It certainly wasn’t what Molly Gamble expected to find in her inbox on a Monday: an email with an attachment signed by 151 female physicians and healthcare leaders, telling Gamble her publication was sexist.
“The majority of us in the newsroom here are women,” says Gamble, editor in chief of Becker’s Hospital Review, a leading industry trade publication. “It was surprising.”
The letter, sent in November of last year, pointed specifically to Becker’s annual roundup of top healthcare quotes, published 11 months earlier in December 2015, noting that only 12 out of 50 were attributed to women and asking that more women be considered for inclusion in the future. (Those quoted on various aspects of healthcare included everyone from Donald Trump and Hillary Clinton to Watson, the IBM supercomputer.)
The letter, says Gamble, whose publication is aimed at hospital and health system executives, “didn’t try to trigger blame. But the power of seeing 151 names….You don’t get a lot of those in your inbox. It carried a lot of weight.”
That’s the idea behind both the letter and the larger initiative it represents: #QuoteHer, a campaign launched by Julie Silver, M.D., an associate professor at Harvard Medical School, for a course she organized in Boston for women healthcare leaders.
Dr. Silver, whose academic research specialty is diversity in the healthcare workforce, says she noticed the disparity of quotes by women when she was trying to find good ones to include in her message in the conference program. “At that point, it was just like, ‘Hey, that’s weird,’” she recalls. “I wasn’t thinking of starting some kind of initiative or campaign.” But as she started investigating, “I noticed there was a pattern of underrepresentation of female physicians and healthcare leaders quoted in articles in major media.”
A social media campaign—along the lines of the impactful #ILookLikeADoctor campaign (designed to break stereotypes for African-American women with advanced degrees)—seemed like a good way to help spread the word in the Twitter-sphere.
“I think it’s a terrific initiative and long overdue,” says Sharon Begley, senior science writer for STAT, a science news site affiliated with The Boston Globe. “Anyone who reads a lot of science and medical coverage cannot help but be struck by the predominance of male voices, quoted, referred to, etcetera.” However, adds Begley—a former Newsweek science editor and columnist—“there are a lot of reasons why that occurs.”
One of them is simply the way reporters usually to work. “Journalists tend to interview the people in power, and those people tend to be male,” says Elizabeth Bass, former science and health editor for Newsday and now a visiting associate professor at New York’s Stony Brook University School of Journalism. This is particularly so when that journalist, as is often the case in today’s downsized newsroom, has little background in the subject area and is working under extreme time pressure. “They tend to quote the people that have often been quoted,” Bass says.
The basic problem is that women are underrepresented in positions of leadership in the medical world.
But even those journalists whose beat is medicine, health, or science admit they tend to quote men for another reason: They’re more likely to be the ones making the news. It’s typically men presenting at the medical conferences journalists attend; typically men who are the lead authors in the papers that provide the basis of a story.
“There are more women out there who should be quoted and are not,” says Mark Fuerst, former president of the American Society of Journalists and Authors, and a freelance medical and health writer whose work appears in numerous publications. “But the experts who are available, who are the top ones in the field, are most often men.”
For younger female physicians, such as the ones at a Harvard conference last year who signed a petition calling for more women in medical stories, the logic is frustrating. “You tend to see the same 10 men quoted over and over again in my field,” says Neha Raukar, M.D., a sports medicine specialist in Brown University’s Department of Emergency Medicine. “Their story is old.”
Crafting a new one, however, may be a slow process. “You go with who you know,” says Liz Neporent, managing editor of Medscape, a part of WebMD. “If I’m going to do something in, say, neuroscience, I have my five go-to people. They’re available, they’re good with quotes. If women are coming into the fold as experts, they’ve got to break into that go-to list for journalists, and that’s going to take time.”
Sheer numbers should eventually begin to push more women to the top of the medical hierarchy and presumably on to the media radar: According to the Henry J. Kaiser Family Foundation, nearly half of all 2015 US medical school graduates were female (8,907 out of 18,705).
Women’s voices can be amplified, Fuerst believes, if they become better integrated in the communications pipeline. “They’re out there, but it’s harder to find them.” He agrees that a list such as the one generated by those at the Harvard conference could be a good first step. “I’d absolutely consult that list if I needed a particular expert,” says Fuerst.
Neporent says she consciously tries to include more female sources in her own stories. “When I call the media office, I’ll ask, ‘Do you have any women in leadership or women experts that you could recommend for this story?’” she says. Often, she admits, the answer is “no.”
Which, Bass says, is the root of the problem. “I think journalists should make an effort to find the best source,” she says. “If they had time to do that, more of the sources would be women, as opposed to going to the sources that have been quoted the most. But I think the basic problem is that women are underrepresented in positions of leadership in the medical world.”
Begley believes journalists can help effect change. “We have to be aware that we are underrepresenting women,” she says. “When we look for sources, we have to pay more attention to the women whose names are on the studies.”
While she can’t change the structure of leadership in healthcare, Gamble knew she could do something about the quotes her publication compiled for its annual roundup, which came out in December 2016.
And indeed she did: Five of the top 10 quotes in Becker’s 2016 list were from women, including this one (no. 4) that speaks directly to some of the same issues Dr. Silver’s initiative is concerned with:
“It’s not negligence,” Bibiana Bielekova, M.D., an internationally renowned neuroimmunologist at the National Institutes of Health, told The Washington Post about why she was twice passed up as a tenure candidate. “Women are considered second-rate citizens. They are fully aware that this is happening, the leadership. It’s happening with their blessing.”
In a response to Dr. Silver, Gamble apologized for the male-heavy 2015 list and expressed support for the #QuoteHer initiative. “Consider us your partners in your cause.”
“They did exactly what any ethical, thoughtful news organization should do,” Dr. Silver says. “Acknowledge an issue and work to correct it.”
As of November 20, Gamble says she and her staff are still working on the 2017 “quotes” roundup, but will continue to take into account the concerns addressed by Dr. Silver. “I am thankful to her for what has been a great learning experience and opportunity for reflection.”
CJR’s health care reporting is sponsored in part by a grant from the Commonwealth Fund.
Correction: The original version of this article incorrectly referred to Molly Gamble as the editorial director of Becker’s Hospital Review. Gamble is the publication’s editor in chief.