In Her Shoes: Understanding the Female Patient Experience
Elizabeth Bolgiano, Executive VP, Chief Human Resources Officer at AMAG Pharmaceuticals, discusses the company’s efforts to imagine “walking a mile" in its female patients’ shoes as they seek care for sexual health-related conditions.
PV: What is the “In Her Shoes" program and why did AMAG initiate it?
Bolgiano: AMAG has a strong and growing presence in women’s health. We have marketed a product to reduce the risk of preterm birth in certain pregnant women, since 2015, and more recently we brought two therapies into our portfolio that have the potential to address female-related sexual health concerns, including low sexual desire in premenopausal women that they find bothersome or frustrating and painful sex women may experience due to an underlying condition of menopause. We’ve now also invested in a developmental stage therapy to help address severe preeclampsia.
Understandably, women experiencing any of these conditions — but certainly those related to sexual health — can feel unsure or intimidated to raise concerns about such personal health topics with their providers. Others who do gain the courage to speak up may end up feeling they weren’t fully heard or helped by their providers or support networks.
AMAG recognizes that to truly help the female patients we serve, we must better understand their health circumstances as well as their experiences with the healthcare system. To be empathetic toward them, we need to recognize not only the surface-level biases that these women are likely to experience, but also the implicit bias that can play a role in preventing them from voicing their needs.
In Her Shoes was an opportunity for AMAG to build awareness around what our patients experience and simultaneously kick off our plan to offer ongoing unconscious bias training to our employees. The initial session only scratched the surface of this challenge. We plan to dig deeper in the coming year and take an even more nuanced approach. The In Her Shoes program isn’t an endpoint; it’s very much a starting point.
PV: How does unconscious bias impact an organization?
Bolgiano: Unconscious bias is something that all of us carry around. We all have a variety of unconscious biases. We want to address these issues and create a safe and supportive environment where people can begin to have those conversations. The In Her Shoes workshop was part of an effort to foster a deeper understanding of our patients.
Through exercises and training around unconscious biases, we have begun to cultivate empathy in the organization. We can each become more conscious communicators and 
better advocates in the world. We believe this approach creates a ripple effect that extends beyond our interactions with our patients, partners, and hopefully with providers.
PV: What are some of the results from the program?
Bolgiano: We found that a lot of people were surprised that they had unconscious biases. The program helped them to understand that our work at AMAG goes beyond the therapies that we provide and elevates education as a way to enhance the care of patients. In general, this program made it easier for people to talk about women’s sexual health and the struggles that women have.
We also wrote a white paper for our employees that lays out many of the assumptions that people make about women and their healthcare needs. The white paper explored ways that each one of us can continue to break down barriers and engage in this conversation.
PV: How will the In Her Shoes Program evolve?
Bolgiano: The In Her Shoes forum resonated in the workforce, and we want to continue with the program on an ongoing basis. We will make training around unconscious bias part of our regular Management Essentials manager training and our commitment to employee development. We plan to provide people the tools they need to be able to carry on these conversations effectively.(PV)
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AMAG’s Efforts to Understand the Female Patient Experience
Sexual health is a key indicator of overall health, but too often women are afraid to speak up about important sexual health concerns, such as pain or discomfort, with their doctors. Fearing that they will be dismissed, judged, or stigmatized many women avoid the conversation altogether. Unfortunately, the problem is that many doctors do as well. This is a gap that AMAG is working to fill by educating patients and providers about the legitimacy of these conditions, how to recognize them, and what to do about them.
Within the company, AMAG’s half-day workshop, In Her Shoes: Understanding the Female Patient Experience with Health and the Healthcare System had two objectives: explore the unique needs and experiences of women with under-recognized sexual health conditions such as dyspareunia and better understand employees’ own assumptions about the patient experience.
