When I was 33 I became an emergency department medical director and chair, roles rarely held by women. Perhaps naively, I thought I could leverage my new position to make our emergency department a better place for everyone, and especially for our female staff and patients.

Studies have shown that women physicians are more likely to follow evidence-based clinical guides, provide more preventive care, communicate better with patients, perform as well (if not better) on standardized exams, and provide more psychosocial counseling to their patients than do their male peers. A study from 2017 even showed that patients treated by women physicians had lower mortality and readmission rates. I assumed that having a woman in a leadership role might offer similar benefits. But that wasn’t exactly how it turned out. 

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Almost immediately, I faced microaggressions and barriers to making meaningful change. There was the executive administrator who argued with me about my title, the chair of medicine who refused to let me speak during meetings, and the per-diem physician with a pattern of sexist behavior reported by nurses and patients. I tried to remove him from the schedule—something fairly easy to do with contractors like him—but my boss continued to support him. A few months later, he missed a patient’s ectopic pregnancy that almost killed her. He thought the pain caused by her ruptured fallopian tube was no more than hysteria. Despite my best efforts, I hadn’t been able to protect this patient from the sexism of one of our physicians.

When I got........

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