Cardiology Magazine

Editors' Corner | Steps in the Treatment of Pulmonary Embolism (Watch Out! The Staircase is Tricky!)

Cover Story | Pulmonary Embolism: A Clinical Approach

Feature | Ten Americas: Growing Disparities Creating Demographic Chasms

Feature | Bridging the Gender Gap in Heart Health: Women's Specialized Clinics

Feature | Championing Change: Herman Taylor on Improving Heart Health For All

New in Clinical Guidance | Newest AUC Provide Clinical Guidance on Cardiac Implantable Electronic Devices

New in Clinical Guidance | ACC Issues Guidance on Arrhythmia Monitoring After Stroke

From the Member Sections | Tackling the Polypharmacy Pandemic in CV Care

Focus on Heart Failure | Thinking Outside the Ice Box: Preservation Techniques, New Technologies in Transplantation

For the FITs | The Emergence of Substance Use Disorders and Their Implications in Cardiovascular Disease

Courageous Conversations | The Invisible Armor: A Personal Reflection on The Power of Resilience as a Black Woman in Cardiology

Quality Improvement For Institutions | NCDR Research: Data Driving Better Practice, Patient Outcomes

Prioritizing Health | Journey of the Health and Well-Being Coaching Profession

Heart of Health Policy | ACC Advocacy Welcomes New Members of Congress

Heart of Health Policy | Action Steps Following CCTA Coding Change From 2025 OPPS Final Rule; Coding Corner: How to Use New ASCVD Risk Assessment and Management Codes

JACC in a Flash | Aircraft Noise Poses Threats to Heart Health; More

The Pulse of ACC | Welcome to Camp Cardiac; ACC.25 Pre-Conference Opportunity: Renal Denervation

Number Check | Powering Quality Improvement

ACC Mission in Action | Making a Global Difference

Courageous Conversations | The Invisible Armor: A Personal Reflection on The Power of Resilience as a Black Woman in Cardiology

Courageous Conversations

"Let me call you back, the nurse is here," he said. "Hello, I am Dr. Tobb, the cardiologist," I said. As he stared me down, the patient finally asked me, "Did you say you are a cardiologist? The heart doctor?" Smiling, I said, "Yes sir, I am."  He replied, "You definitely are not who I was expecting." As a Black woman in cardiology, I am aware of the rarity of my position, and this encounter only served to underscore it.

He allowed me to care for him.

As I write this perspective, my hope is that other women in cardiology, especially Black women, will find encouragement to remain enthusiastic, optimistic, cheerful, kind, and most of all, authentic. 

First, let me acknowledge that only 13% of cardiologists in the U.S. are women, a number that is slowly increasing. Women in cardiology face many challenges, but today, I would like to share my own reflection on prescriptive bias.

While men and women experience microaggressions and prescriptive biases, for now, this reflection is based on my personal experience as a Black woman in cardiology. Black women physicians need an invisible armor of resilience to tackle the additional layers of microaggressions that stem from societal expectations and presumed cultural norms.  Sometimes this is subtle, but at others can be very blatant.

Throughout my career, I have experienced my share of biases, including when an attending physician refused to write a fellowship letter of recommendation because "cardiology is too busy for a female with kids." These biases may have dampened my career prospects – this is why self-advocacy is important.

Although I am not naïve, sometimes it still takes me aback. As I write, I still see myself sitting across a table in a conference room asking a physician leader, "So please help me understand why you stated in my review that I was arrogant?" I can still feel the uncomfortable silence; mere seconds felt like hours. Finally, he said, "Someone came to me about an incident recently that suggested arrogance, so I decided to grade you hard on your 360-review." When I asked if this was something he heard from multiple people, he replied it was actually the first time.

Everyone, including myself, deserves to share their side of the story. Clearly, I did not get that opportunity. If this was a first-time occurrence, could he have wondered if this was a sign of burnout? Or even just take a moment to speak with me? Yet, prescriptive bias possibly led him to believe it must have been true. I went to the meeting to get answers for professional growth but left the conference thinking, am I working for the right leader?

 Feeling the deep void, I realized that this situation was highly motivated by bias. I had experienced what other women, especially Black women, have written and spoken about. Why me? Is being a Black female cardiologist who speaks loud and clear about uncomfortable topics, such as health equity or women's heart health, the new definition of arrogance? 

How could I advocate for myself and seek equitable opportunities? I decided to keep my head up and stay true to myself. My career legacy will be one of actual value and authenticity.

This experience shows that one can still thrive with resilience and proper support. There are always lessons to be learned with every interaction. 

Navigating the emptiness of this story was built on outstanding mentorship. Mentorship is crucial for all stages of one's career. However, as an early career cardiologist, having a mentor has helped me overcome difficult challenges. Having another person invested in your professional growth helps build confidence.

As I attempt to learn from my earlier experience with prescriptive bias, I delved into a few books that my mentor shared with me: "Lean In" by Sheryl Sandberg and "The Four Agreements" by Don Miguel Ruiz. These books have helped me shift my mindset and navigate challenges without cultivating a victim mentality. My mentor shared a quote with me during an early breakfast meeting which truly motivates me to move forward positively: "Sometimes the bias is not about you, but rather the individual's inner issues that need to be addressed."

My final thoughts: Every woman in cardiology has a unique and powerful story that is not about perfection but progress. Remember, you are not alone.

This article was authored by Kardie Tobb, DO, FACC, at Cone Health Medical Group HeartCare, Greensboro, NC.

Resources

Clinical Topics: Prevention, Stress

Keywords: Cardiology Magazine, ACC Publications, Physicians, Women, Resilience, Psychological, Burnout, Psychological