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“The disparity of women physicians in research is a systemic issue that should be mitigated appropriately. Women, especially minorities and immigrants, need institutional support to succeed as clinician-investigators. Medical institutions should actively participate in increasing funding mechanisms available solely for the development and promotion of female clinician investigators. Funding for research projects, in terms of time effort and supplies such as data management tools, is vitally important to address gender inequities in research. Protected time for planning, conducting, and writing grants and manuscripts for the project is also essential. Women and men in medicine need to become better at involving the appropriate clinical expertise in research projects. Research, in general, will benefit from the increased collegiality and partnerships among medical specialties.”
Tina S. Ipe is a pathologist.
She shares her story and discusses her KevinMD article, “A physician unmutes herself after receiving an email.”
This episode is sponsored by The Nuance Dragon Ambient eXperience (DAX). The Nuance DAX solution makes it possible to forget the tech-toggling and reduces documentation burdens no matter how or where care is being provided.
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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.
Transcript
Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Today on the show, we have Tina Ipe. She’s a clinical pathologist, and she wrote the KevinMD article “A physician unmutes herself after receiving an email.” Tina, welcome to the show.
Tina S. Ipe: Thank you so much, Kevin, for having me. It’s a delight to be here.
Kevin Pho: So we’ll get into your article in a little bit, but first off, can you share your story and your journey to where you are today?
Tina S. Ipe: Sure. I am a physician. I am a clinical pathologist with subspecialty training in transfusion medicine. I grew up in New Jersey, and after completing all of my undergraduate, graduate, residency, fellowship training in the Northeast, my family and I moved to the South, where we’ve been for about seven years.
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Kevin Pho: And how’s everything going with the pandemic? How’s that affecting your practice?
Tina S. Ipe: I am hospital-based, and COVID-19 has been a challenging time for all of us. As a person who provides blood and blood products to patients in the hospital, I was tasked with trying to get convalescent plasma, not only for our hospital, the University of Arkansas, but also for the state of Arkansas. So my efforts for the past several months, since March, have really been focused on providing convalescent plasma.
Kevin Pho: And just in general, in your area, how available has convalescent plasma been?
Tina S. Ipe: We have been tremendously blessed by the outpouring of support from Arkansans. We have individuals who have recovered from COVID-19 go and donate at their local blood centers, and we have had it available in sufficient quantities, where we’ve not had any issues with providing it to those who really need it. And our physicians are wonderful, in that they have been mindful of the individuals who truly need it and have followed the FDA criteria in terms of determining the eligibility of patients.
Kevin Pho: That’s wonderful to hear. So let’s talk about your KevinMD article now, “A physician unmutes herself after receiving an email.” For those who haven’t read that article, can you walk my audience through it and share the story of why you decided to write it?
Tina S. Ipe: While I was working on trying to provide convalescent plasma, there was a researcher who had wanted to publish on a part of it. I had found out about it and started a conversation with a colleague of his. Unbeknownst to me, she had then sent an email, where I was speaking with her about the research, and he basically said, just ignore me. To me, that was not OK, because it was a lot of time and effort on my part to try to bring convalescent plasma to a state that previously did not have it. It required me to work through the institutional mechanisms of ensuring that we had the proper strategies, and the clinical groups and their expertise involved, to provide convalescent plasma in a rational manner. Given all of that effort, and my own interest in convalescent plasma, I just felt that his email was really gender-biased and really did not take into account the clinical expertise of those who are on the front lines trying to take care of patients.
Kevin Pho: So when you received that email, and after that initial shock, what did you do next?
Tina S. Ipe: Before I responded to him, I needed to reflect on the different assumptions that this person was probably coming from. He certainly doesn’t know me. I am relatively new to this institution, so he doesn’t know about me, and he probably does not know the effort that went into this. But I also needed to ensure that I had the institutional support, that I had the support to say, “You know what? This is what happened to me. What should I do?” So I reached out to my mentors and colleagues who are working alongside me and providing this product, for their opinion, and they collectively said, “You know what? You do need to respond to this.”
So I did respond to his email, just clarifying all of the things that were established to make convalescent plasma available, and to help him understand, in many ways, the challenges that a woman who is a clinician-investigator, who is a person of color, experiences, and the struggles that, right now, COVID has sort of augmented for all of us.
Kevin Pho: Can you share, just in general, what are some of the challenges that female clinician-scientists face?
Tina S. Ipe: We all have the challenge of trying to find funding sources, right? That continuously is a challenge for those of us who are not MD-PhDs, such as I. I’m an MD with an interest in research who sort of fell into wanting to incorporate research, especially translational research, into my practice. The challenge is that I have to carve my time from my clinical work and my personal time to not only get funding sources for the research that I’m doing, but also find the time to actually do it. I’m a mother of three children, and so a lot of my time involves putting my kids to bed after work and then working from eight to one o’clock to try to get parts of my research done.
And there’s also the need for collaborators. I’m constantly working to search for collaborators from the basic sciences, as well as other clinicians who have the expertise in things that I’m not very familiar with, to collaborate with me, so that we jointly have a goal and a project that we can work on.
Kevin Pho: So you sent this response after conferring with your institution. Now, what happened next?
Tina S. Ipe: You know, he was very kind, and after he saw the email, he apologized for his behavior. Also, I involved him in my research, and we are working to further collaborate on other projects.
Kevin Pho: Good. Well, congratulations on that outcome.
Tina S. Ipe: What I think this showcases is that institutions do need to allow individuals such as myself to have the support to speak out. Previously, I did not feel like I had the voice or the capacity to let my voice be heard. I was scared that I might potentially lose my job, or what were the repercussions of not being that model citizen that everyone expects us to be?
Kevin Pho: We’re talking to Tina Ipe. She’s a clinical pathologist, and she wrote the KevinMD article “A physician unmutes herself after receiving an email.” Tina, after reflecting on this, do you have any lessons that you could share with the other female clinician-scientists who may be listening to this podcast?
Tina S. Ipe: Sure. There are several things that I wish that I had known when I was starting out, right? One is that conducting research, even translational research, is very challenging. You do need partnership and support from the institution to be able to do this work. Second is that, as a woman, you will continuously be challenged to prove your competency and your expertise. You will learn to have to advocate for yourself, and that was something I think I began to realize when I read a statement by Elie Wiesel, who basically said that “silence encourages the tormentor, never the tormented.”
And so that made me realize that people may not readily acknowledge gender and racial bias. However, there is a lot of research that is now being conducted in this field, and I hope that people would take the time to read about it, and also to step into my shoes when, for example, they read my article on how being a woman in research can be challenging, and then, sometimes, to realize that advocating for yourself does come at a price. I had to remove myself from a previous job, because it was not understanding where I was coming from, and I had to leave, and that was the price that I paid.
Kevin Pho: So when you say advocate for yourself, what are some specific ways people can do that?
Tina S. Ipe: So one, you can read more, right? You need to speak to other individuals who have faced the same things as you have. I encourage people to collaborate and work toward a common goal. I think these are things that one needs to do for oneself.
The other thing is that it would be good to get tools, to know how to advocate for oneself. I really did not know the tools, that you can do it in such a way that you can get institutional buy-in. At my current institution, I feel that I have the support of my chair to be able to advocate for myself. She, being a woman herself, understands the challenges of being a woman in medicine. And so I think it’s having collaborators, mentors, sponsors. You have to reach out to different groups, to be able to reflect on the experience that you’re going through, and also to know how you should appropriately respond to the current challenge that you are facing.
The other thing is that I have created women-specific, or my area-specific, collaborations, where a group of women in my field meet together, and we talk about the research that we’re all involved in and how we could, based on our specific strengths, push each other to achieve the goals that they want in their own areas. So, for example, I love to write, so I pretty much do all of the writing in the group. I have another person who does all of the data analysis in the group. So we jointly have created this mechanism to encourage and push each other in our field.
Kevin Pho: And my final question: Do you have a take-home message that you want to share with the KevinMD audience?
Tina S. Ipe: The disparity of women physicians in clinical research, especially women of color, is a systemic issue. Institutions should really work on addressing this gender disparity by providing support and also by speaking specifically on implicit bias. Women don’t have sponsors, and so they need to help; they need to create support systems such that women can get mentorship or sponsorship. Women do not have sufficient role models, so the institution really should work on trying to create a system or a pathway so that women can get role models. There are also system-wide policies at some institutions that disadvantage women who are trying to engage in research. So internal reflection by the institution, to see how institutional policies can be changed, can be very helpful.
And then, beyond the institution, we really do have to review some sociocultural barriers that are preventing women from moving beyond the traditional gender roles and trying for, and achieving, the pay equity and other equities that they deserve.
Kevin Pho: Well, thank you so much for sharing your time and insight, and thanks again for being on the show.
Tina S. Ipe: You’re so welcome.
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