Meet Dr Lucy Modra
Dr Lucy Modra is an Intensivist at Austin Health, lecturer in medical ethics and co-founder of Women in Intensive Care (WIN ANZICS). She is also leading research relating to sex imbalances in ICU patient outcomes and promoting gender equity in intensive care medicine.
Dr Lucy Modra
Tell us about your research?
I'm examining sex differences in the illness severity, treatment and outcomes of adult intensive care patients. My research asks, what types of illness bring women and men into the ICU? Are there differences in the treatments they receive in ICU? And how does this relate to their survival from critical illness?
What drew you to this field?
In 2015 I co-founded the Women in Intensive Care Network, a network promoting gender equity in intensive care medicine in Australia and New Zealand. Fewer than one in four are intensive care specialists are women, the lowest of all the critical care specialties. We did some research looking at gender representation in different medical specialties, and I began to learn more about implicit bias.
Then I became intrigued that there are fewer women than men admitted to ICU as patients. I'd find myself looking around the ICU, thinking, "Where are all the women?" So I started a PhD to try to better understand this sex balance.
Tell us about your proudest moment in research?
I'm most proud of our recent study that described a sex-based minority effect. We found that patients who are admitted to ICU with an illness uncommon in their sex are sicker and more likely to die than the opposite sex. So men who were admitted with a disease that is more common in women were more likely to die than women with the same disease, and vice versa. The minority effect even extended to hospitals: patients admitted to ICUs with relatively few patients of their own sex were more likely to die.
I think this research is important as it demonstrates that patient sex matters in critical illness; that being in a minority group is associated with poorer outcomes. The effect cuts both ways: favoring women with female-dominated illnesses and favoring men with male-dominated illnesses
Imagine you’ve just received a $10m unrestricted grant. What will you use it for?
I'd give additional support to the ANZICS Centre for Outcomes and Resource Evaluation (CORE). CORE maintains the Adult Patient Database and four other clinical quality registries. They're among the best critical care registries in the world, allowing our ICU specialists to continuously monitor and improve patient outcomes. As part of the COVID-19 pandemic response, CORE rapidly developed real-time heatmaps of activity across different units, which allowed 'load-balancing' between units to maintain patient care. The Adult Patient Database is also a phenomenal resource for researchers, enabling studies of critical illness in Indigenous patients, frailty, ICU strain (a measure of workload within an ICU), my own research and much more.
Next, I'd provide funding for hospitals to improve the way they record sex and gender data - particularly to ensure patients can identify their gender on hospital admission including non-binary genders. And I'd support organisations like WIN-ANZICS, CODA-CHANGE and NoWEM, who are working to improve gender balance across the critical care specialties.
What do you think are top 5 interventions that organisations can implement to support women in the healthcare workforce? How can we address our underlying sex biases?
- Mandatory implicit bias training for all!! Most importantly, for healthcare leaders.
- Ensure gender balance across important forums like boards, conferences and committees
- Everyone should wear a name tag with their name, their clinical role and pronouns.
- Introduce robust parental leave and part-time work policies for clinicians of all genders.
- Keep count: audit and publish gender representation data
What’s something about you that most people don’t know?
In high school I wanted to become an outdoor education instructor. Perhaps it's not too late?!
Dr Lucy Modra will be one of the speakers at the upcoming Women in Critical Care webinar on the 22nd of November. Register to learn more about the career journey of Dr Modra and three other female leaders in Critical Care Medicine and their perspectives on gender equity in our workplaces.