- Jessie Allan
1. You are a new member of the SOHM Executive Committee. Can you tell us what made you want to run for this position and what you are hoping to accomplish in this role?
I am thrilled to be a part of the SOHM Executive Committee and aim to bring a unique voice to the leadership that resonates with a wide variety of hospitalists. I am community hospitalist practicing at a large children’s hospital and do a mix of inpatient pediatrics, level II nursery, and newborn medicine. My experience gives me a broader perspective into the needs of pediatric hospitalists. Community and newborn hospitalists are a huge part of the SOHM, but have been historically under-represented in the leadership. As we think about the future of our field, our leadership needs to reflect the diverse practices of hospitalists. Women have also been under-represented as society leaders in PHM. Dr. Julie Kim and I researched the leadership of our major societies and found that when compared to the field at large, women have been under-represented as society leaders (including the EC) for a long time. This was a huge motivation for me to run and excellent sponsorship by both women and men in our field helped make it possible. 2021 is the first year that the gender breakdown of the EC matches with the section at large! But we can’t stop there, we need to continuously think about what voices are present and what voices are missing as our field advances.
2. As the lead author of “Gender Distribution in Pediatric Hospital Medicine Leadership” in the Journal of Hospital Medicine, please tell us your findings and any further research you’re planning in this area.
This project was an absolute blast, and I call it my sourdough of the pandemic (I am a terrible baker). Prior to this study, there was minimal data on gender equity in PHM, so we were, in many ways, starting from scratch. One of the first questions we needed to answer was “how many women are in PHM?” Multiple proxies for the breakdown of the field, including the SOHM, the 2019 inaugural ABP board applicants, and a random sampling of university-based programs, were consistently around 70% women. When we compared the proportion of women who were university-based division directors with the field at large, we found that women are under-represented as PHM division directors. Interestingly, we found that there was a higher proportion of women as associate division directors and assistant PHM fellowship directors compared to the field. When we repeat this study in 5-10 years, it will be interesting to see whether these women advance to primary leadership or if this is another example of the “sticky floor” where women are stagnant in supporting roles. I think it is important to state how incredibly supportive my powerhouse women co-authors were, especially my senior author, Dr. Fromme. There were many times during this project when I needed to take a break (insert lockdown spring 2020), and this group was very patient and encouraging.
This study was a great sitcom with multiple spin-offs, and many projects are actively in progress. One of the immediate next questions we had was “what is the representation of women in PHM scholarly activities such as authorship, speaking opportunities, and society leadership?” This project, led by Drs. Julie Kim and Shawn Ralston, was recently published in Hospital Pediatrics. Another important project is exploring compensation and any potential gender pay gaps in PHM. Compensation is like Bruno- we don’t talk about it! Studies consistently show that there is a persistent gender pay gap across medical specialties, but there is minimal data in PHM. Compensation is a complex and challenging topic to study. Fortunately, the brilliant Dr. Katie Forster is leading this work with anticipated results soon. Lastly, we are also exploring ways that women and men may communicate and advocate for themselves differently, especially in public venues. There is so much work to be done in this space, and I would love to see hospitalists be on the forefront of this research.
3. You are the Social Media Editor for WIM (Women in Medicine). Can you tell us more about this group?
Women in Medicine (@WIMSummit) is an amazing non-profit organization led by Dr. Shikha Jain, committed to closing the gender gap in the medical healthcare system. The organization offers superb programming, including the annual Women in Medicine Summit conference, that empowers women and allies to effectively address gender disparities while also connecting, collaborating, and supporting one another. I joined WIM in 2020 because I quickly realized the importance of going outside of the PHM silo and learning from other specialties. I love this organization’s culture of push-pull mentorship across all experience levels. WIM is a great example of how social media can be used effectively to create community and promote connectedness, which is so important especially as this pandemic continues. I would encourage everyone to get involved with WIM, whether it is to learn how to be an effective ally, to grow your leadership skills, or be part of the new Women in Medicine Speakers Bureau.
4. One of your interests is minimizing unnecessary interventions in infants through QI. What are some of these projects? Any successes that you recommend we implement in our hospitals?
Newborn medicine is an area of PHM that is ripe for decreasing unnecessary interventions. Back in 2013, Dr. Arun Gupta and I had a conversation questioning “why all these perfectly well-appearing newborns born to mothers with chorioamnionitis were getting admitted and started on empiric antibiotics”. This conversation launched an almost eight-year quality improvement project, led by Drs. Neha Joshi and Adam Frymoyer, dedicated to re-evaluating our management of well-appearing infants at risk for early-onset sepsis (EOS). Changing management practices at a large tertiary children’s hospital might be as hard as trying to censor Roy Kent. It took multi-disciplinary buy-in, an extensive literature review, and step-wise changes. We were very fortunate to have buy-in from neonatologists, such as Dr. Bill Benitz. Over two phases, our institution adopted an approach of monitoring well-appearing infants at risk for EOS with frequent clinical exams. Similar to the Kaiser Neonatal Sepsis Calculator, our approach of clinical monitoring significantly decreased antibiotic use and laboratory studies without adverse events. As we learn more about the risks of unnecessary antibiotic use in newborns, it is important for institutions to adapt a more targeted approach for managing infants, whether through serial exams or the calculator. I was thrilled to see this topic, and a few other newborn topics, covered in the 2021 Choosing Wisely list. Next up, I would love to see newborn hospitalists move the needle in our management of jaundice as we patiently wait for the updated hyperbilirubinemia guidelines.
5. You are the co-founder of the AAP SOHM Women in PHM sub-committee—what led you to create this group? Please share with us some of the work this group has done.
The Women in PHM sub-committee was created fall 2019 shortly after Dr. Julie Kim and I led a workshop on gender bias in medicine at PHM Seattle. It became clear to us that there was a huge need to create a community of support for women in our field. The 500 people that immediately joined the sub-committee confirmed this need. We officially launched with our phenomenal steering group in Spring 2020 and were very intentional about our vision to support and advance equity for ALL members in PHM. Our mission is to promote equity for all who identify as women in PHM by creating a supportive venue for dialogue and education, developing opportunities for mentorship and career development, identifying resources for work-life navigation, and by engaging, including, and collaborating with all members of PHM. We were concerned that the pandemic might limit our start, but I actually think it was a catalyst for us to talk about challenging topics such as work-life navigation and boundary setting. We had to be creative about developing community in the new virtual world and quickly realized the importance of social media and virtual events. We also wanted to be authentic in our own struggles. One of my favorite things about this sub-committee is the feedback we have received from various members saying, “thank you for creating a safe place to talk about hard issues”.
Based on a needs assessment from our members, one of our first programs was the WiPHM Mentorship Manors led by Dr. Leena Kendhari and Dr. Tricia Hopkins. Over the course of 2021 we had three pilot groups, that met monthly to cover topics ranging from goal setting to career sustainability. Due to a huge amount of interest, we will be expanding to six cohorts in 2022 – a call will be out soon! We also launched our monthly WiPHM fireside chats interviewing amazing women leaders in our field and covering topics such as imposter syndrome and negotiation. This spring, we have some great sessions planned including a low-commitment book club and a panel focused on infertility. We are also very engaged on twitter (@WomenInPHM) thanks to our list serv/social media director Dr. Maha Kaissi – be sure to check it out!
6. You have been very involved in moving forward the discussions about gender equity in PHM. What work do you see that needs to be done moving forward?
Is there a character cap on this answer? There is so much work to do in this area, and I would encourage anyone who is interested to get involved whether it is around research, advocacy, or other avenues. It is important that we continue having conversations about diversity, equity, and inclusion in PHM at both the local and national levels. One way to start these discussions at your institution is to invite experts to come speak to your division or department. In addition to the names mentioned above, Drs. Jessica Gold, Yemisi Jones, and Heather McKnight are other phenomenal speakers on gender equity.
In order for our field to advance towards gender equity, we must have allyship. Men often refrain from participating in gender equity discussions due to a low psychological standing – that is, they don’t feel it is their place to speak up or get involved. Studies show, however, that gender equity initiatives are more successful when all genders are committed to change. I encourage men to listen to their women colleagues and learn about their experiences. Then, find ways to respond as an upstander when gender bias occurs. If you hear your colleague misidentified as a nurse, reintroduce her as doctor. If you notice that a woman is being interrupted on zoom, say “I am not sure Dr. Allan was done with what she was saying, and I would like to hear her idea”. Since there are more men in certain leadership positions in PHM, we need men (and women) to sponsor women for promotion, awards, leadership positions, and more. This can also be done in the form of peer sponsorship.
Next, if we are going to elevate women as a whole, we need to look at our most marginalized groups, most notably women with intersectional identities. There is significant literature showing that women of color, women who identify as LGBTQ+, and women with disabilities face increased levels of bias, called the “double bind’, and a larger gender pay gap. As we continue to collect more data around gender inequities in our field, we need to also look at race, ethnicity, sexual orientation, etc. The SOHM EC is very committed to tracking the diversity of the section’s leadership and this spring we are rolling out a transparent leadership board to look at the diversity of our leaders, including race, gender, clinical practice setting, and more.
7. Jack Percelay often ends his list-serve commentary with the phrase “that’s just my 2 pennies.” What are your two cents?
Because I am a woman, is it 1.72 pennies? I am kidding… but not really…lets fix the pay gap. My first penny is- find your passion and get involved! What excites you? What do you want to see changed? Maybe you are like me and get frustrated when newborns receive unnecessarily long antibiotic courses. Or maybe you are interested in educating pediatric hospitalists on how to communicate with LGBTQ+ youth. Your interests do not have to look like anyone else’s. The beauty of PHM, specifically SOHM, is that we are a large and diverse group so there is likely someone out there who wants to collaborate with you. Which brings me to my second penny- connect with other pediatric hospitalists and physicians at different programs! If you see someone post an interesting idea on the list serv, reach out to them. My greatest mentors/sponsors came into my life because I took a chance and asked them to collaborate. The PHM conference, SOHM sub-committees, and programs like PALM (shout out to my PALM crew) are great opportunities to network and collaborate. Consider joining the #WeArePHM crowd on the bird app, we are having fun! Twitter isn’t for everyone, but I think it is a great way to share information, network, and advance your career. Several workshops, research projects, and speaking opportunities have been created from social media interactions. Not to mention, it is important to find out when the next PHM Peloton ride is!
I am thrilled to be a part of the SOHM Executive Committee and aim to bring a unique voice to the leadership that resonates with a wide variety of hospitalists. I am community hospitalist practicing at a large children’s hospital and do a mix of inpatient pediatrics, level II nursery, and newborn medicine. My experience gives me a broader perspective into the needs of pediatric hospitalists. Community and newborn hospitalists are a huge part of the SOHM, but have been historically under-represented in the leadership. As we think about the future of our field, our leadership needs to reflect the diverse practices of hospitalists. Women have also been under-represented as society leaders in PHM. Dr. Julie Kim and I researched the leadership of our major societies and found that when compared to the field at large, women have been under-represented as society leaders (including the EC) for a long time. This was a huge motivation for me to run and excellent sponsorship by both women and men in our field helped make it possible. 2021 is the first year that the gender breakdown of the EC matches with the section at large! But we can’t stop there, we need to continuously think about what voices are present and what voices are missing as our field advances.
2. As the lead author of “Gender Distribution in Pediatric Hospital Medicine Leadership” in the Journal of Hospital Medicine, please tell us your findings and any further research you’re planning in this area.
This project was an absolute blast, and I call it my sourdough of the pandemic (I am a terrible baker). Prior to this study, there was minimal data on gender equity in PHM, so we were, in many ways, starting from scratch. One of the first questions we needed to answer was “how many women are in PHM?” Multiple proxies for the breakdown of the field, including the SOHM, the 2019 inaugural ABP board applicants, and a random sampling of university-based programs, were consistently around 70% women. When we compared the proportion of women who were university-based division directors with the field at large, we found that women are under-represented as PHM division directors. Interestingly, we found that there was a higher proportion of women as associate division directors and assistant PHM fellowship directors compared to the field. When we repeat this study in 5-10 years, it will be interesting to see whether these women advance to primary leadership or if this is another example of the “sticky floor” where women are stagnant in supporting roles. I think it is important to state how incredibly supportive my powerhouse women co-authors were, especially my senior author, Dr. Fromme. There were many times during this project when I needed to take a break (insert lockdown spring 2020), and this group was very patient and encouraging.
This study was a great sitcom with multiple spin-offs, and many projects are actively in progress. One of the immediate next questions we had was “what is the representation of women in PHM scholarly activities such as authorship, speaking opportunities, and society leadership?” This project, led by Drs. Julie Kim and Shawn Ralston, was recently published in Hospital Pediatrics. Another important project is exploring compensation and any potential gender pay gaps in PHM. Compensation is like Bruno- we don’t talk about it! Studies consistently show that there is a persistent gender pay gap across medical specialties, but there is minimal data in PHM. Compensation is a complex and challenging topic to study. Fortunately, the brilliant Dr. Katie Forster is leading this work with anticipated results soon. Lastly, we are also exploring ways that women and men may communicate and advocate for themselves differently, especially in public venues. There is so much work to be done in this space, and I would love to see hospitalists be on the forefront of this research.
3. You are the Social Media Editor for WIM (Women in Medicine). Can you tell us more about this group?
Women in Medicine (@WIMSummit) is an amazing non-profit organization led by Dr. Shikha Jain, committed to closing the gender gap in the medical healthcare system. The organization offers superb programming, including the annual Women in Medicine Summit conference, that empowers women and allies to effectively address gender disparities while also connecting, collaborating, and supporting one another. I joined WIM in 2020 because I quickly realized the importance of going outside of the PHM silo and learning from other specialties. I love this organization’s culture of push-pull mentorship across all experience levels. WIM is a great example of how social media can be used effectively to create community and promote connectedness, which is so important especially as this pandemic continues. I would encourage everyone to get involved with WIM, whether it is to learn how to be an effective ally, to grow your leadership skills, or be part of the new Women in Medicine Speakers Bureau.
4. One of your interests is minimizing unnecessary interventions in infants through QI. What are some of these projects? Any successes that you recommend we implement in our hospitals?
Newborn medicine is an area of PHM that is ripe for decreasing unnecessary interventions. Back in 2013, Dr. Arun Gupta and I had a conversation questioning “why all these perfectly well-appearing newborns born to mothers with chorioamnionitis were getting admitted and started on empiric antibiotics”. This conversation launched an almost eight-year quality improvement project, led by Drs. Neha Joshi and Adam Frymoyer, dedicated to re-evaluating our management of well-appearing infants at risk for early-onset sepsis (EOS). Changing management practices at a large tertiary children’s hospital might be as hard as trying to censor Roy Kent. It took multi-disciplinary buy-in, an extensive literature review, and step-wise changes. We were very fortunate to have buy-in from neonatologists, such as Dr. Bill Benitz. Over two phases, our institution adopted an approach of monitoring well-appearing infants at risk for EOS with frequent clinical exams. Similar to the Kaiser Neonatal Sepsis Calculator, our approach of clinical monitoring significantly decreased antibiotic use and laboratory studies without adverse events. As we learn more about the risks of unnecessary antibiotic use in newborns, it is important for institutions to adapt a more targeted approach for managing infants, whether through serial exams or the calculator. I was thrilled to see this topic, and a few other newborn topics, covered in the 2021 Choosing Wisely list. Next up, I would love to see newborn hospitalists move the needle in our management of jaundice as we patiently wait for the updated hyperbilirubinemia guidelines.
5. You are the co-founder of the AAP SOHM Women in PHM sub-committee—what led you to create this group? Please share with us some of the work this group has done.
The Women in PHM sub-committee was created fall 2019 shortly after Dr. Julie Kim and I led a workshop on gender bias in medicine at PHM Seattle. It became clear to us that there was a huge need to create a community of support for women in our field. The 500 people that immediately joined the sub-committee confirmed this need. We officially launched with our phenomenal steering group in Spring 2020 and were very intentional about our vision to support and advance equity for ALL members in PHM. Our mission is to promote equity for all who identify as women in PHM by creating a supportive venue for dialogue and education, developing opportunities for mentorship and career development, identifying resources for work-life navigation, and by engaging, including, and collaborating with all members of PHM. We were concerned that the pandemic might limit our start, but I actually think it was a catalyst for us to talk about challenging topics such as work-life navigation and boundary setting. We had to be creative about developing community in the new virtual world and quickly realized the importance of social media and virtual events. We also wanted to be authentic in our own struggles. One of my favorite things about this sub-committee is the feedback we have received from various members saying, “thank you for creating a safe place to talk about hard issues”.
Based on a needs assessment from our members, one of our first programs was the WiPHM Mentorship Manors led by Dr. Leena Kendhari and Dr. Tricia Hopkins. Over the course of 2021 we had three pilot groups, that met monthly to cover topics ranging from goal setting to career sustainability. Due to a huge amount of interest, we will be expanding to six cohorts in 2022 – a call will be out soon! We also launched our monthly WiPHM fireside chats interviewing amazing women leaders in our field and covering topics such as imposter syndrome and negotiation. This spring, we have some great sessions planned including a low-commitment book club and a panel focused on infertility. We are also very engaged on twitter (@WomenInPHM) thanks to our list serv/social media director Dr. Maha Kaissi – be sure to check it out!
6. You have been very involved in moving forward the discussions about gender equity in PHM. What work do you see that needs to be done moving forward?
Is there a character cap on this answer? There is so much work to do in this area, and I would encourage anyone who is interested to get involved whether it is around research, advocacy, or other avenues. It is important that we continue having conversations about diversity, equity, and inclusion in PHM at both the local and national levels. One way to start these discussions at your institution is to invite experts to come speak to your division or department. In addition to the names mentioned above, Drs. Jessica Gold, Yemisi Jones, and Heather McKnight are other phenomenal speakers on gender equity.
In order for our field to advance towards gender equity, we must have allyship. Men often refrain from participating in gender equity discussions due to a low psychological standing – that is, they don’t feel it is their place to speak up or get involved. Studies show, however, that gender equity initiatives are more successful when all genders are committed to change. I encourage men to listen to their women colleagues and learn about their experiences. Then, find ways to respond as an upstander when gender bias occurs. If you hear your colleague misidentified as a nurse, reintroduce her as doctor. If you notice that a woman is being interrupted on zoom, say “I am not sure Dr. Allan was done with what she was saying, and I would like to hear her idea”. Since there are more men in certain leadership positions in PHM, we need men (and women) to sponsor women for promotion, awards, leadership positions, and more. This can also be done in the form of peer sponsorship.
Next, if we are going to elevate women as a whole, we need to look at our most marginalized groups, most notably women with intersectional identities. There is significant literature showing that women of color, women who identify as LGBTQ+, and women with disabilities face increased levels of bias, called the “double bind’, and a larger gender pay gap. As we continue to collect more data around gender inequities in our field, we need to also look at race, ethnicity, sexual orientation, etc. The SOHM EC is very committed to tracking the diversity of the section’s leadership and this spring we are rolling out a transparent leadership board to look at the diversity of our leaders, including race, gender, clinical practice setting, and more.
7. Jack Percelay often ends his list-serve commentary with the phrase “that’s just my 2 pennies.” What are your two cents?
Because I am a woman, is it 1.72 pennies? I am kidding… but not really…lets fix the pay gap. My first penny is- find your passion and get involved! What excites you? What do you want to see changed? Maybe you are like me and get frustrated when newborns receive unnecessarily long antibiotic courses. Or maybe you are interested in educating pediatric hospitalists on how to communicate with LGBTQ+ youth. Your interests do not have to look like anyone else’s. The beauty of PHM, specifically SOHM, is that we are a large and diverse group so there is likely someone out there who wants to collaborate with you. Which brings me to my second penny- connect with other pediatric hospitalists and physicians at different programs! If you see someone post an interesting idea on the list serv, reach out to them. My greatest mentors/sponsors came into my life because I took a chance and asked them to collaborate. The PHM conference, SOHM sub-committees, and programs like PALM (shout out to my PALM crew) are great opportunities to network and collaborate. Consider joining the #WeArePHM crowd on the bird app, we are having fun! Twitter isn’t for everyone, but I think it is a great way to share information, network, and advance your career. Several workshops, research projects, and speaking opportunities have been created from social media interactions. Not to mention, it is important to find out when the next PHM Peloton ride is!