Pregnancy in physicians: A scoping review.

BACKGROUND: The personal health and professional impact of physician pregnancy requires further study. We performed a comprehensive scoping review of physician pregnancy to synthesize and assess the evidence to aid decision-making for relevant stakeholders. METHODS: A search of 7 databases resulted in 3733 citations. 407 manuscripts were included and scored for evidence level. Data were extracted into themes using template analysis. RESULTS: Physician pregnancy impacted colleagues through perceived increased workload and resulted in persistent stigmatization and discrimination despite work productivity and academic metrics being independent of pregnancy events. Maternity leave policies were inconsistent and largely unsatisfactory. Women physicians incurred occupational hazard risk and had high rates of childbearing delay, abortion, and fertility treatment; obstetric and fetal complication rates compared to controls are conflicting. CONCLUSIONS: Comprehensive literature review found that physician pregnancy impacts colleagues, elicits negative perceptions of productivity, and is inadequately addressed by current parental leave policies. Data are poor and insufficient to definitively determine the impact of physician pregnancy on maternal and fetal health. Prospective risk-matched observational studies of physician pregnancy should be pursued.

Dr. Thanjavur Santhanakrishna Kanaka-A Pioneer and Neurosurgical Innovator.

BACKGROUND: Thanjavur Santhanakrishna Kanaka, M.B.B.S., M.S. (General Surgery), M.S. (Neurosurgery), Ph.D., and former Captain, Indian Army Medical Corps, was born on March 31, 1932. She became the first woman neurosurgeon in India and all of Asia. METHODS: This manuscript was compiled through a combination of interviews and references to other articles and some of the published manuscripts of Dr. Kanaka and her colleagues. RESULTS: Dr. Kanaka was a trailblazer for women in neurosurgery and a pioneer in functional and stereotactic neurosurgery. During her long and productive career, she authored dozens of articles reported in prestigious neurosurgical journals worldwide and helped inspire and train the next generations of neurosurgeons in India and abroad. Even after retirement, Dr. Kanaka continued to focus on serving the medical community through her Sri Santhanakrishna Padmavathi Health Care and Research Foundation in Chennai with the mission of serving underprivileged and senior citizens in the local community. In addition to her accomplishments as a practicing neurosurgeon, Dr. Kanaka's career was notable for her successful collaborations with biomedical engineers on medical device development using locally sourced materials and talent in India. CONCLUSIONS: Through her innovative thinking, compassion for her patients, and unwavering resilience, Dr. Kanaka has continued to serve as an inspiration to all pursuing a career in academic medicine and neurosurgery.

[Surgery During Pregnancy - Regulations and Requirements]. / Operieren während der Schwangerschaft ­ Regelungen und Bedarfe.

Due to the marked increase in the numbers of women in medicine, professional and political discussions on equality among doctors are gaining increasing attention. One such issue is "operating during pregnancy". As a result of existing legislation and federal regulations, it has been virtually impossible for pregnant surgeons to continue their surgical work. After approval by the Federal Council or Bundesrat, the revised Maternity Protection Act will come into force on 01.01.2018. It will thereafter be easier for surgeons to operate during pregnancy. The focus will now be on the transformation of workplace practices, in which individual risk assessments of the participating surgeons will be carried out in order to achieve a risk-adapted operation, and thus to prevent premature and unwanted restrictions on the employment of pregnant female surgeons.

"I would never want to have a mental health diagnosis on my record": A survey of female physicians on mental health diagnosis, treatment, and reporting.

INTRODUCTION: Physicians have high rates of suicide and depression. Most state medical boards require disclosure of mental health problems on physician licensing applications, which has been theorized to increase stigma about mental health and prevent help-seeking among physicians. METHODS: We surveyed a convenience sample of female physician-parents on a closed Facebook group. The anonymous 24-question survey asked about mental health history and treatment, perceptions of stigma, opinions about state licensing questions on mental health, and personal experiences with reporting. RESULTS: 2106 women responded, representing all 50 states and the District of Columbia. Most respondents were aged 30-59. Almost 50% of women believed that they had met the criteria for mental illness but had not sought treatment. Key reasons for avoiding care included a belief they could manage independently, limited time, fear of reporting to a medical licensing board, and the belief that diagnosis was embarrassing or shameful. Only 6% of physicians with formal diagnosis or treatment of mental illness had disclosed to their state. CONCLUSIONS: Women physicians report substantial and persistent fear regarding stigma which inhibits both treatment and disclosure. Licensing questions, particularly those asking about a diagnosis or treatment rather than functional impairment may contribute to treatment reluctance.

Sexual harassment in the medical profession: legal and ethical responsibilities.

Sexual harassment of women in medicine has become a subject of national debate after a senior female surgeon stated that if a woman complained of unwanted advances her career would be jeopardised, and subsequent reports suggest that sexual harassment is a serious problem in the medical profession. Sexual harassment of women in the medical profession by their colleagues presents substantial legal, ethical and cultural questions for the profession. Women have enforceable legal rights to gender equality and freedom from sexual harassment in the workplace. Both individual offenders and employers face significant legal consequences for sexual harassment in every Australian state and territory, and individual medical practitioners and employers need to understand their legal and ethical rights and responsibilities in this context. An individual offender may be personally liable for criminal offences, and for breaching anti-discrimination legislation, duties owed in civil law, professional standards and codes of conduct. An employer may be liable for breaching anti-discrimination legislation, workplace safety laws, duties owed in contract law, and a duty of care owed to the employee. Employers, professional colleges and associations, and regulators should use this national debate as an opportunity to improve gender equality and professional culture in medicine; individuals and employers have clear legal and ethical obligations to minimise sexual harassment to the greatest extent possible.

Gender and the experience of mental health expert witness testimony.

Mental health expert witness testimony involves complex tasks, and the capacity to perform under pressure is a fundamental skill of a forensic professional. In this context, it is important to understand the nuances of the provision of expert witness testimony. There have been several efforts to examine gender bias across legal and medical systems. Despite these reviews, little is known about how men and women differ or are similar with regard to performing expert witness functions. The purpose of this pilot study was to examine whether the testimony experiences of psychiatry and psychology experts vary by gender. Differences across certain domains, such as the sense of never experiencing anxiety and the sense of one's impact on case outcome were seen across genders. Few other gender-based differences in the experience of providing expert witness testimony were seen. Although the findings of this study raise further questions, they highlight some of the important subtleties noted in forensic practice and the work of the expert witness. In future studies, researchers should continue to explore these findings on the influence of gender and expand to consider culture and race as additional factors in the experience of expert witness testimony. As forensic professional practice evolves, it is important to understand unique aspects of forensic practice, to improve training of forensic experts, and to assist forensic experts in anticipating what they may experience related to the provision of expert testimony.

Warmth and competence on the witness stand: implications for the credibility of male and female expert witnesses.

In this study, we examined how manipulations of likeability and knowledge affected mock jurors' perceptions of female and male expert witness credibility (n = 290). Our findings extend the person-perception literature by demonstrating how warmth and competence overlap with existing conceptions of likeability and knowledge in the psycholegal domain. We found that experts high in likeability, knowledge, or both were perceived equally positively, regardless of gender, in a death penalty sentencing context. Gender differences emerged when the expert was low in likeability or knowledge. In these conditions the male expert was perceived more positively than the comparable female expert. Although intermediate judgments (e.g., perceptions of credibility) were affected by our manipulations, ultimate decisions (e.g., sentencing) were not. Implications for theory and practice are discussed.

Commentary: observations and concerns on the bigendering of our forensic fields.

The study by Neal et al. of mock jurors in the penalty phase of a homicide case led me to observations on gender changes over the past few decades in the professions of law and forensic psychiatry and psychology. From an earlier paucity of women in these professions, today their percentages have greatly increased. Yet, as in this study, there are differences that work to the advantage of men in how the genders are perceived as expert witnesses. Suggestions for addressing gender discrepancy are offered, along with a cautionary note, such as in the area of experts in cases involving abortion.

[Blood-borne infections and the pregnant health care worker. Risks and preventive measures]. / Blutübertragbare Infektionen und die schwangere Mitarbeiterin im Gesundheitswesen. Risiko und Präventionsmaßnahmen.

Due to the increasing proportion of women in health care, as well as changes in working conditions (implementation of safety devices, minimally invasive/endoscopic procedures) the question arises whether the applicable laws and regulations for the protection of working mothers are outdated and should be updated.Individual risk analysis, as well as the inclusion of the pregnant health care worker in the decision-making process with regard to continuation or modification of the work practice serves as a protection of the expectant mother and unborn child and allows a continuation of the occupational activities.

[Legal competence problems among general practitioners]. / Habilitetsproblem i fastlegepraksis.

BACKGROUND: We wanted to investigate to what extent Norwegian general practitioners (GPs) working within a patient list system have patients who they are legally incompetent to treat, what services they offer these patients, and what attitudes a representative sample of the GPs has towards situations where one is asked to offer services to such patients. MATERIAL AND METHODS: A questionnaire was sent to 622 randomly chosen GPs. We registered sex, age, list size, size of the local community and health region for every practice. For eight hypothetical situations, we recorded whether the doctor clearly, probably or hardly would offer services. RESULTS: About one quarter of the doctors had their spouses and own children below 18 on their list. Many had secretaries or colleagues on the list. From 18% to 31% of the doctors confirmed that they have prescribed reimbursable prescription drugs to one such patient. There were great variations in views on legal competence to treat in these hypothetical situations. INTERPRETATION: GPs encounter problems of legal competence to treat. Many were of the view that a pragmatic approach is needed in day-to-day general practice. GPs should be aware of their own practice and aware of both legal competence problems and other challenges induced by having family, close friends and co-workers on the list.