The Pay Gap- a Rude Reminder of it’s Existence Courtesy of a Sexist Doc

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As we were all so rudely were reminded today, by the now infamous sexist Dr. Gary Tigges, a pay gap exists in medicine just like in all other fields. Looking back on the history of medicine, and of the world, it’s not hard to see how we got there.
Medicine, like any other scholarly pursuit, was dominated by men for several hundred years. Modern medicine, in the 21st century, saw the spread of medical schools and the numbers of licensed physicians increase dramatically. Women lagged behind men for decades and decades, until just the last few years. In the US, the majority of people entering medical school are now women. We will continue to outpace men in the coming years.
So why is there still a pay gap? Just like in other fields, the answer is complex. It starts with the fact that women historically have entered lower paying specialties like pediatrics, family practice, and psychiatry. Men have domineered the specialties that pay higher- namely any specialty where procedures and surgeries are performed. Women have faced discrimination getting into these surgical and more lucrative specialties for years, thus amplifying the pay gap, and are only now in the last 5-10 years breaking into them in record numbers.
Even when women get into the specialty of their choice, they still make on average 27% less than their male counterparts (source Doximity survey), which amounts to over $100,000 less per year. The usual reasons apply here: being punished for taking time off to have children, being seen as less dedicated to their jobs, having to call off due to childcare or family emergencies, women who negotiate for higher salaries are viewed as abrasive or demanding, etc.
So how can we end the gender pay gap in medicine?
1. Compensate non-surgical specialties with higher wages. Medicine has become a culture where “pay for procedures” has dominated for years. Let’s value traditional medicine by increasing pay for those who practice the bread and butter of patients’ care.
2. Salary transparency. Contracts for payment are so cloaked in mystery that we often don’t know how much our colleagues make. It is frowned upon to discuss salary, which only allows men to continue to earn more.
3. Encourage, don’t dissuade women from negotiating. Offer other benefits than salary- like flexible scheduling or extra vacation days to incentive women.
4. Don’t apologize for our success or undervalue our worth. Own your accomplishments! Get rid of “I’m sorry” syndrome of perpetually apologizing.
5. Finally make paid family leave a reality!!!!! It is a stain on our country that we have not enacted this in the year 2018.
6. Imbed affordable childcare into all our hospitals and doctors office. Childcare is often expensive and can be unreliable, let’s make it a no-brainer by having it available in the workplace.
And last- but most importantly- speak up and speak out! Don’t let your voice be silenced and use your vote to elect candidates who prioritize closing the wage gap!

What does it feel like to be fat?

When you are fat, what does it feel like? It mostly feels like you are nothing. Like you are invisible and disposable. People look right through you. They bump into you and don’t apologize. To them, you don’t exist, you don’t matter. Until the moment your fatness affects them, and then you do.
Seated next to me on the airplane? Yes, thank you, I see your constant fidgeting. I know my thigh is pressing against your leg. I am clenching my arms to my sides to try and give you more room, but I know I am invading your space. I saw you glare at me as I sat down and moved the seatbelt to its longest setting. I heard your sigh when I asked to get up and put my bag in the overhead. And guess what? You and all the other passengers saw me struggle to lift the heavy bag, but no one- no one- offered to help me. You dart out of your seat before the seatbelt sign was even off, like you were going to catch my fatness like a disease if you stay one second more next to me.
Watching me walk through the gym? You pretend to be in your bubble on the elliptical with your headphones, but don’t worry I see the disgusted look you shoot my way. I have been going for only ten minutes at a snail’s pace, but am drenched in sweat, it’s dripping all over everything. I get off the machine and wipe it down with the sanitizer. I see you waiting for it and I see you armed with your own paper towels and soap, ready to remove the filth of the fat girl’s sweat. Moving through the weight machines I may as well be a ghost, unless I am taking up valuable real estate at the machine you want. I heard you and your six-packed friends asking why I even bothered. I heard you.
Parked your beach blanket next to mine? I see you look at me and my husband. No we don’t have kids. It’s just us. I didn’t get fat gestating the next generation, I just am. I did this to myself. I picked a run of the mill one- piece; splurging on underwire so my boobs don’t hit my knees. I see you visibly wince as I rub lotion on my skin and walk to the water’s edge. You sit there smoking and throwing your beer cans on the sand, yet you think you are better than me solely based on my appearance. My fatness means I am a lazy, stupid, likely poor and uneducated person. You couldn’t care less, I mean nothing to you. If I told you I am a doctor, you would laugh in my face. It’s incomprehensible to you I am anything other than a fat, worthless woman.

A Snapshot Of Mental Health

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Treading Water

I think as we go through life we will all have different phases. Times when we are killing it and crushing life, moving forward at the speed of light. Times where everything is calm, relaxed and peaceful, and life is good and happy. And times when the wheels are coming off the bus and it’s all you can do to stay on the road.
I’ve certainly been through all those phases multiple times in my life. Just as my anxiety and panic have had their ups and downs through the years. I was always anxious even as a kid, I remember being afraid to sleep at night for years, hiding under my blankets until exhaustion would creep in and lull me to sleep. For many years my anxiety was not something that registered to me, it was just my normal state of being to worry constantly and be an insomniac, and I thought it was perfectly ordinary.
In college I had my first bout of life-altering anxiety and panic. I was then, as I am now, a highly functional, competitive, type A person who was always involved in 12 different things at once and making my way towards medical school. In the wake of my first real and terrible breakup, I became unwound. Beyond just the typical break-up blues, I was in constant state of anxiety. Then, as it had been now, I sought medical helps in multiple ways, and had many physical symptoms. I went to my college’s medical clinic and counselor and even to the ER with symptoms that in hind-sight were born of my anxiety disorder. This episode also led me to have a brief run of using diet pills that gave me dangerous tachy-arrhythmias. Luckily, my roommates and friends pulled me out of my own head and got me back on solid ground.
My second life-changing encounter with anxiety and panic happened in medical school. During my first two years of school I became more and more reclusive. I could not enter a classroom or have an encounter with my classmates or professors or take an exam without having a panic attack. I got to the point where I did not want to leave the house to get groceries, as I was terrified everyone I met was judging me and could see that I was falling apart. I went to the dean of the school and requested to take a year off. At that time, I did not know if I was ever going to go back to medicine. I worked as a research assistant for a year in a darling company in Yellow Springs, and slowly found my way back to myself and to living a regular life. I was able to become reinvigorated and upon returning to medical school, I found myself and my place again in the world.
My anxiety has continued in bursts and spurts, always there at some level since that time. In residency, terrible physical injury led to another prolonged episode of worsened anxiety, and depression. It is only because of the love of my life Rob that I have been able to come out of all these past episodes unscathed. He is my grounding force and my light, and he has never, ever wavered in his support of me.
I write about these past episodes now as a way of release. As a way to remind myself that I have been there before and come out the other side. As a way to acknowledge my own innate humanity and struggles. In taking time to reflect, I am able to get outside of myself temporarily and let myself know that there is a way out of this.
And that could not be more important. Because right now I feel as if I am treading water and only a second away from drowning. I feel as if my panic is not coming in “attacks” but is a constant force underneath my skin on the verge of tearing through. I have moments where I succumb to the panic and cry and scream until I cannot take even one more breath. So I need to remember that I am a person who has had this struggle before and come through it. I need to tell myself that it is going to be okay. I need it to be okay.

 

International Women’s Day

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In honor of International Women’s Day here’s to all the amazing, smart, kind, generous, beautiful, strong, dedicated ladies in the world! ❤️❤️
As I’ve gotten older I have become more strongly attached to being a woman. I grew up a tomboy and pretty oblivious to gender roles in society, thanks in large part to my family always making sure I knew I could excel at whatever I chose to do in life. Over time, I’ve seen blatant and subtle acts of sexism pepper my days. I’ve seen the vast differences in how women are treated based on their culture, religion, ethnicity. I’ve reflected back on my own life and how it has been shaped by my gender, even if I didn’t realize it… the opportunities I had, and the ones I didn’t.
I am grateful for my experience in the world as a woman. I’m grateful for my voice when so many women in the world are forced to be silent. I’m grateful to be able to stand up for myself and to speak out against gender disparity. I am grateful for my amazing husband, the center of my world, who is an awesome feminist and a true partner to me. I am grateful for all the many phenomenal women I know and how we celebrate and empower each other!

#internationalwomensday

Goal Jeans

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Many people would look at these photos and be mortified to post them online. These jeans obviously are too small and all my fat rolls are hanging everywhere 😆. Guess what? I could not be more proud of this picture. I was ashamed of my body for my whole life, then one day 18 months ago I stopped being ashamed. And I stopped being afraid.
I finally said, you know what, this is my current body, it kinda sucks and it’s unhealthy and in pain all the time and it’s holding me back, but it’s me. I stopped running away from myself and started to see myself for who I really was. That someone was much the same person I am today- smart, caring, type A control freak, a pretty good doc, sometimes funny and sometimes mean, a well rounded person. But that version of me wasn’t healthy. I was hiding and ashamed of how my body had gotten so out of control and limited me from doing the things I loved in life.
So today, I am not ashamed of how flawed my body still is. I choose to look past the fat and the cellulite and the loose skin and the pannus and the wrinkles and the saggy boobs and see the good. The muscles which are getting stronger every day. How my skin is so much healthier and acne free since I started eating better. That my patients still think I’m 20 😆😆😆.
Everything in life is about perspective. I choose to be proud and happy that I can finally kind of button these jeans. These are my “goal jeans” from college- good old Abercrombie and Fitch size 12. Whether or not I ever am able to button these all the way is beside the point. That would be great, but I’m going to choose to focus on how far I’ve already come, not how much further I have to go. I’ve already met and surpassed so many of my goals, and I choose to believe I can do anything I put my mind to. 💪🏻💪🏻💪🏻 ❤️❤️❤️

Instagram @doctorofacertainsize
#drjennygetsfit #goals

F*ck Skinny, Get Fit!

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Riiiiiiiiight???? Over the last 15 years I constantly dreamed of being thinner. We are bombarded day in and out with unrealistic body ideals, and it’s hard not to succumb to that vision. But my dreams were not really about my physical appearance, they were always about how much better my quality of life would be when I lost weight. I would dream about hiking in the mountains, skiing, scuba diving, running, playing volleyball, or even just being able to walk my dogs in the woods. For me losing weight is not about the final number on the scale, or the size clothes I wear, or conforming to some insane misogynistic beauty ideal. At the same time, it can be so hard to let go of the numbers. My goal has been to lose 106 pounds, and it is frustrating to still be 17 pounds from meeting that. Being able to let the scale do what it will do, and to keep working on improving my health has been so difficult, but I have been gaining more patience recently and acceptance of my body, regardless of what the scale says.
I am never going to be a stick thin model. I have #thickthighs and a #bootyfordays and #curves to spare. I used to hate all of those things when I was a teenager growing up, I wanted to be petite and limber and delicate like my friends. With the wisdom of age I know that my body is becoming stronger and more muscular everyday, which only means that I will able to do more and participate fully in my life. I have learned to love my strong body and my curves and to flaunt them instead of hiding them. I’m embracing my newly found sense of self and my body. No more sitting back wishing I could do things, time to get out there and live it. So let’s ditch the word “skinny” from our vocabularies and focus on being healthy, strong, and fit.

“Where Does He Work?”

 

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I went to the doctor today. I’ve been battling an overuse injury in my right leg and finally relented to getting another opinion other than myself and my friends. This injury has really been hampering my training, and has been super annoying. First off, I am a bad patient like most doctors are. I go to hear their advice and opinion, but I do not always follow it. Even going into this visit I declined to do the routine x-rays until I saw the doctor and was examined. Sometimes when you are in the practice of medicine you have too much knowledge for your own good. I know I will push things past the limit I would recommend to my patients. I’m happy to report that I had no major injury- no stress fracture! I’m going to try my best to take it a little easier and not overdo it with my running this next month so that I can run my half marathon in May.
Anyway, I get there and I’m sitting getting checked in by the M.A. I had to come from work for the appointment, as I couldn’t get a time on my days off. This picture is from my visit today and what I was wearing.  The M.A. is going through my meds and history and reviewing my records and then comes to check my blood pressure. So I’m sitting there in my pink scrubs, which are embroidered with my name, “Dr. Hartsock”. I’m sitting there and she is taking my blood pressure and she says “I’ve heard that name before, where does he work?”
Boom. It seems even in scrubs embroidered in my own name, I still am not seen as a physician. Yes, I am young. Yes, I am a woman. Yes, I like the color pink. Yes, I am polite. Yes, I smile a lot. It is possible to be all those things and still be a bad ass doctor.
I hope as more and more women enter into medicine our implicit gender biases and gut reaction to assume every doctor must be a man can be overcome! We are women, and we are doctors, damnit!

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