Emergency physicians have more difficult access to management positions



The women, most of the health personnel of the emergency services and emergencies, had to adopt the toughest decisions of the pandemic when nothing was known about covid-19, demonstrated autonomy and leadership as society fought blindly against the virus and became more contagious by being on the front line of the hospital trench. However, his presence in management positions and in the direction of services is still light years ahead of his peers. Now, the Spanish Society of Emergency and Emergency Medicine (SEMES) wants to make a radical turn to this reality.

“The emergency doctors have shown on the ground in this time that we are unstoppable, that there are leaders and brilliant women who have to be in those management positions. pandemic has shown how unfair it is that women are not in leadership positions. (…) We’re sick of men telling us what to do “, denounces Iria Miguens, head of women, the SEMES initiative for the visibility of emergency and emergency professionals.

“We didn’t even have time to cry”

Miguens, an emergency doctor at a large Madrid public hospital, defends that her companions have been the “true leaders of the management “of the health crisis despite the uncertainty and harshness experienced: in the worst months of 2020, they had to be autonomous because they had no ground to tread:” The one in front of the patient is you. We did not have time for reflection, nor to share doubts, not even to cry. We have put ourselves to the test, “he recalls.

Auxiliary women, nurses and doctors are the majority in the emergency services. Historically they have been the most affected when it comes to accessing research, teaching and management positions, penalized by maternity. “As soon as they are mothers, women suffer a brutal halt in scientific production”, the expert emphasizes. After having had to make the toughest decisions against the clock, emergency doctors want a balanced representation in the offices of power and more facilities for their research professional development.

“They say that we are the weaker sex, but we have been able to handle the care and emotional burden, stress and fear 24 hours a day, seven days a week, for so many months. We have made such tough decisions, the protocols changed daily, the scientific evidence varied every day, … The pandemic is as if it had exploded everything: women should be in leadership positions on our merits, not on quotas, which do not fool us now “, criticizes the emergency room.

The criminalization of motherhood

SEMES tried to sketch a sort of Map of the presence of women emergencies in the different emergency and emergency services. From the responses of more than 900 health professionals in this field, it was seen that men held more leadership positions than women, almost double (12% versus 6.8%).

63% of the professionals detected problems stemming from motherhoodwhile only 35% of men considered fatherhood to be a limiting factor.

From here, the women project aims to study the real situation of emergency physicians, put an end to the discrimination they suffer and provide “the recognition due to the women who dedicate their personal lives” to caring for the most vulnerable patients, those who go to the emergency room.

“It is a very vulnerable time for patients. You not only need the development of scientific knowledge, but empathy, understanding and even protection, qualities that women have developed for historical and sociological reasons. I do not mean that my male colleagues do not do well, but it is a common denominator of all women, “he asserts.

In Madrid, 70% of the management of public hospitals are occupied by men: “Is it really that 70% is better?” Asks the doctor.

Caring for the one who cares

“As we are more in the field of assistance, we have infected many plus. If we had been in offices, we would not have been infected, “he adds.” Women are needed to promote guidelines and quality standards that take into account gender perspective“.

Miguens demands a more humanizing management that promotes caring for the caregiver, especially after such difficult months of the pandemic. In his opinion, the study of the psychological impact on health workers (with a high presence of post-traumatic stress, insomnia and anxiety) should take into account the situation of men and women. They, explains the expert, have a greater guilty feeling for having felt that they were abandoning their relatives for work: “We have a great capacity to be simulators, to put others ahead. We have not dared to cry,” she says.

To move forward, ER professionals cannot look too far into the past, it is “a denial for survival”, but they ask that society not forget: “Everything has already been forgotten, it is unfair for society to do so. The infantilization that occurred by not showing images of what was happening in hospitals is absurd, we leave a debt for future generations” , laments the doctor.

Reduce the gender gap in emergencies

To reduce the gender gap, SEMES is going to make public this November quality standards that it will send to the different emergency and medical services.

Among the proposed measures are the creation of equality and conciliation committees, the elaboration of individualized protocols for the assistance and detection of gender violence, adopt the decisions of the service with a gender perspective and the promotion of the academic, research and managerial representation of its women professionals.

The recognition of female talent, the weighting of the time off for maternity, breastfeeding and care of the elderly and dependents so that this does not represent a brake on the professional development of emergency physicians and have uniformity and specific facilities for women, such as changing rooms or lactation rooms.

Emergency physicians also demand better organization of work shifts and hours, greater flexibility for personal and family conciliation, and more stable contracts. Also nurseries in hospitals, which give greater visibility to female references and a greater training in the specific pathology of women.

Miguens explains that the female population attends the emergency services less than the male population and that their symptoms and ailments differ from those of men: they feel pain differently and in a medicine managed by men since its inception, women’s pain is underestimated.

“It has always been thought that women are weaker and this is not the case. The reality is being studied and measured and it will have a scientific impact that will need to be disclosed,” he concludes.

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