2022 Edition
“Do not live someone else’s life and someone else’s idea of what womanhood is. Womanhood is you.”
Viola Davis
The Editor's Take:
November Newsletter + Ask AMWA Form
Welcome back AMWA to your November Newsletter! In this edition, we have two solo articles, a new paired article, and a guest speaker interview. Your writers have written on the physiological differences on the basis of sex and the recent election. Our new paired article is called Spotlight, where your writers highlight the history of an influential woman and their impact on medicine. This month Zoe Du and Janavi Mehta have written about Margaret Sanger. Additionally, we are bringing you another Guest Speaker Interview. In the third General Body Meeting, AMWA UTD had Mrs. Kimberly Donner, M.P.A.S., PA-C, a board-certified Physician Assistant (PA) in the Department of Pediatrics – Pediatric Otolaryngology at UT Southwestern Medical Center. Read through her interview with Hafsa Mohammed and learn more about PA.
Also, don’t forget to check out our Spotify playlist for this month! We are also bringing back Ask AMWA, where AMWA UTD members can get a chance to answer a few poll questions about a topic and ask some of your own. Please take a moment to fill out our anonymous Ask AMWA form. Responses from this form will be used for the December newsletter so it is important that we get everyone’s opinions.
I hope you enjoy this edition and please do comment with your thoughts below! As always, if you have any questions or ideas feel free to email me at Tanya.Baiju@utdallas.edu.
- Tanya
Guest Speaker Interview: Kimberly Donner M.P.A.S, PA-C
By: Hafsa Mohammed
For AMWA’s third general body meeting this semester, I was delighted to speak with PA Kimberly Donner M.P.A.S. PA Donner has been a Physician Associate for about 12 years now and currently works in the Department of Pediatric in the Pediatric Otolaryngology unit at UT Southwestern. She earned her undergraduate degree from Baylor University and her Master of Physician Assistant Studies from the University of Texas Medical Branch in 2010. Since then, she’s worked in pediatric otolaryngology and Emergency Medicine.
Choosing Career and Challenges Faces Along the Way
Within healthcare, there are various sectors and careers one can find themselves choosing. Although they all have their respective upsides and downsides, I was interested in PA Donner’s choice in becoming a PA over other healthcare professions.
“My journey started as pre-med. I was pre-MD. I took the MCAT and did all the prerequisites. A lot of my friend’s parents were physicians, so I grew up around doctors. But there was something in me that wanted more balance, so I found some PAs in my senior year of college to shadow. I spend a lot of time in the operating room with them. This was a very last-minute decision in which I ended up pushing my graduation back to fulfill the requirements. I haven’t looked back since.”
Throughout her years in PA school and the following years after graduation, PA Donner explains that she struggled with some challenges in adjusting to the lifestyle and learned some hard lessons along the way. A difference between medical school and PA school is perhaps the brevity of the program. As such, a lot of challenges arose from constantly learning through experiences and trial by fire.
An attractive feature of being a PA is the flexibility and versatility of the role. Something which PA Donner readily took advantage of when switching from EM to Pediatric Otolaryngology. She explained that she had always wanted to work with kids because children are ‘inspiring’ and ‘resilient’. Eventually, she left the ER and joined ENT to work in the pediatrics department. The switch was a lot more procedure heavy and gave her the opportunity to perform procedures such as draining abscesses, changing tracheas, nasal cautery, and others.
Role of a PA
Within Healthcare, there is a multitude of professionals that work together as a team to provide the most efficient care possible to patients. Often there are so many puzzle pieces that are working together that it’s hard to find one’s place within the mess. PAs, especially fit within the team in their own way. I asked PA Donner to explain her experiences within the healthcare team. “As a PA you are kind of a glue in a way. You work closely with the nurses and really closely with the physicians. Your relationship with your supervising physicians can be challenging.” She goes on to explain how her experiences shaped her within her role and were a learning experience during her career.
A career as a PA is often misunderstood by the public. As it is a relatively new job within the health field sector and does not really have an equivalency in other countries, many people don’t have the best understanding of how PAs approach patient care or what capacity they work under. PA Donner explains the evolution of PAs throughout the years and the current purpose and expectation they serve to meet.
“The role of a PA started as a military position as a medic during the Vietnam War in the 70s. The role has definitely changed in the last 12 years I’ve been a PA, a lot of people have gotten into very specific subspecialties. It’s a little less family-medicine model than it was, but there is definitely still a huge need for PAs in family medicine and primary care. There are also a lot more PAs now than there were before.”
Recently the AAPA, the American Academy of Physician Associates, underwent a title transition that changed the name from Physician Assistant to Physician Associate. This move was to cement the idea that PAs work within their own capacity and disregard the notion that PAs are somehow lesser than other healthcare professionals, namely physicians, in the field. I asked PA Donner to elaborate on how she felt this decision by the AAPA evolved her career.
“There is a discrepancy or misconception that PA or mid-levels are not as good as physicians or better than nurses. When really there is no comparison, it’s more of a team effort. Our goal is to offer comfort and access to care. We have tools that are different than physicians. There is a component of misconception when people say ‘Oh you’re the physician’s assistant, you’re the helper, you’re the aide.’ I have autonomy. I do see why the AAPA saw the name change was better, but it doesn’t change my job. I know what I do. I know my role. I have the security in that. However, I do understand why the branding long-term makes a lot of sense.”
Work-life Balance
A motivating factor in becoming a PA is perhaps the appealing work-life balance that PAs have compared to physicians. Not to diminish the difficulty of the career, as all healthcare professionals have their own hardships, but a prying question that many prospective PA students have is how one successfully prioritizes both work and other activities.
“The key to work-life balance is taking time off, stepping away, and re-evaluating your priorities because they change. Life has ebbs and flows. Just being aware of that and recognizing burnout is really important. Work will always be there, you can always come back to it. That’s the thing about being a PA. I don’t feel like I’m letting people down if I take time away. Taking a sabbatical is okay. The practice is not going to fail without you. If you can’t take care of yourself, you can’t be a great provider. It really is an all-or-nothing job. You can’t fake it if you aren’t feeling well.”
Advice and Food for Thought
The journey to becoming a PA is not an easy path. Students are constantly finding opportunities to expand their horizons and become a better fit for PA school. From working in healthcare facilities to striving for leadership positions in clubs, all while maintaining good grades is a very tedious load to manage. Having been in the same position, PA Donner offered a few words of advice.
“Volunteering, shadowing, spending time doing anything that is a people thing. Medicine is a people thing. Determining what your strengths are. Are you empathetic? Are you a caregiver? Are you afraid of blood? You don’t know unless you try, so that’s why it’s really important to have experience. PA schools want to see that you got your hands dirty and know what you are getting into. The biggest thing is exposure. Being a unique person is really helpful.”
While it may seem that everyone is doing the same thing. Everyone processes their experiences in different ways. PA schools want to see individuals that are reflecting upon those experiences and conveying that they truly understand the career choice they are getting into. This is also applicable to students striving to be accepted into other healthcare fields. Illustrating that one has the passion and dedication for the career through valuable experiences is imperative to moving forward in your respective journey.
Physiological Differences on the Basis of Sex
By: Zoe Du
At one point or another, many of us have probably been told a variation of “it’s just female problems” or “you’re being overly emotional because of hormones.” When we seek help during some of our most physically vulnerable moments, our health concerns are often brushed off; the challenge is not to receive a diagnosis but to have our symptoms validated and believed.
The disparate treatment of female and male patients has increasingly been recognized, but there is still an uphill climb to dismantle millennia of bias. One of the consequences of a male-dominated and subsequently male-biased medical field is that women’s health is misrepresented, undertreated, and not well understood. For instance, a study found that women are seven times more likely to be misdiagnosed and discharged during heart attacks, and the reason is clear. Beyond the persistence of biases in individual patient-provider interactions, the physiology standard medical practices are based on carries the assumption that the male body is the norm and the female body is abnormal. Women have historically been excluded from research for such asinine reasons as “female hormones fluctuate too much,” but the fact that females have different hormones is in and of itself a reason to include women in research. It points to the reality that there are real physiological differences between male and female bodies that have significant implications for the presentation and development of disease and drug interactions.
Improvements in sex and gender-based disparities in health outcomes require equity rather than equality. Sex-based differences are real, but it is a gross misrepresentation to reduce these differences to hormonal, and emotional responses. As we move forward, more research needs to include women to better understand previously unstudied sex-based differences. The clinical implications of research need to be better incorporated into medical training. As future female health professionals, we have the power to help make these necessary changes a reality.
If you are interested in learning more, below are some examples of sex-based differences.
Women have lower bone mass and are significantly more prone to developing osteoporosis.
Compared to men, women have smaller lungs, narrower airways, and lower lung diffusion capacity than men.
Women demonstrate a greater glucocorticoid response to stressors compared to men.
Women have less left ventricular mass and smaller chamber size than men and subsequently have a smaller stroke volume.
The mechanisms and biological reasons are not well understood, but pain modulation is different in women, resulting in a significantly higher prevalence of conditions like fibromyalgia and migraine in women compared to men. Women comprise 70% of the population that experiences chronic pain.
Spotlight: Margaret Sanger
The Good, The Bad, The Ugly
By: Zoe Du and Janavi Mehta
In a post Roe V. Wade America, access to contraception is likely to be the next target in policy affecting women’s health. In light of the current direction of political discourse, let’s take a look at the origins of the birth control movement with Margaret Sanger.
Born in 1879, Margaret Sanger was the sixth of eleven children, born to a working-class family in New York. Sanger grew up impoverished and would lose her mother to tuberculosis when she was 19. These two experiences shaped Sanger’s values and ultimately the course of her life; as Sanger saw it, the toll of eleven children and seven miscarriages both physically weakened her mother and reinforced a cycle of poverty.
Sanger’s belief that access to contraceptives would transform women’s lives was reinforced by her work as a nurse, coming across the victims of several botched back-alley abortions. Margaret Sanger lived in an era governed by the Comstock Act, which prohibited contraceptives. She made it her life’s mission to repeal the law and make contraceptives accessible to women.
In 1914, Sanger began to advocate for birth control through her own publication, The Woman Rebel and was indicted a year later for sending diaphragms through the mail. In 1916, Sanger opened the nation’s first birth control clinic, for which she was arrested. Over the course of her trials, the courts would rule that doctors could prescribe birth control for medical reasons, enabling Sanger to open a clinic in 1923 that would grow to become Planned Parenthood.
Through several decades of advocacy and pushing the boundaries, Margaret Sanger brought her vision to fruition. In 1937, prescribing birth control was legalized and in 1971, the Comstock laws were overturned. In the 1950s, Sanger recruited Gregory Pincus to work on the development of a “magic pill,” culminating in the first oral contraceptive which was approved by the FDA in 1960. When Sanger passed away in 1966 her work at the helm of the birth control movement had already transformed the lives of countless women across the country.
It is without a doubt that Sanger shaped women’s health as we know it today, but it is also important to acknowledge her shortcomings. Through her birth control advocacy, she became associated with the eugenics movement. In recent history, Sanger’s words have been invoked by politicians to illustrate her as a bigot who wished for the extermination of minorities. While these words have been taken out of context (she was expressing her fears of how her advocacy for birth control could be interpreted in minority communities), there is truth to the fact that Sanger believed birth control could be used to “limit and discourage the over-fertility of the mentally and physically defective.” These words serve as a stark reminder that it can be dangerous to place “heroes” on pedestals. Sanger accomplished incredible things that millions of women have benefited from, but she was also a flawed individual with dubious and problematic views. So, let’s both celebrate the good Sanger accomplished and acknowledge the bad and the ugly.
Not What Anyone Wanted:
The Political Parties Split the Government
By: Janavi Mehta
The midterm elections have not been treated with much importance for many people in American history. However, this particular midterm election held more at stake than most midterm elections of the past. In midterm elections, the trend often seen is that the president’s party loses seats in the House and the Senate, often losing enough to cede control of that particular body to the other party. For both major political parties in the United States, the need to secure the House and Senate made for several highly contested and narrow races. Even now, the results of some of these states' races remain unknown until a rerun is made or the counting of votes is finished and checked. However, enough races have been concluded to determine that the House will go to the Republicans and the Senate will stay in the Democrats’ hands. Here’s why this round of midterms was different from the rest and what this means for the next two years.
Over the years, the divide between the Republicans and Democrats has deepened and has made discussion politics more about arguing than civil conversations in close to every area of society. From friend groups to classrooms, to the media, and the politicians themselves unable to find common ground anywhere. This divide has made many people more emotionally invested in politics and thus, more likely to show up to vote. Furthermore, the issues of this election were some of the biggest worries that voters have had to deal with in some time. Abortion rights, inflation, gun rights, and crime were at the top of the list for voters this cycle. For Democrats, the priority went to abortion first and then inflation while the opposite was true for Republicans (US Midterm Elections Results).
As Alexis McGill Johnson, the CEO of Planned Parenthood said, “‘Our bodies have always been contested. We understand what it means that when you lose the ability to control your own body, all of the other rights can be taken away (Haines).’” Another factor in this election was the massive number of the youngest voting demographic taking to the polls. Researchers say that the voter turnout from 18 to 30 years old comprised nearly 30% of all voters (Melillo). As the graph from BCC demonstrates, the 2022 midterms and the 2018 midterms have had significantly higher turnout numbers. This could be due to the polarization of the nation or the nature of the issues relevant to the time, perhaps both.
Since the legislative branch is split in control, this likely means that most bills will not pass through both houses unless there is some measure of bipartisan support for the bill. Additionally, the battleground for abortion rights will be continued to be fought out at the state level and other rights, such as LGBTQ+ and trans rights, may be either protected or axed under changing governorships. Overall, the concerns that cannot be resolved in the next two years will build the foundation of the campaigns run in 2024, the next presidential election.
The results of the midterm elections reflect the very nature of the country itself: split and deadlocked. Yet, there is hope for the future as the youngest generation continues to show up to the polls and all Americans are setting new records with the turnout for each coming election. Though the party in power may not always be of our personal choice, we can invest more power in the people and reinforce the democratic fabric of this nation.
Sources
https://time.com/4081760/margaret-sanger-history-eugenics/
https://www.womenshistory.org/education-resources/biographies/margaret-sanger
https://www.pbs.org/wgbh/americanexperience/features/pill-margaret-sanger-1879-1966/
https://time.com/6074224/gender-medicine-history/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3690315/
Haines, Errin. “How Women Defied and Made History in This Year's Midterms.” The 19th, 10 Nov. 2022, https://19thnews.org/2022/11/women-made-history-representation-rights-midterm-elections/.
Melillo, Gianna. “Researchers Say 2022 Election Had Second Highest Young Voter Turnout in Last 30 Years.” The Hill, The Hill, 11 Nov. 2022, https://thehill.com/changing-america/respect/diversity-inclusion/3730922-researchers-say-2022-election-had-second-highest-young-voter-turnout-in-last-30-years/.
“US Midterm Elections Results: How the Parties Did in Maps and Charts.” BBC News, BBC, 17 Nov. 2022, https://www.bbc.com/news/world-us-canada-63556122.
Comments