergency Medicine? Men Who is most likely the first author on a medical publication? Men Who is most likely the first author on a emergency medicine publication? Men Who is most likely to be the first author on a Pediatric Emergency Medicine (PEM) Paper? Men 62% of PEM  are women but only 42% are lead authors in the four high impact pediatric journals. Who are often excluded from being subjects in medical research? Women The Clinicians: Who historically has been the clinician in the room? Men Who is most likely to rises to top leadership positions within the hospital structure? Men. Only 3% of healthcare CEOs are women, 6% are Department Chairs, 9% are Division Chiefs, and 3% are serving as Chief Medical Officers. This is despite women comprising 80% of the healthcare workforce. Who gets paid more in medicine? Men ($20,000/year) Who gets paid more in academic medicine? Men ($17,000/year) Who gets paid more in academic Emergency medicine? Men ($12,000/year) Who is more likely to be introduced with their professional title at grand rounds...