Pediatric News Turns 50
50 years of pediatric residency: What has changed?
From fewer work hours to more technology, more student debt, and fewer clinical responsibilities, pediatric residency has shifted dramatically in...
In the last 50 years, the field of pediatrics has vastly changed, particularly for female physicians.
For starters, the number of female pediatricians has rapidly grown over the last few decades. In 1970, 21% of pediatricians were women, compared with 59% in 2013, according to the American Medical Association physician characteristics and distribution data 2015 edition. The overall pediatric workforce also has increased: A total of 18,332 pediatricians were practicing in 1970, and 84,559 pediatricians were in practice in 2013.
Along with numbers, the field of pediatrics has seen significant changes in practice size, technology, clinical responsibilities, and record keeping, to name a few. However, longtime pediatricians say there are also many ways that the specialty has stayed the same.
Dr. Bennett’s story
When Jean L. Bennett, MD, opened her solo pediatric practice in 1963, she initially had no nurses or team of assistants to help carry out clinical duties. With one receptionist answering phones and Dr. Bennett in the exam room, the Clearwater, Fla., practice opened for business. There was no shortage of patients, Dr. Bennett recalls.
“There was no such thing as neonatology. As a pediatrician, one took care of well and sick newborns and of course, saw a variety of infectious diseases in the office,” Dr. Bennett said in an interview. “We started our own IVs, we did our own lumbar punctures, we did subdural taps, we did exchange transfusions. We did all of those ourselves.”
Dr. Jean L. Bennett
Dr. Bennett was no stranger to being the lone woman on the job. She was the first woman to graduate from the University of Florida College of Medicine in Gainesville, the first woman to serve as chief of staff at Morton F. Plant Hospital in Clearwater, and the first woman to chair the hospital’s department of pediatrics. Despite being the first in many cases, Dr. Bennett does not remember facing discrimination from colleagues or community members, nor experiencing prejudice against her gender as a medical student or young resident
“My experience was different, of course, than other people graduating at that time, but I can truly say that I always felt the playing field was level,” Dr. Bennett said. “Nobody gave me anything for being a woman, and nobody took anything away.”
Compared with concerns that physicians have today, such as electronic medical records and increasing regulations, Dr. Bennett remembers a relatively worry-free career. She recalls some concern over the medical malpractice crisis in the 1970s and 1980s, but said the majority of her tenure was spent with a clear mind and positive attitude.
“In the 60s, I was naive enough not to worry a whole lot,” she said. “I was in the process of getting my practice started, and I was raising in a family at the same time. I would struggle to tell you the things I spent time worrying about. I went to work every day with a joyful attitude, grateful that I was in a community where I could serve.”
Two of the most significant changes Dr. Bennett witnessed during her career were the development of pediatric subspecialists and the establishment of children’s hospitals. Both markedly altered the field of pediatrics and the way in which children were cared for, she said.
“Early in medicine, children were thought of as the stepchildren of medicine, if you will,” she said. “All the attention research-wise and provision-wise was for adults. During my tenure, I saw that attitude change. The attitude that children were just little adults certainly changed, and the development of specialty hospitals for children, that was a real plus.”
Dr. Bennett spent 27 years in solo practice before hiring additional doctors at what is now Myrtle Avenue Pediatrics, a group practice in Clearwater. She retired in 2003 after a career spanning 40 years. The best advice she would offer young pediatricians is to treat their staff well, especially the front office staff who answer phones and make appointments. Pay them well, train them, and treat them right in order to retain loyal employees and reduce turnover.
In addition, Dr. Bennett stresses that young women who want to be pediatricians should not focus on their gender. “I would remind them that they are physicians who happen to be women,” and they should not think of themselves as female physicians, she said. “Personally I believe becoming a physician is a calling, and I don’t think it is gender oriented. I think males and females can have that calling. I see no difference.”
Dr. Eaton’s story
In the 1960s, when most young pediatricians were opening practices or joining small groups, Antoinette P. Eaton, MD, chose an different path. A passion for serving undeserved families led her to back to what is now Nationwide Children’s Hospital in Columbus, Ohio, where she had completed her residency. In the early 60s, Dr. Eaton served as assistant medical director at the hospital, and in 1965 she become director of the hospital’s birth defect center.
Back then, insurers operated much differently, Dr. Eaton recalled. Insurance companies would not pay for outpatient care, and so children with developmental or congenital disorders would have to be admitted to the hospital for treatment. “It was a complete reversal of what it is like now,” she said.
Dr. Antoinette P. Eaton
“We all saw each patient, and then we would get together and conference on the patient and decide on the best approach,” Dr. Eaton said in an interview. “I would definitely say it was unique. It certainly ingrained in me how valuable the team approach to medicine was then and is now. It’s become a very popular approach, and I’m happy to see that, but that was my approach way back in the mid-60s and mid-70s.”
Like female pediatricians of today, Dr. Eaton worked to juggle her career and her role as a mother to four children. She found balance by working part time when necessary and getting off early when her children were school-aged. “Being a mother and being a physician, especially in leadership, there’s always going to be pressure for allocating your time appropriately between all of those demands, but I can tell you I always made being a mother my top priority, and I don’t think I sacrificed my professional duties as a result,” she said. “I think it was possible to combine them, although it’s certainly challenging at times.”
Dr. Eaton went on to become director for maternal health at the Ohio Department of Health and later served as president for the AAP Ohio Chapter and as AAP president from 1990 to 1991.
Her most important achievement however, was being a strong voice for children, she said. “My biggest accomplishment, I hope, was standing up for children and speaking out for children and assuming leadership roles in organizations like AAP to underscore that important role as an advocate.”
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