SHIFTING THE TIDE: ADVANCING THE REPRESENTATION OF WOMEN AND GIRLS IN THE PROFESSIONAL WORLD
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PRESIDENT’S PAGE Celebrating Women in Medicine: Pioneers, Innovators, and Leaders
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EVP/CEO LETTER History of Women in Medicine: Pioneering Struggles, Pathways and Progress
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Michelle Caraballo, MD, Chair
Drew Alexander, MD
Ravindra Bharadwaj, MD
Joy Chen, MD
Ann Leitch, MD
Ravina Linenfelser, DO
David Miller, MD
Sina Najafi, DO
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BOARD OF DIRECTORS
Deborah Fuller, MD, President
Shaina Drummond, MD, President-Elect
Gates Colbert, MD, Secretary/Treasurer
Donna Casey, MD, Immediate Past President
Neerja Bhardwaj, MD
Sheila Chhutani, MD
Philip Huang, MD, MPH
Anil Tibrewal, MD
Rajeev Jain, MD
Raghu Krishnamurthy, MD
Aekta Malhotra, MD
Marcial Oquendo-Rincon, MD
Celebrating Women in Medicine: Pioneers, Innovators, and Leaders
Deborah Fuller, MD
September in the United States is a special month dedicated to celebrating the remarkable contributions of women in medicine.
This month-long observance, known as “Women in Medicine Month,” honors the advancements and accomplishments of women physicians in shaping the U.S. healthcare system. From breaking barriers in medical education to leading groundbreaking research and providing compassionate patient care, women physicians have played an indispensable role in the evolution of health care.
The journey of women in medicine has been one of resilience and determination. In the early 19th century, women faced significant obstacles in pursuing medical education. Elizabeth Blackwell, the first woman to receive a medical degree in the United States in 1849, paved the way for future generations of women physicians. Her perseverance and dedication challenged societal norms and opened doors for women to enter the medical profession.
Following in Blackwell’s footsteps, women like Mary Edwards Walker, who served as a surgeon during the Civil War and later became the only woman to receive the Medal of Honor, continued to break barriers. These trailblazers not only proved their competence but also highlighted the importance of diversity in medicine.
Women physicians have made significant contributions to medical research, often in the face of adversity. Dr. Helen Brooke Taussig, a pioneering cardiologist, is credited with developing the field of pediatric cardiology. Her
work on “blue baby syndrome” led to the development of life-saving surgical techniques for congenital heart defects.
Another notable figure is Dr. Virginia Apgar, an anesthesiologist who created the Apgar Score, a quick and simple way to assess the health of newborns immediately after birth. This innovation has saved countless lives and remains a standard assessment in delivery rooms worldwide.
Women physicians have also been at the forefront of public health initiatives. Dr. Leona Baumgartner, the first woman to serve as commissioner of health for New York City, played a crucial role in promoting public health education and preventive care. Her efforts in advocating for vaccination campaigns and health education programs significantly improved the health outcomes of New Yorkers.
Dr. Antonia Novello, the first woman and first Hispanic to serve as surgeon general of the United States, focused on improving health care access for underserved populations. Her advocacy for children’s health, AIDS awareness, and anti-smoking campaigns left a lasting impact on public health policies.
Compassionate patient care has always been a hallmark of women in medicine. Dr. Rebecca Lee Crumpler, the first African American woman to earn a medical degree in the United States, dedicated her career to providing medical care to freed slaves and underserved communities. Her work emphasized the importance of equitable health care for all.
Dr. Susan La Flesche Picotte, the first Native American woman to become a
physician, tirelessly served her community on the Omaha Reservation. She provided medical care and advocated for public health and education, addressing the social determinants of health long before doing so became a common practice. Women physicians have also been instrumental in advancing medical technology. Dr. Patricia Bath, an ophthalmologist and inventor, developed the Laserphaco Probe, a device used in cataract surgery. Her invention has restored vision to millions of people worldwide and revolutionized the field of ophthalmology.
Dr. Gerty Cori, a biochemist and the first woman to win a Nobel Prize in physiology or medicine, made groundbreaking discoveries in carbohydrate metabolism. Her research laid the foundation for understanding how the body converts food into energy, which has implications for treating and curing diabetes and other metabolic disorders.
The contributions of women in medicine extend beyond their clinical and research achievements. Women have also been vocal advocates for gender equity in the medical profession. Organizations like the American Medical Women’s Association (AMWA), founded in 1915, have been instrumental in supporting women physicians and addressing issues such as gender discrimination, work-life imbalance, and limited leadership opportunities.
Dr. Elizabeth Blackwell’s legacy
continues through such institutions as the Elizabeth Blackwell Award, which honors women who have made significant contributions to the advancement of women in medicine. This recognition serves as a reminder of the ongoing efforts to achieve gender parity in the medical field.
Dallas has been home to many remarkable women physicians who have made significant contributions to the medical profession. One such pioneer is Dr. Gladys J. Fashena, a renowned pediatric cardiologist who made lasting contributions to her field and to the Dallas medical community. Dr. Fashena’s work in pediatric cardiology helped advance the understanding and treatment of congenital heart defects, improving the lives of countless children.
Another notable figure is Dr. Nancy Dickey, a family physician and graduate of the University of
Texas Medical School at Houston. Dr. Dickey made history as the first female president of the American Medical Association (AMA) in 1998. Her leadership and advocacy for family medicine and women’s health have had a profound impact on the medical community.
As we celebrate Women in Medicine Month, it is essential to recognize the progress that has been made and the work that still lies ahead. Women now make up a significant portion of the medical workforce, and their representation in leadership positions is steadily increasing. However, challenges such as gender bias, pay disparities, and work-life imbalance continue to persist.
The future of women in medicine is bright, with a new generation of women physicians poised to make even greater strides. Mentorship
programs, scholarships, and initiatives aimed at promoting diversity and inclusion are helping to create a more equitable and supportive environment for women in medicine.
The contributions of women physicians to the U.S. health care system are immeasurable. From breaking barriers in medical education to leading groundbreaking research, advocating for public health, and providing compassionate patient care, women have played a vital role in shaping the landscape of medicine. As we celebrate Women in Medicine Month, let us honor their achievements, acknowledge the challenges they have overcome, and commit to supporting the next generation of women physicians who will continue to transform health care for the better. DMJ
Women in Medicine: The Art of Beauty
History of Women in Medicine: Pioneering Struggles, Pathways and Progress
Jon R. Roth, MS, CAE
The history of women in medicine is a testament to perseverance and resilience, from the ancient healers and midwives to the trailblazing physicians of the modern era. Their journey has not been easy, as societal norms, legal barriers and institutional struggles with gender disparities have often stood in their way. Throughout the ages, women have played critical roles in advancing medical knowledge and practice.
When we think about pioneering women in medicine, we often think first of the Blackwell sisters, Elizabeth and her younger sister, Emily — the first and third female physicians in the United States. There is, however, a rich history of women in medicine, as women have been involved in health care since the ancient times, serving as herbalists, midwives, and healers within their communities.
The world’s first known female physician, Peseshet, lived and practiced in Egypt during the Fourth Dynasty, about 2500 BCE, during the time of the construction of the great pyramids at Giza. Peseshet’s history is known due to an inscription in the tomb of her son, Akhethetep, excavated in 1929. Peseshet’s royal title was “Lady Overseer of the Lady Physicians,” a title that encapsulated her role as a supervisor of female physicians (and possibly male physicians, as well) and that underscores the respected role women played as health care practitioners in ancient Egypt. The inscription in her son’s tomb tells us that Peseshet “lived to a good old age” and “possessed honor before the king.” She also served as a priestess to the king’s mother and as an overseer of other priestesses. In addition, she was honored as one “concerned with the king’s affairs” and “known to the king.” Indeed, her title as an “acquaintance of the king” was the highest honor a woman could hold at that time in ancient Egypt. Medicine, at that early time, had evolved as a science with established practice specialties in the Old Kingdom, including ophthalmology, den-
tistry, proctology, internship, and surgery. The Edwin Smith Surgical Papyrus from the Old Kingdom describes medical history-taking, physical findings, diagnoses, prognoses, and therapies. Just as they do today, physicians like Peseshet recognized that there were difficult cases beyond their ability to treat.
In ancient Greece and Rome, the role of women in medicine was more restricted. Society was less accepting of women in formal medicine, as male physicians like Hippocrates dominated the field. However, women still played significant roles as midwives and herbalists. Agnodice is a legendary figure from fourth-century B.C. who lived in ancient Athens. She is credited with being the first female midwife or physician in ancient Athens. Agnodice worked from her home disguised as a man, because women at the time were forbidden to practice medicine. Her popularity with female patients grew, and rival physicians accused her of seducing the women of Athens. As a result of their resentment, she was eventually charged with illegally practicing medicine as a woman. At her trial, she revealed herself to be a woman by lifting her tunic to expose her clothed breasts. She was found guilty, but was defended by her female patients and later acquitted, leading to a change in the law that allowed women to practice medicine.
In Rome, women such as Metrodora authored early medical texts. On the Diseases and Cures of Women is attributed to her. Her writings, focusing on women’s health, were significant as they emphasized women’s contributions in understanding and treating female medical conditions.
During the medieval period, women continued to serve as healers and midwives, particularly in Europe. Sadly, as universities became the center of medical learning, women were barred from attending. However, Trotula of Salerno, regarded as the world’s first gynecologist, was an 11th-century female physician in Italy and one of the most
notable women of this era. She is credited with authoring several collections of medical writings, including The Trotula, on women’s health, childbirth, and gynecology that were influential in medieval medicine. Her work was widely respected and used by male physicians for centuries. Despite the significant contributions of women like Trotula, the rise of formal medical institutions, often run by the Church or male-dominated guilds, increasingly excluded women from formal medical education and practice.
During the Islamic Golden Age, from the eighth through fourteenth centuries, Islamic women were integrated into traditional medical practice. Female physicians, such as Rufaida al-Aslamia in the seventh century, were pioneers in medical care, especially during wartime, when they served as the equivalent of battlefield nurses and surgeons. In the Islamic world during this period, there was more of an inclusive approach to women practicing medicine than in medieval Europe.
The Renaissance and Enlightenment periods brought advances in science and medicine and marked a period of intellectual and scientific growth, but they also saw the consolidation of male dominance in the medical profession. Medical education became formalized in universities, from which women were excluded. However, women continued to practice medicine in less formal capacities, often serving as midwives, herbalists, and carers in domestic settings. Their knowledge of childbirth and natural remedies was indispensable. One of the most significant figures from this period is Jane Sharp, an English midwife who authored The Midwives Book in 1671, the first comprehensive midwifery text written by a woman. Sharp’s work was groundbreaking for its time, not only offering practical advice on childbirth and women’s health but also challenging the male-dominated medical profession’s growing influence over childbirth. Unfortunately, the witch hunts of the 16th and 17th centuries targeted many
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women healers with accusations of sorcery. This period of persecution manifested both a fear of women in the medical field and a desire by men in medicine to control medical knowledge.
By the 18th century, despite the restrictions placed on them, some women managed to break into the medical field. Dorothea Erxleben became the first woman in Germany to earn a medical degree. After petitioning the King of Prussia, she was granted permission to study and practice medicine. Dorothea was initially educated by her progressive physician father. After being granted permission to study medicine at the University, she never entered, feeling socially obligated instead to rear her cousin’s five orphaned children. Later, rearing nine children (four of her own), she began to practice medicine without a degree. She was charged with medical quackery but passed a royal exam edict and submitted a dissertation to the University of Halle. She pointed out that doctors were too quick to prescribe unnecessary opiates for illnesses that did not require them, offering suggestions for correct usage and dosages. After passing the exam, she gained her degree and continued to practice medicine in her hometown.
The 19th century was a pivotal time for women in medicine, as more women began to demand access to medical education and professional opportunities. One of the most significant and well-known figures of this era is Elizabeth Blackwell, who in 1849 became the first woman to receive a medical degree in the United States, graduating from Geneva Medical College in New York. Blackwell faced significant discrimination and opposition from her male colleagues and medical schools, but her determination opened the door for future generations of women. She went on to establish the New York Infirmary for Women and Children in 1857 and later played a role in establishing the London School of Medicine for Women. Elizabeth left the New York Infirmary in 1869 and returned to London, where she gave up medicine and focused instead on her moral crusades. Elizabeth’s younger sister, Emily, the third woman to earn a medical degree in the United States, kept the infirmary going for years after Elizabeth departed for England. Emily practiced medicine until she was 73. Despite playing key roles in advocating for the education of women in medicine, the Blackwell sisters sought their own advancement in medicine as a crusade to fight against moral degeneracy while opposing non-medical women’s rights.
In the United Kingdom, Elizabeth Garrett Anderson became the first woman to qualify as a doctor in 1865, despite facing similar obstacles. Anderson’s persistence led her to study privately and take her exams through the Society of Apothecaries after being denied admission to medical schools. She later co-founded the London School of Medicine for Women with Elizabeth Blackwell. This original institution of higher learning provided
medical education exclusively for women. Other women determined to practice medicine did so in secret. The most famous of these, James Miranda Barry, lived in England as a man to practice medicine. She obtained a medical degree in 1812 and rose to the rank of Inspector General as a surgeon in the British Army.
Emily Stowe was the first woman to practice medicine in Canada, earning her medical degree in 1867, after overcoming significant opposition to entering medical school. In France, Madeleine Brés, became the first female physician in the country after earning her medical degree in 1875.
Another female medical pioneer of the 19th century was Mary Edwards Walker, a surgeon during the American Civil War and the only woman ever to receive the Medal of Honor. Walker’s contributions to medicine, particularly in the fields of surgery and battlefield care, were remarkable at a time when women were often relegated to nursing roles.
The first Black woman to earn a medical degree in the United States was Rebecca Lee Crumpler, who earned her degree in 1864, only 15 years after Elizabeth Blackwell. Rebecca used her education to care for emancipated slaves through the Freedmen’s Bureau.
Throughout the 19th century, women faced institutional barriers to entering the medical profession. However, by the end of the century, the efforts of these pioneers had resulted in the opening of more medical schools to women and the gradual acceptance of women into professional medical organizations.
The early 20th century saw continued progress for women in medicine, as they began to take on more prominent roles in public health, medical research, and medical education. However, their journey was far from complete, as societal views about women’s capabilities persisted.
In 1915, Rosalind Franklin, an English nurse and physician, became one of the first female doctors to work for the British government, contributing to public health initiatives and medical research. Marie Curie, recognized for her contributions to physics and chemistry, also contributed through her pioneering work with radioactive elements to advance medical imaging.
In the United States, women like Alice Hamilton made significant contributions to industrial medicine and public health. Hamilton was a pioneer in the field of occupational health and the first woman appointed to the faculty at Harvard Medical School in 1919. Her research on the effects of industrial toxins helped shape workplace safety regulations and improved the health of countless workers.
Despite these advances, women in medicine still faced significant challenges in the early 20th century. Many medical schools limited the number of women they admitted, and professional opportunities for women
were often restricted.
The latter half of the 20th century was characterized by the feminist movement, which played a crucial role in breaking down barriers in many fields, including medicine. By the 1970s, women were entering medical schools in greater numbers, spurred by civil rights movements and shifts in societal expectations. Medical institutions gradually become more inclusive, with women making up an increasingly larger proportion of medical students and practicing physicians. Women now represent a substantial portion of medical school students and are increasingly taking on leadership roles in hospitals, medical schools, and professional organizations.
Today, women are leaders in all areas of medicine, from clinical research and academia to policy making. Gender equity in medicine has advanced significantly, though challenges remain, including gender bias, pay disparity and underrepresentation in leadership positions. Work-life balance, particularly in demanding medical careers, remains a concern for many women physicians. Mentorship programs, professional networks, and advocacy organizations continue to support the advancement of women in medicine, ensuring that future generations of women physicians will continue to break barriers and make lasting contributions to the field of medicine.
From ancient healers to modern-day physicians and researchers, women have played, and continue to play, an essential role in the future of medicine. As women continue to enter the medical profession in greater numbers, their impact on the field will only grow, ensuring that health care becomes more equitable, compassionate, and innovative for all. The journey is far from over, but with continued advocacy and reform, the future of women in medicine looks brighter than ever.
DMJ
Jon R. Roth, MS, CAE DCMS EVP/CEO
Employment Law Guidance: Upholding Women’s Rights in the Workplace
By Brandon Kulwicki, Attorney with Hall, Render, Killian, Heath & Lyman, P.C.
As women continue to enter the professional workforce in record numbers, it is important for both employers and employees to be aware of applicable employment laws regarding gender. Both federal and state laws outline the rules and regulations that protect women’s rights in the professional workforce, including women who are or may be pregnant.
At the federal level, three primary employment laws control this area: the Equal Pay Act, Title VII of the Civil Rights Act of 1964 (Title VII), and the Americans with Disabilities Act (ADA).
The Equal Pay Act requires that both men and women in the same workplace be given equal pay for equal work. The jobs do not need to be identical, but they must be substantially equal. Moreover, job content determines whether jobs are substantially equal, not the job title.
Title VII is enforced by the Equal Employment Opportunity Commission (EEOC). Under Title VII, it is illegal to discriminate against employees based on pregnancy, childbirth, or related medical conditions, and employers must treat employees the same who are similar in their ability or inability to work.
The ADA protects employees against discrimination based on disability, which applies to some pregnancy-related conditions.
In addition to the federal protections, the state of Texas has two additional relevant laws pertaining to women in the workforce.
The Texas Commission on Human Rights Act makes it illegal for employers to discriminate in the workplace based on race, color, disability, religion, sex (including pregnancy or a related medical condition), national origin, age, and genetic information (Tex. Labor Code § 21.001).
Mothers are legally permitted a break time to express milk or breastfeed in any location where the mother is authorized to be, such as work. Employers must have policies that support and apply reasonable accommodations that include (1) work schedule flexibility, (2) accessible locations for privacy, (3) access nearby to clean oneself and equipment, and (4) access to hygienic storage for the breast milk (Tex. Health & Safety Code § 165.003).
It is important to ensure that women in the workforce, whether mothers or not, are protected and afforded their rights. DMJ
This article is educational in nature and is not intended as legal advice. Always consult your legal counsel with specific legal matters. If you have any questions or would like additional information about this topic, please contact Brandon Kulwicki at (214) 615-2025.
Information for Authors
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The Dallas Medical Journal selectively accepts articles from industry professionals that meet our editorial guidelines. We always seek original, informative articles that ultimately will be a useful source to give our professional readers a broad yet unique reading experience.
If you are interested in submitting an article for consideration, or have additional submission questions, please email Lauren Williams at lauren@dallas-cms.org.
HOUSE CALL
DCMS Celebrates Women in Medicine
by Samantha Sabio
TIFFANY MOON, MD, is a board-certified anesthesiologist, entrepreneur, author, wife, and mother — among many things. Much of her life had been focused on professional success until she realized there were many ways to define a successful life. Her journey into introspection and self-discovery serves as an inspiration for other women throughout medicine and beyond to expand their limits and embrace what makes them unique.
Beauty, social media, and community leadership are just a few areas of interest for Dr. Moon. But Dr. Moon describes herself as a total academic as a child. “I was the quintessential nerd in all aspects of the word,” Dr. Moon said. Which also meant that a career in medicine was not at all inconceivable, even at a young age. In fact, her parents had already propositioned the career choice to her. “In terms of choosing medicine as a career path, I think it was already chosen for me,” she recalled. “But I love my profession regardless.”
Dr. Moon’s academic inclination began after she immigrated to
the United States. “I immigrated to the United States when I was six years old,” Dr. Moon said. “In my childhood, I moved schools every one to two years. So I was always the new kid.” Constantly moving took a toll on the young Dr. Moon. It was difficult for her to form strong routines or to make long-lasting friendships. After some time, she found herself turning to her studies. “I always found solace in books and studying,” Dr. Moon said. “Therefore, I was a very good student.”
At the age of 14, Dr. Moon took the SATs and applied for the Texas Academy of Math and Science (TAMS ). Students accepted into the program withdraw from high school and begin taking college courses at the University of North Texas (UNT). She began the program at the age of 15 and took two years’ worth of classes at UNT. After completing the program, Dr. Moon finished the remaining two years of her undergraduate degree at Cornell University in Ithaca, New York. From there, she went straight into medical school at the age of 19. Dr. Moon attended medical school at UT Southwestern right here in Dallas, graduating with Alpha Omega Alpha (AOA) honors as well as a Distinction in Research at the age of 23.
Her academic aptitude didn’t stop there. After graduating medical school, Dr. Moon completed her residency in anesthesiology at the University of California, San Francisco (UCSF). She had chosen the school not only for its remarkable reputation as one of the top anesthesia residencies in the country, but also for the excitement of being in a popular city. “UCSF has one of the top 10 anesthesia programs in the country,” she explained. “And San Francisco was the epicenter of the internet and technology.” As for anesthesiology, Dr. Moon was drawn to its collected approach and controlled environment. “[Anesthesiology] just nat-
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urally appealed to me,” she said. “I’m good with my hands, I like to be prepared, and I’m very calm in the face of crisis.” Dr. Moon had rotated through several specialties before finally finding that instant connection with the specialty of her choice. “When I rotated on anesthesia, it’s like the light shone upon me,” she joked. “I don’t regret my decision for one day. I love anesthesia.”
For most of her professional career, Dr. Moon has worked as a fulltime anesthesiologist. “When you’re a full-time anesthesiologist, plus trauma call and liver transplant call, it leaves very little time for family and hobbies and self-care,” Dr. Moon said. And at the height of the COVID-19 pandemic in 2020, Dr. Moon realized that her nonstop work ethic wasn’t sustainable.
“Six weeks after I had my twin girls, I went back to work,” Dr. Moon said. “Full time, nights, and weekends plus clinical research trials and working as the director of resident recruitment.” Dr. Moon admitted that she went back to work so fast and so fervently to prove her worth as a physician and anesthesiologist. “I wanted to prove that I was dedicated, that I was serious, that I wasn’t going to be one of those women who had kids and then slowly petered out.” She had witnessed this before with other female physicians. And she noticed how differently those women had been treated due to their commitments outside of their profession. “I internalized that I needed to do all of this in order to prove myself,” Dr. Moon said.
And this wouldn’t be the only time in her career that Dr. Moon would feel a different kind of weight in being a female physician versus a male one. At times, patients would question her credibility or ask for a different doctor. Other times, she’d receive criticism and judgment from peers for her social media and television presence or her business endeavors. But for Dr. Moon, she’s learned to turn a shoulder to those who don’t support her passions. “I’m just going to continue being me,” Dr. Moon said, with a confidence to be admired. “If there’s something you want to do, it can be done.”
And that’s the same approach she’s taken to her other endeavors outside of medicine. After the COVID-19 pandemic hit, Dr. Moon took a step back from medicine to prioritize other aspects of her life. “I asked to go part time so that I could have one day a week to pursue other endeavors outside of medicine,” she said. Her pursuits first took her to social media where she began creating content with her family. They even took her on a short stint to reality television as the first Asian-American member of the cast of Real Housewives of Dallas. Most recently, she’s dedicated her time to planning a leadership summit and writing a book.
When asked about the inspiration for her leadership summit, LeadHer Summit, Dr. Moon explained that her initiative began because she wanted to experience a different kind of medical conference. “I wanted a CME [continuing medical education] conference that was fun, [with] topics like marketing, how to bring big ideas to life, legal pitfalls to avoid, and how to build a wealthy life as a woman,” Dr. Moon said. “I didn’t learn any of this when I was in medical school almost 20 years ago. These are the things I want to learn about right now.” And these are the skills that she wants to help other women cultivate.
Initially, Dr. Moon hadn’t intended on planning her own conference. She merely wanted to find and attend one that suited her evolving professional interests. But when that didn’t work, she took advantage of a new perspective. “One day my husband asked me, ‘Why don’t you just make your own conference?’” Dr. Moon said. “He said, ‘You
have all these amazing powerful and professional female friends. Ask them to be the speakers, find a hotel, then start planning the summit.’” It was his suggestion that became the catalyst for the aptly named LeadHer Summit. And while Dr. Moon was and still is anxious and excited for all things to come with the summit, she’s finding a lot of grace experimenting with this new project. “I’m figuring it out. I’m meeting all these amazing people. I’m learning how to do it as I do it.”
In interviews and podcasts, Dr. Moon had been asked about her life story time and time again, and with the building interest, she realized there might be a larger market that her story could reach. So, she began work on a way to tell that story. “The book is half memoir, half personal development,” Dr. Moon described. “It’s the story of my life, but more expanded and developed, and at the end of each chapter is a lesson that I learned in that period of my life that readers can take and use in their lives. It’s a memoir with a message.”
From teaching medical students and residents to publishing 50 peer-reviewed articles to managing a business, Dr. Moon certainly has a long list of accomplishments, but when asked, she says that she’s most proud of her persistence as a young adult that got her here in the first place. “[I’m proud of] graduating at the age of 23 with AOA honors from UT Southwestern and getting into arguably one of the best anesthesia programs in the country,” Dr. Moon said. That and raising her children. “[My husband and I] teach them to be kind, and we try to model good behavior for them,” Dr. Moon said. “I’m raising them, I hope, to be good people.”
Her support system has played a prominent part in her success over the years as well. “I’ve had a mix of different mentors — one person for work, one person for my business and entrepreneurship, one person that helps me with my parenting. I think you have to build a community of people who support and uplift you and have your back.” Dr. Moon recalled a time when she didn’t have a community to rely on and emphasized the importance of surrounding yourself with a strong support system. “Now I have friendships with people who lift and empower me rather than the ones who try to blow out my flame,” Dr. Moon said.
Among these supporters is her family. When Dr. Moon is not taking care of her patients or planning a revolutionary leadership summit or working on the release of her upcoming book, she’s spending time with her family. “I love spending time with my family.” Dr. Moon shared stories of singing Taylor Swift with her girls and trying new skincare products on her nights in. Despite her busy schedule, she still finds time to be with the people she loves the most.
“You can have other endeavors outside of medicine and still be a really good doctor,” Dr. Moon said. “When I’m at work, I’m a great anesthesiologist. I’ve put a lot into my career. My other endeavors don’t diminish my capabilities as a physician.” This is the lesson Dr. Moon emphasized the most. If you have a passion or an idea or a desire to do something different, then just do it.
The inaugural LeadHer Summit will take place from November 8 to November 10, 2024, at the JW Marriott Dallas Arts District. For more information and to register for the event, visit LeadHerSummit.com. Dr. Moon’s book will be available for presale in October 2024. DMJ
SONYA MERRILL, MD, PHD, has accomplished a lot in her professional career. She’s earned several academic degrees, operated a solo private practice, trained hundreds of internal medicine residents, and participated in international medical missions. And now she works as a sleep medicine physician at Cooper Clinic in Dallas. Throughout her entire career, Dr. Merrill has and continues to show tenacity and talent as an inspiring woman in medicine.
For as long as she can remember, Dr. Merrill has always wanted to be a doctor. “I don’t remember when I first thought about [becoming a doctor],” Dr. Merrill said. “It’s always been what I wanted to do.” The respect doctors received and the compassion they showed were not lost on Dr. Merrill, even as a child. She saw these traits reflected in her maternal uncle, a small-town physician, and two of her childhood pediatricians — all of whom played a significant role in helping to pave her own career path.
As the daughter of two academics, Dr. Merrill has always been intellectually inclined. “My parents were both professors,” she said. “They played a big role in my academic interests and career development over the years.” Her studious nature would carry her through graduate programs and, eventually, medical school.
Dr. Merrill began her journey in higher education at Wellesley Col-
lege in Massachusetts. During her time at Wellesley, she had the opportunity to study abroad at the University of Cambridge in England. This experience changed the course of her academic career. “I loved it,” Dr. Merrill raved. “I would’ve transferred there to finish my undergraduate degree if it had been possible financially. It was the best time of my life.” She ended up returning to Wellesley to finish her undergraduate degree with a major in philosophy. But even as she left, she knew she would find a way back to England.
Which is what led her to apply for graduate studies there. “I did a master’s degree in medical ethics and medical law at the University of London,” Dr. Merrill said. “And during [my first year], I knew I wanted to extend my time there further and deepen my understanding of ethics, so I enrolled in the PhD program in philosophy.” With a respected and inspiring female professor as her supervisor, Dr. Merrill completed her PhD in three years and became a confirmed Anglophile.
Despite living and studying in England, Dr. Merrill still found time to research and apply to medical schools in the United States. Dr. Merrill said, “I started the application process during my master’s degree and was accepted and held deferments at a couple of medical schools. But halfway through my PhD program, I decided that I really wanted to apply to Harvard.” An early mentor, one of her childhood pediatricians in fact, had attended the acclaimed university, and this inspired her to apply there herself. “I was accepted, and they were gracious enough to give me a deferment as well while I completed my studies in England,” she recalls. She enjoyed the challenge of medical school and the opportunity to be back in her home state of Massachusetts.
An academic at heart, Dr. Merrill aimed to bridge the gap between her two disciplines of medicine and ethics. At one point, she had aspired to work in public policy and even did a summer internship in the White House during the Clinton administration.
Like Dr. Merrill’s earlier academic career, selecting a specialty also took her down multiple paths, starting with psychiatry. “At Harvard, I had some really wonderful professors and clinical mentors, and I did several psychiatry clerkships,” she said. Additionally, her mother worked as a professor of psychology, a related discipline. So Dr. Merrill set her sights on becoming a psychiatrist fairly early on.
When it came to choosing a residency program, Dr. Merrill initially cast her net far and wide, entertaining options all around the country. “I interviewed all over,” Dr. Merrill said, “from California to Vermont. But at the end of the day, I went to UT Southwestern [Medical Center] because I wanted to be back in Dallas.” But as she progressed through her residency, she eventually realized that perhaps psychiatry wasn’t what she wanted to do after all.
To her surprise, internal medicine was calling her name. During her internship, she spent time at Presbyterian Hospital of Dallas, now Texas Health Dallas, where she did rotations in internal medicine and emergency medicine. Working as part of a team to address patients’ medical problems was where Dr. Merrill thrived. “I really enjoyed internal medicine,” she said. “I realized I was going to be sad to put down my stethoscope at the end of my intern year.”
So after completing her second year of psychiatry training at UT Southwestern, she enrolled in the internal medicine residency at Texas Health Dallas. While there, she developed an interest in pulmonary critical care. Dr. Merrill applied to pulmonary critical care fellowship programs from coast to coast, but in the year leading up to her program , she happened upon a sleep medicine fellowship at UT Southwestern that would once again change her plans. “I matched to my
first choice in pulmonary critical care at Brown University in Rhode Island,” Dr. Merrill said, “but halfway through my sleep medicine fellowship in Dallas, I realized I wanted to focus exclusively on sleep medicine and notified the folks at Brown that I wouldn’t be joining them after all.”
After completing her sleep medicine fellowship, she began working right here in Dallas, something she was eager to do after all her years of schooling. “I joined a neurology practice at Medical City Dallas Hospital,” Dr. Merrill said. “I was also invited by my mentor, Dr. Mark Feldman, who had been my residency program director at Presbyterian Hospital, to serve as one of the core faculty [members ] in internal medicine.” The following year, Dr. Merrill would become the associate director of the program. She would also start her own solo private practice, Dallas Sleep Medicine Specialists, on the campus of Texas Health Dallas.
While running her practice was very fulfilling, Dr. Merrill admitted that it was a difficult endeavor while also working full time in academic medicine — especially after her mother became ill.
“Five and a half years ago, my mom was diagnosed with normal pressure hydrocephalus,” Dr. Merrill said. This neurological disorder can affect motor functions and cognitive abilities, both of which her mother would experience. “I realized that in order for [my mom] to get better, I couldn’t continue to work such long hours with so many responsibilities,” Dr. Merrill said. So she resigned from her position at the residency program at Texas Health Dallas.
ized medicine remains a perfect fit for her practice.
Today, Dr. Merrill continues to work in sleep medicine at Cooper Clinic. She evaluates patients with sleep disorders and motivates them to improve their sleep health. And while she’s worked her entire life to get to this point and loves practicing clinical medicine, she views her greatest accomplishments as having been made in the spheres of education and community service.
As the associate program director at Texas Health Dallas for 12 years, Dr. Merrill oversaw the training of hundreds of residents. She was able to lead and guide them and, later, see them off to do wonderful things in their fields. “That’s where I really feel proudest of what I’ve achieved— being so involved in graduate medical education.” Dr. Merrill also noted her continued desire to give back. “Starting in 2001, my mother and I took medical mission teams to India regularly,” Dr. Merrill said. Along with other volunteers, she was able to bring medical care to thousands of people in urban slums and remote villages in India who otherwise would not have received it. She recalled, “It was very rewarding, and I would love to be able to do medical missions again at some point.”
However, three years later when the opportunity to spearhead a sleep medicine program at Cooper Clinic in Dallas arose, Dr. Merrill returned to full-time work. In many ways, being at Cooper Clinic has been different from working in her own practice. Primarily, Dr. Merrill harbors an appreciation for the strong sense of community and collegiality. “[In a solo practice], I didn’t have that community of physicians,” Dr. Merrill said. “So it’s wonderful to be working now with like-minded colleagues where we’re all focused on the individual patient in front of us and can provide unhurried and thoughtful care.” Dr. Merrill noted that the clinic’s emphasis on preventive and personal-
Throughout her life, Dr. Merrill has had a strong support system, from influential mentors to encouraging colleagues and, of course, her family. “Certainly, my parents have to be at the top of the list,” Dr. Merrill said. “When I started my private practice, my mother was there every week. She helped me set up the office and remained a tremendous help to me for years.” While Dr. Merrill has found support and encouragement in her family, her friends, and her colleagues, she admitted that sometimes, she simply relies on herself and her faith, quoting, “I can do all things through Christ who strengthens me” (Philippians 4:13).
When she’s not working at Cooper Clinic or taking care of her father at home, Dr. Merrill is focused on planning her next big adventure. “My dominant passion is travel — I’ve been to nearly 70 countries,” Dr. Merrill said. In recent years, she’s enjoyed taking her parents with her, despite the challenge of traveling with two elderly people in wheelchairs. She noted, “My dad is nearly 90 and still loves to travel, and my mother loved to travel as well.” Just like how her academic and professional careers have covered a lot of ground, Dr. Merrill plans to continue traveling the globe wherever and whenever she can. DMJ
Shifting the Tide: Advancing the Representation of Women and Girls in the Professional World
By By Brandon Kulwicki, Attorney with Hall, Render, Killian, Heath & Lyman, P.C., and Rachelle Madison and Grace Friloux, Summer Associates with Hall, Render, Killian, Heath & Lyman, P.C.
The Texas Women’s Foundation has taken monumental strides in organizing a foundation that is committed to ensuring the advancement of the economic security and leadership opportunities for women and girls.1 The Texas Women’s Foundation changed its name in 2018 from Dallas Women’s Foundation to reflect its expansion as a statewide foundation that has become one of the largest women’s foundations in the world. From its start in 1985 when it began with 19 founders, the Foundation has maintained the goal of unleashing the power that strong women have in making a better world. By leveraging external capital, the Foundation is able to combine resources and form collaborations, bringing about meaningful social change to improve the lives of women and girls.
Fulfilling Its Mission Through Impact Investing
The Texas Women’s Health Foundation integrated impact investing to achieve greater alignment of its investments with its philanthropic mission “that invests in the power of women and girls to drive positive change. Through research, advocacy, programs and grantmaking, [the foundation] advance[s] economic and leadership opportunities for women, girls, and families to build stronger, more equitable communities for all.” To achieve this mission, the Foundation leverages external capital to garner social change among women and girls. To ensure the best future for women and girls, the Foundation strives to generate a sustainable social and economic environment. Applying its impact investing model, the Foundation invests in affordable housing, health services, economic development, and education.2
Economic Security Initiative
To fulfill the mission set forth by the Foundation, one of the primary areas of focus
is economic security for women and girls. There could be a 51% reduction in poverty rates of Texas women if women were paid comparably to men. Looking philanthropically, only 12% of charitable dollars go to women and girls globally and only 1.6% nationally. In a study, the Texas Women’s Foundation Statewide Research team found this initiative has impacted more than 62,244 Texans, including 40,581 women and girls from diverse ethnic and socioeconomic communities. If achieved, they will have the ability to be financially independent. By investing in this area, the Foundation ensures that women have the leadership opportunities to reach their full potential and build positive change in the community. To achieve this goal, the Foundation focuses on ensuring women and girls have access to education, childcare, health care, and housing. 3
Leadership Initiative
Women are more likely than men to be dramatically underrepresented in leadership positions despite evidence that shows the countless economic and social benefits of women leaders in business and the community. This fact presents itself in every setting, including hematology and other related specialties, as women are continually overlooked for recognition and awards, paid less than their male counterparts, and receive little opportunity to obtain leadership roles.4 When these disparities arise, the Texas Women’s Foundation can assist with its leadership initiative to balance out the bias, discrimination, limited mentorship opportunities, and work-life balance. Even though 52% of professional jobs are held by women, only 14.6% of executive positions are held by women. The goal of this initiative is to build a culture in Texas in which women and girls are full participants at every level. While the Foundation has made a $2 million annual commitment to develop and support programs, policies, and practices that
increase the number of women in leadership positions, the best estimates indicate that gender pay equity will not be achieved in Texas until 2049. The Texas Women’s Foundation provides unique and effective programs for women and girls to acquire, refine, and strengthen their leadership skills and potential. Some of these programs include the Women’s Leadership Institute, Young Women’s Initiative, #BestSelf, and Women & Wealth.5
Conclusion
In conclusion, the Texas Women’s Foundation serves as a leadership-focused program that supports women and girls through research, advocacy, grants, and programs. With the continued progression of women and girls entering the professional field, there is heightened awareness of the disparity existing in wage and position opportunities. The proposed initiatives reflect a concerted effort to improve the overall opportunity for women and girls to obtain leadership positions, earn equal wages to their male counterparts, and establish economic security to ensure a comfortable future. DMJ
This article is educational in nature and is not intended as legal advice. Always consult your legal counsel with specific legal matters. If you have any questions or would like additional information about this topic, please contact Brandon Kulwicki at (214) 615-2025 or your primary Hall Render contact.
Brandon Kulwicki is an attorney with Hall, Render, Killian, Heath & Lyman, P.C., a national law firm focused exclusively on matters specific to the health care industry. Please visit the Hall Render Blog at http:// blogs.hallrender.com/ for more information on topics related to health care law.
Special thanks to Rachelle Madison and Grace Friloux, Summer Associates, for their assistance in the preparation of this article.
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What You Don’t Know About the TMA Member Long-Term Disability Insurance Plan
TMA Insurance Trust
If you investigate the topic of disability insurance, you quickly learn it is complex . However, since residency, you have been told that your most important asset is your ability to earn a good income and that disability insurance is the best way to help protect it. We respect that you have worked hard for years to become a physician and have earned the opportunity to make a good income. We want to help you protect it well.
TMA Insurance Trust is an independent, full-service insurance agency with decades of experience counseling generations of Texas physicians on how to help protect their incomes and assets. This article will provide an overview of the TMA Member Long-Term Disability Insurance Plan, issued by The Prudential Insurance Company of America, and the comprehensive nature of the benefits and features built into the coverage and how that coverage compares to an individual disability policy.
permanent and you cannot practice, you will continue to receive benefits until you reach your Social Security retirement age. Should you become disabled after age 70, you can receive up to 24 months of benefits.
If your injury or illness limits you to practicing part of the time and your income decreases by 20% or more, you can receive a Partial or Residual Disability Benefit commensurate with the percentage of income that is lost. This valuable benefit is built into the TMA Member Plan . It is an optional coverage (known as a
The TMA Member Plan Starts With “Own Occupation” Coverage
The purpose of disability insurance is to help replace a portion of your income when you become too ill or injured to work. The TMA Member Long-Term Disability Insurance Plan provides Own Occupation Coverage. This means if you cannot perform the duties of your occupation, including your medical specialty, due to illness or injury and have a loss of income of 20% or more, you may receive benefits. If your disability is
has features included that will not limit your ability to maximize your coverage like some individual policies do. These are outlined below:
No Offsets: Unlike individual policies, the TMA Member Plan does not impose an offset. In other words, your benefits will not be reduced (offset) due to any other insurance benefits you may receive. Individual insurers impose this limit to ensure your total benefits from all sources will not exceed the percentage of your income covered by their policies. This is a valuable provision of the TMA Member Plan because your benefit is not reduced by any other disability benefits you may receive.
rider) that is available for an additional cost with an individual policy. We consider the partial/residual disability benefit to be mandatory coverage for physicians because a significant number of claims either begin as a partial loss of income or evolve into a partial loss of income while the physician is recovering and returns to work on a part-time basis.
More Benefits Built Into the TMA Member Plan
The TMA Member Plan includes benefits that are available only as coverage options on individual policies for additional costs. The TMA Member Plan also
Catastrophic Coverage: Disability insurance claim adjusters use what is known as “activities of daily living ” (ADLs) to determine the severity of a disability claim. These
are tasks that a person conducts that define their ability to live independently. Examples include being able to dress oneself, conduct personal hygiene, manage personal grooming, etc. With the TMA Member Plan, if the claimant cannot perform two ADLs, their benefit will be automatically increased by 20%. This benefit is included in the TMA Member Plan. It is an option on an individual plan for an incremental cost.
Future Increase Option: Many physicians secure their disability insurance early in their careers. However, over time, as their incomes increase, their coverage will no longer properly protect their incomes.
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“This program offers a challenging curriculum of leadership training and self reflection The speakers from the different sectors of healthcare were engaging and provided real examples of how our healthcare system weaves together, for better or worse I feel more prepared as an effective leader of the teams I influence today and the teams of my future ”
The Dallas County Medical Society and the UT Dallas Alliance for Physician Leadership Program (APL) are offering a year long, physician leadership certificate that will cover timely and important topics in today’s everchanging healthcare environment. The certificate program covers areas of focus such as physician wellness, leadership skills, value-based contracting, quality performance, emerging IT opportunities, revenue and financial management. The program is cohort style and will adapt to industry trends and the needs/topics of interest to the physician attendees.
The DCMS/APL program is exclusively for DCMS members and will include six in-person full-day sessions, a final project session, along with interim readings, case studies, and engagement with program faculty on an ongoing basis. The program design is intended to provide meaningful and focused learning with the in-person cohort, while respecting the time demands of a physician’s schedule.
Gates
covered with the TMA Member Plan before age 40 and have outstanding education loans, your monthly benefit will automatically be increased by 25% (up to a maximum benefit of $250,000) to help you make your outstanding education loan payments. Unlike individual policies, this benefit is a no-cost-toyou provision of the TMA Member Plan. The value of this benefit is apparent. The additional benefit will help preserve your primary benefit for living expenses and help keep your loan payments current.
the lesser of 6 percent or 50 percent of the increase in the Consumer Price Index for that year. This option makes sense for young physicians with years of practice ahead of them who need to make sure the buying power of their disability insurance benefits is not eroded over time by inflation. However, if you are a physician over age 50 and think you have accumulated enough of a financial cushion, combined with your current disability insurance benefit, to carry you through a long-term disability event, you may not need this optional coverage. This is when speaking with an experienced advisor is prudent.
The Bottom Line
The Future Increase Option allows a physician who is covered prior to age 40 to increase their coverage without the need to go through underwriting again prior to them attaining age 45. This eliminates the need for medical and financial underwriting, including sharing tax documents and the need to take a medical exam. So while your additional premium will reflect your age, it will not reflect any changes in your health or financial situation. This valuable feature is included in the TMA Member Plan, but it is an option you will pay extra for with an individual plan. We consider this a valuable coverage for residents and young physicians who could see dramatic increases in their incomes.
Student Loan Reimbursement: Many physicians have loans to pay back once they graduate medical school. Loan payments add an extra financial burden to a young physician’s budget. Have you ever considered what would happen if you could not practice due to an illness or injury? The loans still need to be paid back, and now you are without an income. If you had a family member or friend cosign your education loan, they are now responsible for making those payments. When you are
25% “Thank You” Premium Credit: The 25% Thank You Credit will equal 25% of your insurance premiums.1 That means your premium payments will be 25% lower, which could effectively save you thousands of dollars over the life of the policy. This is on top of our already-affordable premium rates and is our way of helping our members make sure their incomes are more protected. An advantage for women members is that our premium rates are gender neutral, so you will not pay more than your male colleagues. Typically, this would not be the case with an individual policy.
Simplified Underwriting: Applying for the TMA Member Long-Term Disability Insurance Plan is significantly more convenient than applying for an individual policy. In fact, for coverage of $5,000/month or less, we will not ask for complex financial statements or tax documents to verify your income. So we reduce the “hassle factor” and help protect your income sooner.
A TMA Member Plan Option to Consider: Cost-of-Living Adjustment (COLA ): This optional inflation-fighting feature helps protect the buying power of your disability benefits over time. Automatic annual increases to your disability benefits are equal to
When we designed our TMA Member Long-Term Disability Insurance Plan, we built in many benefits and features we considered to be necessary and valuable to help ensure members’ incomes are well protected. We also strived to keep the cost affordable for members. In fact, if you included all of the benefits and features in the TMA Insurance Trust Plan, the annual cost for a 35-year-old female physician would be $460.20. An individual policy with the same benefits and features would cost $2,737.24 per year. Given this, we think we were successful in meeting those objectives. And you should know that since the Plan’s inception in 1969, no participant’s coverage has ever been canceled or not renewed. In the past 20 years, TMA Insurance Trust has paid over $137,000,000 in benefits that continue to be paid today. The Plan’s decades of financial stability stand as a testament to our ongoing commitment to TMA members.
For many members, helping to protect their income is a priority. That is why it’s a priority for us. Our experienced advisors stand ready to provide guidance and support so you can make informed and smart decisions for you, your loved ones, and your future. And remember, our advisors are not driven by sales-based commissions — because they don’t receive any. Their focus is to help you put the best disability plan in place for your situation and budget. To speak with one of our advisors, call us toll-free at 800-880-8181, Monday through Friday, between 8:00 AM and 5:00 PM CST, or complete the contact request form to have an advisor contact you. It will be our privilege to serve you. DMJ
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Everyone is significant, and at Frost, we treat them that way. We give our customers a square deal and keep their assets safe and sound. These beliefs have guided Frost from the very beginning in San Antonio and have served our customers well since 1868.
T.C. Frost provided Texans with the supplies they needed to prosper on the frontier. Today, Frost provides individuals and businesses with financial tools and advice to thrive in a fast-paced world.
We offer our customers a full range of banking, investment, and insurance products to help them better manage their money, grow their wealth, and protect their assets. And our disciplined relationship approach has stood the test of time.
Whether it’s education, economic development, health and human services, or the arts, we support the nonprofit organizations where our employees and customers live and work.
We’re from here, and we’ve always played an active role in the communities we serve and call home. Through volunteer programs
or independently, our employees offer their hands and hearts to mentor young people, serve on the boards of nonprofits, care for the elderly, and help with important causes. We don’t open new financial centers just to serve the area’s financial needs but also to play a part in bettering the community for years to come.
At Frost, everything we do is aimed at making people’s lives better. And for over 150 years, that commitment has steadily guided our approach to our employees, our planet, and the communities we proudly serve.
When you have an account with Frost, you have a relationship with Frost. When you call, we’ll answer the phone 24/7, right here in Texas. And we’ll be here for you with a square deal and prudent financial advice and tools to help you with all the milestones in the years ahead.
“Working with you has been the most positive experience we have had with an insurance agent.”
Dr. Trent Stephenson
Providing exceptional service leads to us receiving testimonials like this one from Dr. Stephenson. For an insurance agent, providing great service boils down to two critical elements: desire and experience. The desire to provide it and the experience to deliver it.
This describes the attributes of TMA Insurance Trust’s agent-advisors.
This longevity of serving members has imbued our advisors with the experience necessary to understand their needs, know the nuances of the coverage that can meet those needs, and embrace the Association’s high expectations of service. They have the qualities required to serve members exceptionally well.
When you or your practice need insurance, or if you think the level of service you currently receive should be improved, contact one of our advisors to experience a higher level of service and care. They can be reached by calling 800-880-8181 , Monday to Friday between 8:00 AM and 5:00 PM CST, or by scanning the QR code. You can also visit us anytime online at tmait.org . It will be our privilege to serve you.
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Surgical miscounts are considered never events because they are usually preventable by following established procedures.
ProAssurance offers risk assessments designed to help practices minimize errors by establishing and evaluating safety procedures and communication protocols.
With reliable procedures in place, our insureds are more likely to reduce errors in their medical practice, avoid claims, and make claims more defensible if they do occur.
