Women in Interventional Cardiology Driving Career to Success

Women in Interventional Cardiology: Driving Career to Success- Managing the Ups and Downs Cindy L. Grines MD, FACC, MSCAI Chief Scientific Officer Northside Cardiovascular Institute Atlanta, Georgia

Why we need more Women in Cardiology u We are highly qualified l Better test scores and GPA l Studious, dedicated, caring and compassionate u Higher quality of care, guidelines based management u Better patient outcomes u Better pt satisfaction scores Pts love female doctors! u Technical skills and ability to perform under stress thought to be similar u Female cardiologists recognize symptoms in female pts JAMA Intern Med. 2017; 177(2): 206

Academic rank, prestigious administrative titles and salaries are significantly lower despite adjustment for number of publication, prestige of journal, research funding, and clinical productivity

How to Manage the Ups: We revolutionized the management of STEMI patients, having proven: Primary PCI is superior to thrombolytics: PAMI study l Stenting reduces reocclusion and restenosis in STEMI patients: Stent PAMI l STEMI patients can be safely transferred for primary PCI (Air PAMI) or treated with PCI at hospitals without surgical backup (PAMI No-SOS) l Low risk STEMI patients can skip the CCU and be safely discharged at day 3 (PAMI-2) l IABP does not benefit high risk STEMI patients, we are currently investigating better devices (PAMI-2) l Importance of multiple unstable plaques – spurred many randomized trials to determine role of PCI l

Industry and other physicians will attack you

How to Handle your Professional Success at Home u. I made a big splash…. now what? u. Emotional letdown after meetings u. Professional jealousy of your competitors…. But also partners, boss and others at your home institution u. Don’t let success go to your head. Remember, everyone is replaceable

Mistakes I have made along the way u Working hard and assuming that everyone knew of my accomplishments. I am not a self promoter. Don’t assume your immediate supervisor will speak highly of you…they may be jealous u Working with my door closed (to avoid distractions). They thought I was not at work! u Not negotiating a higher initial salary. Subsequent salaries are based on prior salary. u Not managing up…or not up high enough to hospital administration / dean, etc.

Mistakes I have made along the way u Not knowing that many important decisions are made behind closed doors, before “the meeting” occurs u Not lobbying behind the scenes to gather consensus. I foolishly thought that was what meetings were for. u Being too busy with patients, research, speaking, motherhood to take the time to schmooze…. I never went to lunch, hung out at the doctors lounge, etc. Huge missed opportunity to create allies

Mistakes I have made along the way u Not realizing that you can’t act like a man, in a man’s world u Taking people at face value (charmed by their friendliness but then backstabbed) u Not understanding that many (most) people make decisions based on “what’s in it for me” rather than what is best for the institution. u Believing that your superiors are actually interested in quality and academics. . it’s all about the bottom line

Additional Mistakes u Not being interested in the business / finances of cardiology l Less likely to be promoted to higher administrative levels u Not having a professional coach Design your professional development path l Observe your interactions at meetings, etc l u Marrying my college sweetheart because he was cute and fun

Challenges for Women in IC: Possible Solutions u. Only 4. 5% of interventional cardiologists are women and perform only 3% of procedures (Cath Cardiovasc Interv. 2016) l Need to give exposure and encouragement to female medical students, residents and general cardiology fellows l Need help to build practice, cultivate referral doctors l Investigate/initiate job sharing, shift work u. Women 3 times as likely to experience discrimination and this does not appear to be changing over time (JACC 2008; 52 : 2215– 2226), (JACC 2008; 52: 2215– 2226), Discrimination awareness training –starting before and during college and in the workplace l Standard interview questions l l Income and promotion transparency u. Critical need for greater diversity of physician leadership in clinical trials – as principle investigators/co-investigators. More podium presence l Networking with industry, develop female research consortium l

Despite what you are told, the primary focus of your hospital / group is to make money u Building your practice: l Starting programs l Getting referrals l Staying in the game. u Avoiding landmines / professional jealousy: l Building and maintaining relationships with v. Your boss and those above him/her v. Your group vancillary staff u Not dropping the ball: l How to juggle your relationships, children and a personal life with your professional career

Women in Interventional Cardiology: How to Make it Work? Grines Secret Recipe for Success u Earn the respect, support and friendship of your colleagues – It takes a team! u Seize the opportunity, and reach for the stars u Work hard, but also play hard – because life is short u Don’t take yourself too seriously (We’re not that important) u You may love your job, but your job does not love you u There will never be a good time to have kids; just do it!