A gynaecardiologist means a cardiologist for women. I want better cardiovascular healthcare for females, but I also want a better position for female cardiologists. In the U.S. and many other countries the position of a female cardiologist is still very inferior compared to the male. I know that female cardiologists are more interested in the subject of female patients and healthcare for women, but they don’t get the positions in which they may be able to make the change. It’s a very macho culture still. In the Netherlands, it is difficult for my female colleagues to get a good position in a hospital, when they are not in the core group and earn less; they have to do the work and the men will be on the stage and earning the money. This is another issue of course, but I am the pain in the arse of the Dutch society of cardiology!
In the Netherlands around 75% of medical students are women, but what we hear from the female students here and in other countries is that the atmosphere that cardiology departments have, the macho behaviour that is still hanging around, means that they don’t want to work there for the rest of their lives. Women still have to be fighters to get in and to survive, and it is not very easy for women to persist in a career in cardiology. In the U.S. less than 10% of new cardiologists are women because the culture of cardiology isn’t very attractive still.
The European Society of Cardiology has set up the Women Transforming Leadership programme for ambitious young female cardiologists, which is a good thing—they have the opportunity to participate in a week’s leadership course in Oxford. I think we as older cardiologists, and I am 60 now, need to support the young generation. I need to help my younger female colleagues to get a good position. I think I owe that to the future.
What are your key areas of interest and research?
- Women with hypertensive pregnancy disorders
- Female-specific manifestations of acute coronary syndromes, such as coronary artery dissection
- Microvascular coronary disease in middle age
- Cardiotoxicity due to breast cancer treatment
What are the major challenges in your field?
An important one is to get microvascular coronary disease more into practice, because there are many cardiologists who say, “ I don’t believe in it”, but it is not about religion. They believe in gravity waves—I can’t see gravity waves and I believe they exist so why shouldn’t a microvascular system exist?
We have developed the tools in cardiology to treat epicardial stenosis, but most coronary perfusion is in the microvessels, which we can’t see with a coronary angiogram. We need to develop better tools to make functional disorders visible and we need to develop more medications to treat this. About 50% of females in their 50s with recurrent chest pain and without obstructive coronary disease have microvascular coronary disease. We believe in bacteria but cannot see bacteria unless we have a microscope. We need to have the right tools to make the microvessels visible. This has lagged behind in cardiology developments over the past 30 years.
What is your top management tip?
Don't forget your personal life, because although ambition is important there is always a personal life behind. What I know from my own past is that if you get more and more rigid because people don’t accept what you are doing, you may be too hard. Therefore you need to also culture your soft skills, to be human when you are also a pioneer. As a manager, you need to keep an eye on your PhD students. They can have difficult times when things don’t work like they want so you have to keep an open eye otherwise people will disappear and become frustrated.
What would you single out as a career highlight?
In April 2017 I was honoured by the king of the Netherlands as an Officer in the Order of Orange Nassau (pictured left). This felt very much like the acknowledgement for what I have done in my career.
If you had not chosen this career path you would have become a…?
Perhaps a musician, artist or painter.
What are your personal interests outside of work?
I enjoy music and going to concerts. I have many paintings, and I enjoy the artists’ talent.
Your favourite quote?
Never give up.