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Women physicians have long been at center stage in the future of health care. But as the COVID-19 pandemic magnified, many are struggling with burnout and depression as the industry recovers from an unprecedented period of patient demand.
According to the 2022 Medscape poll, these health issues are intensifying in the physician ranks. Most strikingly, the physician specialty facing the greatest burnout rate is obstetrics and gynecology at 53%.
Minnesotian and OB/GYN physician Kellie Lease Stecher MD has now courageously spoken out about these and other workplace and lifestyle issues in her book Delivering: DOCTOR MOTHER ADVOCATE.
A mother of two the book looks at the deep psychological costs tied to being a woman physician in today’s world and how COVID-19 has exacerbated the malaise. Throughout the book, Stecher examines the central question of whether today’s healthcare delivery model can be greatly enhanced by addressing the systemic gender and racial inequities that exist within the system? In her mind, the response would be a resounding, YES!
Stecher believes that all women in the medical profession have a story to tell about their journey. It’s here in her book where she opens up in a very vulnerable way about her path from childhood to MD – a striking account that will keep you flipping through the pages. In the end, it “delivers” a rare look at the extraordinary psychological pressures women physicians face in their commitment and service to patients.
“I grew up in Wisconsin, right by Appleton, and was a Packers fan. So try not to hold that against me [Laughter]. I still am but Aaron Rogers has made me question my life choices with his anti-vaccine, anti-science rhetoric because as a physician I certainly support scientific data. So that has been a challenge for me.”
After attending St. Mary’s University in Winona, Minnesota as an undergraduate she returned to Wisconsin to attend the Medical College of Wisconsin. She then trained in an OB/GYN residency program in Grand Rapids, Michigan before returning to Minnesota to be with family.
“I had my son during my chief year of residency. I realized that we didn’t just want to be transplanted somewhere without any family close by even though I loved the people in Michigan. In hindsight, even though I probably would have been happier in my career if we had just stayed there, the decision to come back where we had family and friends was the right one.”
Stecher says she knew from a very early age that she wanted to be a physician and thus began to sow the seeds for that when she was a mere four years old.
“I used to sit and read Red Cross books that talked about tourniquets and CPR and everything. That’s the nerdy four-year-old that I was. And then as I progressed through school I found that most people who wanted to attend medical school put themselves on a very specific academic track. In other words, they knew they needed the extracurriculars and athletics to round out their education. And of course, they knew that they needed to get a certain GPA. So that really was my focus for the vast majority of my life.”
She notes that even as an undergraduate she knew she needed to set yourself up for medical school.
“When I was an undergraduate, I had my first healthcare-related job as a certified nursing assistant. That’s when I began to realize what it's like to be treated like a disposable, bottom-of-the-barrel kind of person because that’s how CNAs are often treated.”
It was this sense of being a cog in the wheel doing the bad work that no one else wants to do that really struck Stecher at the time:
“You get only like a two-week training program and then all of the sudden you are responsible for making sure that patients are safe, which I found really unnerving. Thankfully, I worked with a group of people who were very responsible and really diligent. However, you could see how scary having that responsibility for the safety and the cleaning and getting patients fed and making sure that people are checked on regularly could be.”
She says that even back then the staffing ratios and shortages were pretty alarming.
“We were responsible for individuals that needed a lot of assistance. I remember thinking that I didn’t just want to be a CNA. Rather, I wanted to be someone who was brainstorming, making sure what care was needed, and taking advantage of something I really excelled at which were emergency situations.”
Stecher adds that while attending medical school, she initially wanted to be a pediatrician because she loved kids. But her view on this shifted, she says, after she did her pediatric training rotation.
“It was lovely but it was not my passion. On the other hand, the first baby delivery I did, was a defining moment for me. I knew then that I had to be an OB/GYN and in women’s health.”
She says she loved the opportunity to take care of women:
“I loved being able to help them with infertility issues and with depression. And I could help them with surgical needs. So I think OB/GYN for me really captured every part of the career that I wanted to have. That’s how I ended up in this realm.”
Asked about what sparked her to write a book about her journey, Stecher offered this:
“I actually wrote it early on during the Covid pandemic. The book is in many ways a reflection of a desire I’ve had my whole life to fix things for others. That’s just kind of how I’ve always been.”
In her talks with patients and other health professionals across the country, she has found that there is a universal thread in terms of what women experience with today’s prevailing healthcare delivery model.
“All of us have struggled at some point in our lives with heartbreak stuff, with healthcare stuff, with being taken seriously or being credible, or any number of things. So this book in large part about having an authentic conversation about things I’ve been through in my life so that other women don’t have to feel alone.”
Speaking openly like this, she says, often runs counter to the common narrative, particularly for women in medicine in medicine where one is supposed to fit in with the status quo, fit into the hierarchy, not talk too much about themselves, not talk about the human stuff they’ve faced.
“Really I think that all of this made me a better physician. And it’s really interesting to see the generational changes because the vast majority of my patients come to me because they know I’ll be honest with them and give them options and that I’m not going to shy away from an honest conversation.”
In “Delivering,” Stecher takes the reader into the deep recesses of a woman’s life, exploring issues like sexual assault, abuse, and losing a child.
“If, as women, we don’t feel alone, we’re going to be stronger in terms of how we approach these things as individuals. So I believe there is a little something in the book for everyone. But really I wanted to make sure that people weren’t suffering by themselves during this new time of disconnection.”
In particular, the pandemic she says has really opened up a reservoir of loneliness for many women, an unprecedented challenge unlike we’ve ever faced.
“I feel like so many of us have become even more disconnected and less empathetic over the last couple of years. I don’t know whether it’s that we are more siloed and using digital technology and not having the human connection we’re used to. But it’s something that we really need to address.”
In terms of women’s healthcare, Stecher believes that every OB/GYN can testify to the fact that postpartum anxiety rates are going up. And then there is the dramatic increase in physician and nurse suicide rates. This, she says, is why she started a patient care heroes organization at the beginning of the pandemic to provide healthcare professionals a place they could go to find resources and connections.
“The challenge I see is that there is a lot of fear and stigma with respect to reaching out for mental resources still. There can be ramifications in terms of our professional licensing and credentialing. These issues kinda swirling around influx creates a sense of separation and even an inability to communicate with the people we are close to. In the end, there is the fear that as a physician, if I have to admit something I need to address, that’s going to lead to XYZ consequences. All of this creates more distance between people.”
Stecher is also very open about the persistent inequities that exist in healthcare today and is determined to make a difference in changing that:
“I think it’s really important for us to understand that white men in healthcare have a totally, separate different experience than anybody else. The issues I have seen, and studies support this, is that men are seen as having immediate credibility in the medical profession whereas women aren't. They can simply say that something didn’t occur during a particular delivery of care experience whereas women have to come up with infinite levels of proof and evidence that something did happen. So it’s really a challenge on all levels that’s deeply embedded into the fabric of healthcare.”
She believes that until we deal with the inequities in how we handle staff and physicians and colleagues, we are never going to change how we deal with racism and sexism in patient care. Stecher concludes:
“That’s something that I am hugely passionate about. By way of example, maternal mortality, I believe is one of those things that should be at the forefront of everyone’s minds. Sadly, maternal mortality increased during the Covid pandemic along with higher ratios of black people dying in general. So there needs to be bias training and better education. We need to deal with these prevailing concerns better. Because what we are currently witnessing is simply not acceptable.”
Appreciate your pieces so much! Thank you for this one.