Cover Story - September 2005
Harlingen family physician Adela Valdez, MD, recalls her
first visit to the physicians lounge during her residency in
McAllen. Pregnant and new to the hospital, she decided to grab a
cup of coffee before changing out of her street clothes and into
I walked in, got coffee, and then walked out of the lounge. A
male physician ran after me and barked out, 'Young lady! Do you
know that this is the physicians lounge?' I was surprised, but
responded immediately that I did know and I was, in fact, a
physician. He was most embarrassed and apologetic. We actually
ended up becoming close friends."
Dr. Valdez understands why the man immediately assumed she was
not a physician. There weren't "many women in medicine, certainly
not pregnant women" when she graduated from medical school in 1980,
and there had been only one woman resident before she arrived in
Encountering a woman physician anywhere in Texas then was not as
common as it is today.
reported in 1975 that 112 women entered Texas medical schools in
1973. That number rose to 665 by fall 2004. Last year, the
Association of American Medical Colleges (AAMC) reported that women
applicants made up just over half of the 2004-05 national applicant
pool, outnumbering men for the second straight year.
The fall 2002
Journal for the American Women's Association
(JAMWA) predicts that by 2010, nearly 1 in 3 U.S. physicians will
be female. This boost in medicine's female population has become a
catalyst for the ways women are changing the field of medicine.
It's no secret Texas women often were discouraged from
pursuing medicine, or that such dissuasion rarely prevented their
In 1896, Leslie Waggener, MD, president of The University of
Texas Medical Branch at Galveston (UTMB), gave his last public
address before the Texas Woman's Press Association. There he
expressed his disapproval of women becoming physicians. "The work
of a doctor or surgeon is not work for a woman," he said.
Not long after Dr. Waggener died, Marie DeLalondre Dietzel
became the first woman to graduate from the school in 1897.
Even after Dr. Dietzel's graduation, critics still believed it
was a waste of time to train women in medicine. Their chief
argument was that women would marry and stop practicing. Worse,
they were depriving young men -- who it was thought would
eventually contribute more than their female counterparts -- from
precious spots in medical school. Finally, it was assumed women
were too emotional or incompetent to practice good medicine.
In 1932, Ruth Jackson, MD, the first practicing female
orthopedist in the United States, opened a practice in Dallas.
The following year, the American Academy of Orthopaedic Surgeons
(AAOS) was founded and invited all practicing orthopedists to
become members. Except Dr. Jackson. She was not asked because of
her gender. Undeterred, she would go on to pass the American Board
of Orthopaedic Surgery exam in 1937, and become the first woman
certified by the board and the first woman admitted to AAOS.
The father of the woman who would later become the first female
Texas Medical Association president dismissed her medical dreams at
age 5. "Damn fool idea," he told her.
She ignored him, and in 1935 Fort Worth pathologist May Owen,
MD, discovered that the powder once used in surgical gloves
(commonly known as French chalk) caused scarring, adhesions, and
This finding is only one example of Dr. Owen's remarkable
career. She would later establish the May Owen Trust Fund, which
provided low-interest loans to medical students, and would continue
to work until her death in 1988.
Dr. Owen, who became TMA president in 1960, blazed a trail for women's involvement in organized medicine. She was followed by Ruth Bain, MD, of Austin, in 1982, and Betty Stephenson, MD, of Houston,
in 1994. Women physicians' membership on TMA boards, councils, and committees has increased over the years. In 2000, Fort Worth allergist Susan Rudd Bailey, MD, became speaker of the TMA House of
Delegates after serving as vice speaker for three years. Dr. Bailey retired as speaker at the end of TexMed 2005.
As of Aug. 1, TMA had 9,773 women members. Nancy W. Dickey, MD,
a family physician in College Station and president of
Texas A&M University System Health Science Center, was elected the first woman president of
the American Medical Association in 1997. Dr. Dickey strongly
believes that women's involvement in organized medicine is imperative
as the profession continues to evolve.
The role of women in organized medicine is very important
because we represent a growing proportion of the profession and our
perspectives are important for problem solving. No significant
subset should be without a voice, and to forego using that voice is
to leave the profession poorer," she said.
There are so many women pioneers in Texas medicine," said Dr.
Valdez, assistant dean for education at The University of Texas
Health Science Center at San Antonio. "It's been wonderful to watch
the population of women medical students change from a handful to
the majority. I am thankful for the women who were way before me.
They helped make that possible."
The Sugar Land Four
In her book,
Restoring the Balance: Women Physicians and the Profession of
, UTMB professor Ellen S. More, PhD, writes, "Only since the 1970s,
in the wake of complex social, political, and legal changes, have
significant numbers of women doctors been able -- and willing -- to
move toward the center of professional authority in the United
Dr. More says that the pioneer women physicians were forced to
confront access to the profession, while the challenge for their
successors has been to solidify their standing and to flourish on
their own terms.
Indeed, an article by Shelley Ross, MD, in the AMA's September
says some of the changes in medical practice attributed to women
are equally advantageous for both sexes. It has become more
acceptable for both men and women physicians to refuse work to the
point of physical and mental exhaustion. Moreover, there are now
more flexible residency training programs, part-time work,
maternity and paternity leave benefits, and tax benefits for day
Dr. Ross's article also points out that solo practices are
disappearing and the number of large groups in which physicians
work shifts to provide coverage is increasing.
This setup is just one factor behind the success of Sugar
Land's Family Practice Doctors Center. Drs. Jennifer Diamond,
Jessica McKelvey, Seva Papageorge, and Tayma S. Weber not only
manage the all-woman practice, but they also run a hectic home
schedule that includes caring for their children.
"The other day a new patient told me she was excited that we
were all women," said Dr. Diamond. "She said, 'I'm so glad all
four of you are women. This practice is wonderful. You must have
great happy hours.' I started laughing. We have seven kids between
the four of us under the age of 5. We are rushing in and out the
door and sometimes forget to even say good-bye to each
The four physicians say being a part of an all-woman practice
has its advantages. They have covered for each other's maternity
leave, will see a colleague's patients if she has to leave because
of a sick child, and have been able to set hours that accommodate
their situations at home.
Additionally, the women recruited the help of hospitalist
Tajuddin Momin, MD, something that was not easy to arrange.
Originally the hospital and fellow primary care physicians were
against the idea.
Using a hospitalist was an evolution for the hospital," Dr.
Papageorge explained. "There had been no such thing, and we faced a
lot of adversity. However, once the system was in place, those who
were against the idea saw that the arrangement actually benefited
Adds Dr. Weber, "Dr. Momin cares for patients around the clock
at the hospital and can admit or discharge them directly. After the
patients leave the hospital, he refers them back to us for
continuing care. Some of the physicians who were so against the
idea have now asked him to be their hospitalist."
The Balancing Act
When asked to name their primary challenge, they are quick to
use the term "balance." Dr. More points out in her book that "the
theme of 'balance' winds through the entire history of women
in medicine. For more than a century and a half, American women
physicians have grappled with the dilemma of how to be a woman and
a physician, how to be different from, yet equal, to their male
Dr. Weber says she and her colleagues struggle "to define this
hybrid of physician and motherhood. We are all trying to maintain
both roles successfully. We cannot compromise our work as
physicians. I can't afford to stay up late doing personal stuff
because I have to come into work alert and ready to provide the
best possible care for my patients."
Erica W. Swegler, MD, a Keller family physician and immediate
past president of the Texas Academy of Family Physicians, admits
that the balancing act is difficult. She has a framed print of the
Chinese character for "balance" in her office as a visual reminder.
A mother of two, Dr. Swegler believes the key is for women
physicians to recognize they can have the lifestyle they want,
while still providing the best possible service to their
Today there are so many options of practice settings and
situations. Young women are growing up to see that they have
choices," she said. "I'm in a small group practice. There are five
other physicians to share calls with, which has been terrific.
Medicine will always have the 24-hour component and the commitment
that goes beyond what most other people do for their jobs. What's
important is for physicians to look at their options. They can make
their lifestyle as easy or as difficult as they choose."
An article in the July 1, 2001, issue of
American Family Physician
says, "There is no right time to have a child in medicine." It adds
that women with children and families sometimes face a more
difficult dilemma because they struggle with child care issues,
working-mother guilt, and isolation from their spouses.
El Paso County Medical Society President Kathryn Zerbach, MD,
knew she was meant to become a physician. The first female surgeon
in her residency program, she had not thought of herself as a
pioneer. "Practicing in El Paso has been a terrific opportunity for
me. The community was definitely ready for a woman physician
specializing in breast care, even if some of my colleagues were
Many initially assumed I was an obstetrician, especially if I was
in scrubs. That was the only surgical field with which they had any
prior experience with female physicians."
She adds that the most painful consequence of her career was
missing a significant portion of her daughter's childhood. She
still feels the regret 22 years later and admits she often does not
know how to advise medical students or residents regarding
practicing surgery and having a family. She knows how different
their situations are from her own.
"In the beginning, I was subsequently met with only negative
reactions from would-be mentors. They told me becoming a surgeon
was impossible. I was too old, a woman, and a single parent. Most
women go into medicine prior to starting their families. The rigors
of surgery training and a surgical career make decisions regarding
the timing of family matters difficult to sort out. I was older, as
was my child. We made it work for us, but it certainly wouldn't
work for many women. That's probably why, despite the large
increase of females in medicine, the percentage of women surgeons
continues to remain fairly low."
Academia … the Final Frontier
AAMC reported that in 2003, women made up 30 percent of medical
faculties. Although surgery and orthopedic departments continued to
have low proportions of women faculty, obstetrics and gynecology,
pediatrics, and public health and preventative medicine had more
than 40 percent women in faculty positions.
Regarding academic leadership, the February 2005 issue of the
said only 14 percent of senior faculty and 10 percent of
medical school deans in 2004 were women. The numbers represent
progress (there was only one female dean in 1990), but the
percentage is low when compared to the overall academic
Reasons why women physicians are not as involved in academia as
their male counterparts vary. A 2002 study printed in
explored the challenges facing medical school department
chairs, paying particular attention to issues confronting women in
such leadership positions. The study's findings said barriers to
the women's advancement ranged from the constraints of traditional
gender roles to a lack of effective mentors.
study also says women physicians without children achieved the rank
of professor as frequently as men, but women with children did not.
Additionally, physicians with children reported the lowest levels
of satisfaction with their academic career. It concluded that
institutional changes must occur and that targeted initiatives
supporting women, especially those with family responsibilities,
Women must be taught how to negotiate equitable contracts; there
needs to be a demand for equity in academic appointments," said Dr.
Dickey, the only woman president of a Texas health science center.
"Women physicians also need to mentor their female colleagues so
they have the formal and the informal skills for advancement.
Medicine will only become more challenging as we deal with more and
more complex science, and we need to assure that whatever their
gender, those who have a desire to become physicians are given the
opportunity to do so. In all likelihood, it will take the best of
both men and women for medicine to be its best."
Unquestionably, women in Texas medicine have made great
strides in past decades. Their rising numbers have not only caused
them to revaluate what is best for both their practice and personal
life, but it also has caused their male colleagues to reconsider
their own lifestyles.
Said Dr. Valdez, "Last week I was talking to a recent graduate
who has noticed how women have positively influenced both the work
hours and concept of balance within medicine. I think that since
women physicians have learned to balance their lives, men are also
considering how to do the same for themselves. It's a whole new
concept that we have brought to the field."
In Sugar Land, Dr. McKelvey experienced a personal result that
neither she nor people like Dr. Waggener could have predicted.
My 5-year-old said something, and I realized she had no idea
that men could also be physicians. I am a woman physician. My
colleagues are all women physicians, as is her pediatrician. She
had only encountered women physicians. As for men, she thought they
could only be nurses because that was all she had come across."
Erin Prathercan be reached at (800) 880-1300, ext. 1385, or (512) 370-1385;
by fax at (512) 370-1629.