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In fall 1997, a shortage of intravenous immunoglobulin (IVIG) developed in the United States because of increased demand for the product, reduced supply, and product recalls. This shortage is a useful model for understanding how our health care system responds to scarcity. Although the U.S. government took steps to inform the medical community of the shortage, with few exceptions, the government did not respond to the shortage in a timely or effective manner. Instead, it took a relatively passive role, leaving IVIG manufacturers and distributors, health care institutions, and clinicians to fend for themselves. The shortage likely had an uneven impact on patients, based on the relative market strength of the health care institutions in which they received care and the individual patient's ability to absorb the increasing out-of-pocket costs of scarce IVIG. Market mechanisms have now largely alleviated the shortage and significantly reduced its detrimental impact on patients. However, future shortages of IVIG or other scarce medical products, such as vaccines and antibiotics, would benefit from more immediate and coordinated efforts not only to make sure that scarce health care resources are distributed in a just manner but also to identify and remedy the sources of health product supply problems.

Gender differences in treatment seem to appear most strongly for genital-specific conditions. The results may suggest that physicians use fewer resources to treat the genital-specific conditions of patients who share their sex.

In this article, the author endeavors to clarify the shifting nature of gender and motherhood for women physicians. She examines trends in the gender gap in marriage, divorce, childbearing, work hours, and earnings. The author draws on data from the 1990 and 2000 U.S. decennial censuses and data spanning 1991 to 1997 from the Survey of the Practice Patterns of Young Physicians. Compared with women in the general population, the trends for women physicians have been favorable. Women physicians are more likely to marry and less likely to divorce than are other women. Among employed physicians, gender differences in earnings and work hours are also narrowing slightly. Nevertheless, a gap is growing between female physicians with children and childless women doctors, and a small but growing percentage of young physician mothers are electing to forgo labor force participation entirely. Thus, young physician mothers still suffer significant professional sacrifice.