It was surprising to receive an email advising me that I had appeared on the front page of the Atlanta Journal Constitution (AJC), the local newspaper in Atlanta. Without reading the article, which addressed the end of the flu crisis in Georgia, there I was with my colleague and friend Hany Atallah, MD. There was an image of Dr. Atallah and me. I was advised the image was quite reflective of the seriousness of the flu season and the flu season finally coming to a close. What I didn’t see, which my husband immediately brought to my attention, was the verbiage underneath the photo. My husband simply stated, “Now that’s unconscious bias right there on the front page.” Puzzled, I didn’t understand what he meant. However, there it was. My colleague and friend Hany was noted as Dr. Hany Atallah, and I was noted as Sheryl Heron, not Dr. Sheryl Heron (see Figure 1).

As one who has spent a large part of my professional life giving local and national presentations on unconscious bias, there it was staring me in the face. As an African-American woman, full professor in emergency medicine, vice chair as the article noted, and assistant dean, why wasn’t I afforded the title of doctor as my male colleague was?

The data are clear on gender and racial bias, with more studies addressing this reality each day. These biases contribute to microaggressions and the continuous need for women and underrepresented minorities (URMs) to feel they have to prove themselves.

My colleague Michelle Lall, MD, MHS, president of the Academy for Women in Academic Emergency Medicine (AWAEM), and I were co-authors on a paper addressing the current status of gender and racial/ethnic disparities in academic emergency medicine physicians.¹ The paper revealed that gender and URM disparities exist and persist as it relates to salary and rank among full-time US academic emergency medicine faculty. There are also gender and URM disparities in rank and leadership positions. Women earn less than men regardless of rank, clinical hours, or training. There are multiple studies showing that women physicians lag behind their male counterparts in compensation, research funding, leadership opportunities, and achievement.^2–9 These trends have been consistent over the last 15 to 20 years and are not improving.

As we continue to examine unconscious bias, not calling attention to examples such as these when they occur will only serve to perpetuate the problem. We’ve earned the right, as our male colleagues enjoy, to be addressed as doctor, and we count on the media to help us recognize these biases. We can and must do better.

Dr. Heron is professor and vice chair of administrative affairs in the department of emergency medicine, assistant dean of clinical education and student affairs, and associate director for education and training at the Injury Prevention Research Center at Emory University School of Medicine in Atlanta.

References

1. Madsen TE, Linden JA, Rounds K, et al. Current status of gender and racial/ethnic disparities among academic emergency medicine physicians. Acad Emerg Med. 2017;24(10):1182-1192.
2. Jagsi R, Griffith KA, Stewart A, et al. Gender differences in the salaries of physician researchers. JAMA. 2012;307(22):2410-7241.
3. Lo Sasso AT, Richards MR, Chou CF, et al. The $16,819 pay gap for newly trained physicians: the unexplained trend of men earning more than women. Health Aff (Millwood). 2011;30(2):193-201.
4. Seabury SA, Chandra A, Jena AB. Trends in the earnings of male and female health care professionals in the United States, 1987 to 2010. JAMA Intern Med. 2013;173(18):1748-1750.
5. Grisham S. Physician compensation report 2017. Medscape website. Accessed June 12, 2018.
6. Jena AB, Khullar D, Ho O, et al. Sex differences in academic rank in US medical schools in 2014. JAMA. 2015;314(11):1149-1158.
7. Wehner MR, Nead KT, Linos K, et al. Plenty of moustaches but not enough women: cross sectional study of medical leaders. BMJ. 2015;351:h6311.
8. Cheng D, Promes S, Clem K, et al. Chairperson and faculty gender in academic emergency medicine departments. Acad Emerg Med. 2006;13(8):904-906.
9. Boiko JR, Anderson AJM, Gordon RA. Representation of women among academic grand rounds speakers. JAMA Intern Med. 2017;177(5):722-724.