The combination of the COVID-19 pandemic, systemic racism and gender inequity can have serious ramifications for women in medicine. While times of crisis can exacerbate the distinct challenges and burdens faced by women physicians, leadership can positively influence change.

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“Leading in a crisis, everyone has their own way of addressing it,” Renée Crichlow, MD, said during a recent webinar hosted by the AMA Women Physicians Section.

“For me, it breaks down into the must acknowledge, must activate and must advise,” said Dr. Crichlow, director of advocacy and policy, and assistant professor in the Department of Family Medicine and Community Health at the University of Minnesota School of Medicine.

“We can do this in many different ways, from many different perspectives,” added Dr. Crichlow, also immediate past president of the Minnesota Academy of Family Physicians.

Acknowledge the urgency

The first step is to acknowledge the situation, which means understanding “the urgency, even if we don’t have the full situation,” said Dr. Crichlow. “What I tell my learners is whether you want to or not, as a physician, you are a leader, and as a woman and a mother, we all know that we have multiple obligations.”

“Some of us are right in the sandwich level where we're taking care of our parents and we're taking care of our children. We're taking care of our homes,” she said. “It doesn't matter if we’re professionals. It doesn't matter if we're leaders of national organizations. When we go home, we still have the disproportionate burden of care.”

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“One of the things that you have to come to realize in crisis is there's no such thing as routine, and it was one of the things I had to acknowledge myself,” said Dr. Crichlow. “My family structure would have to change in order for me to be a physician and lead during this crisis.”

Learn more from the AMA about ways to tackle challenges facing women physicians in the pandemic.

Activate the purpose

Physician leaders must think about who they are leading “because, as a leader, you have to define and you have to help shape the vision,” said Dr. Crichlow. “You have to basically point the way. This is our purpose because the purpose is what gets us through.”

“For me, purpose is an important part of activating people,” she said. “In my position, I felt it very necessary to activate the people I felt the greatest responsibility to: the graduates of our programs, the learners that I teach, my friends and family, my community and trying to get ahead of this before it was coming to set the stage that we are there and we have things to do.”

“A lot of my graduates were all over the country, but we were all going to be facing similar issues and I wanted to get them prepared,” said Dr. Crichlow. “Social media was the direction I was able to take because I knew that we were going to be isolated, but we were still going to need to be able to connect.”

“I kept getting out there. I kept doing the things that I felt was necessary to prepare the people that I was leading and caring for every day,” she said.”

Advise those you are leading

“A lot of it is about getting people to have the conversations as a leader. We can’t fix all these things by ourselves and we can’t pretend to know all the answers,” said Dr. Crichow. “We have to engage in the conversations. The conversations around race in America are very uncomfortable.

“One of the things I try to teach my learners, and myself repeatedly, is it's so often that the places we need to go to make the difference are uncomfortable,” she added. “You can actually think of discomfort as a signpost towards healing.”

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“These are issues that people have been working on for decades. We're not going to solve them overnight, but we're never going to solve them if leadership doesn't engage. You're never going to solve it if we try to hide from the fact that this is a critical time.

“As leaders, we have to acknowledge what's going on. We have to activate the people that have the ability to make the difference,” said Dr. Crichow. “We have to advise as the person who also knows what the vision and what the mission is, and our advice is going to help people stay on that.”

Learn more from the AMA about how to care for health professionals during crisis and beyond.

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