May 21, 2020

AAWR Online Caucus Features Discussion of COVID-19 Impact on Women

The first virtual annual meeting of the American College of Radiology® (ACR®), May 16–19, featured a discussion on the challenges faced by women in radiology during the COVID-19 pandemic. At the American Association of Women in Radiology (AAWR) 2020 Online Caucus, panelists recounted experiences shared by many in this unprecedented crisis as well as some developments that are unique to women.

Progress on Pause

Elizabeth K. Arleo, MD, immediate past president of AAWR, kicked off the session by discussing the now-tabled Paid Family and Medical Leave (PFML) act. Arleo announced that the AAWR submitted a historic resolution on Feb. 17 for PFML in private radiology practices. The act would strive to provide 12 workweeks of paid leave for all genders. It was the culmination of a lot of time, work and effort — and then the world turned upside down, she noted.

COVID-19 hit, and suddenly everyone needed to reassess. The decision was made to defer voting and withdraw the proposal for consideration this year. “In a sad Catch-22 situation, more people now than ever need paid family leave,” Arleo said. “It’s disappointing to postpone it, but they believe it’s the correct thing to do, given the pandemic. We’re hopeful we can bring the resolution to the floor next year.”

Weathering the Storm

“The number one word: uncertainty.” Kirti Magudia, MD, PhD, summed things up succinctly when she talked about navigating life as a working mother of two young children and wife to a husband who is an emergency physician and, therefore, cannot work from home. Panelists discussed the various challenges they’ve come up against throughout the last few months, including now often-mentioned issues, such as personal protection equipment shortages, financial strains, availability of home workstations and testing kits and maintaining proper socially distanced safety protocols in hospitals and practices. They agree everyone is suffering, but it seems to be even harder for women.

“Working moms have a lot of added stress,” said Shadi A. Esfahani, MD, MPH. She noted impacts on breastfeeding mothers and difficulties they may experience with proper social distancing and cleanliness in lactation rooms. “There’s also the impact on first-year residents and medical students to consider,” Esfahani said. “Their physical rotations have been canceled, so we’ll need more pipelines to encourage students and women to explore radiology.”

Panelists also spoke of increased workloads for women, while productivity has decreased. “Women’s productivity has gone down, in research especially,” said Anna Lee, MD, who noted that papers with women as first authors have gone down since the pandemic began. Lucy B. Spalluto, MD, estimates this is likely due to greater demands on women at home when it comes to child or elder parent care. Spalluto finds she is constantly busy, doing most of her research and academic work at night and on weekends because she has no other time in the day. “Look at how much people’s workloads have increased — particularly women who are working close to 80 hours a week,” she said. “That’s about a 20-hour difference in the number of hours between women and men.”

Path Forward

As the world begins to open back up, some challenges wane, while others arise. Panelists spoke about the need for a staunch commitment to patient safety. They anticipate patients will be scared to return for non-urgent elective imaging, and they want to make sure patients feel — and are — safe. This will involve many changes, they said, including de-densifying reading and waiting rooms, switching to online scheduling and patient forms, having patients drink contrast before they come in for imaging or having patients wait in their cars for appointments.

The new normal of the post-pandemic radiology world may require radiologists to step back and look at the bigger picture, according to Rachel Gerson, MD. “I’d like us to think about not just retuning to how we did things before, but how might we change things in the future,” she said. “What things probably don’t need a six-month follow-up? There’s a lot of overuse in imaging, which is good for our bottom line, but not good for imaging.” Gerson challenged her colleagues to think creatively and try to conceive of a different reality in the future that puts the focus on the appropriate, judicious use of imaging and resources.

“This crisis has had a profound impact on so many lives,” said Yiing Hu, medical student and incoming intern, “but with this unique challenge, we have an opportunity to demonstrate positive change.”