The field of urology is a specialty that has always been dominated by men, but what does the gender gap look like now?
In a recent interview, Jennifer Miles-Thomas, MD, discussed how the gender gap in urology has evolved over time. In addition, she stressed the importance of women in this field as the population of female urologic patients continues to grow. Miles-Thomas is the President of Urology of Virginia, PLLC, Virginia Beach.
The first strategy is to actually have female urologists in your practice. I think it's difficult. This is still really a male-dominated field; however, the patient population is well mixed. There's men and women that are patients, and a lot of female patients are asking and requesting female urologists. So, I think the need is there and from our standpoint, the communication needs to be there. We understand that you may not just do female urology. You may do oncology, you may want to treat stones, but we have people who are asking for you in particular. And so, if someone understands that they're valued and they're needed, then I think it’s more than likely that they'd want to join you.
We have female urologists in our practice; we currently have 4. And the number 1 thing for retention is to listen. The experience for a female in urology is different than a male in urology. There's a lot of microaggressions. There [are] a lot of inappropriate comments and conduct that happen. Also in the operating room, as surgeons, there's a certain personality type, and it's really accepted a lot more as a male to say or do certain things [that would get you] written up if you're a female. It's blatant; it's there. The number 1 thing that we do to maintain our female urologists is to listen. To listen to what happened, and to make sure there wasn't a disparity between others in the practice.
Percentagewise, it's about 10% now, which is much improved from when I came out. And what's happening to close that gap? Well, I think we've recognized that it's important to have a better mix of people who are providing the care. First, in medical school, there's a lot more women who are being exposed to urology. And then, I think, in residency, a lot of the classes now are at least 50% women. When you bring women into a group, just the same as any other field, the more diverse the field, the better answers you get, the stronger the program is going to be. And so, I think it's a pipeline. You start maybe even in high school. [For] med school, you have to have exposure. [For] residency, you have exposure, and you also have exposure to faculty—people who can mentor you and explain [why] this is how it is and how to help change things. Once you are faculty and you’re recruiting, [it’s important] to be available for the real questions.
It depends on how you're paid and the structure of the compensation model. So, if you're truly paid for, let's say, [relative value units, (RVUs)] versus collections, there are some disease states that women have more than men that don't reimburse as well. And so, one of the strategies is to make sure that there's a better mix of that patient population, and that it's not just all shifted to maybe the female urologist to see that certain type of disease state. And that will really help, too.
I think urology is just a great field. It's a great field because it's diverse. Not in so much as who's providing the service, but the different disease states that we can treat. So, you could be a urologist who only functions in the office and never goes to the OR. You can do 80% of what you do in the office. Or you can be someone who does large, major cases in the hospital. You can treat men, you can treat women, you can be a pediatric urologist just to treat children. So, I think urology is a special field. Between the medical and the surgical interventions, and then diversity of the patient population, there are so many options. I think more women should go into urology.