Changing the Palace Guard: Analysing the Impact of Women's Entry into Medicine

Abstract

Women's rapid entry into medicine raises important questions about change in this historically male-dominated profession. In addition to shifting the gender balance, do increasing numbers of women signal a more fundamental change in the way in which medicine is organized and practised? A growing body of research suggests such change. Yet there is continuing controversy about the meaning of observed gender differences in practice, whether they reflect an essentially pragmatic response to women's dual workload of family and career, or whether they are the result of underlying differences in attitudes, values and orientations. This article uses data from a survey of a recent cohort of family physicians in Ontario, Canada, to document the extent of gender differences and similarities in medical practice, and their interrelationships to family situation, political attitudes and patient care attitudes. The results show that seemingly related differences in practice are accounted for in different ways: while some are associated with differences in family situation, others are tied to attitudes, while others are a function of gender alone. The results also reveal gender similarities which do not suggest that women are becoming more like men, but that men, and the profession as a whole are changing. We would emphasize the importance of interpreting gender differences and similarities within a broader conceptual understanding of change in the profession.

Women in medicine�?�is there a problem? A literature review of the changing gender composition, structures and occupational cultures in medicine

“…Although US and Canadian women were more likely to work in group practice, few gender differences were found in group or solo practice organisation 5,6 , 18 . A consistent finding in practice differences is that female doctors have a higher proportion of female patients due to patient preferences 10,18 , 98,99 …”

“…However, studies 79,87 , 88 that attempt to look for more objective markers of talk tend to find few gender differences in variables such as mean words per consultation, frequency of question tags and mitigated directives, number of interruptions, emotionally focused talk and negative comments (United Kingdom, United States). Other studies 10 have found no gender differences in length of visits and physical examinations (Canada) and interpersonal relationships are perceived as relatively unproblematic for both genders 4 . Many gender similarities in practice style have also been emphasised 89 …”

“…Women tend to make the majority of the health care decisions for their families, prefer a female doctor and use health services more frequently 10,18 , 98–100 (United States, Canada, the Netherlands). In addition female patients prefer a female doctor for intimate examinations 101,102 and US trainees reported being more comfortable in performing same‐sex intimate examinations 103 .…”

Gender and Feminization in Health Care Professions

“…Although women are more likely to be in group practice and younger women dentists in their prime child‐bearing years do tend to work slightly fewer hours than their male colleagues, older women and men work the same number of hours and in similar types of practice. Studies of women in medicine (Boulis and Jacobs 2008; Williams 1999) and pharmacy (Muzzin et al. 1994) have produced similar findings.…”

“…Women physicians and pharmacists do not work substantially fewer hours per week than their male counterparts. In medicine, observed differences in the number of patients seen, or time per patient visit (and other related factors), are small, inconsistent, and appear to be more a function of the types of practice in which women work (Boulis and Jacobs 2008; Williams 1999). American women physicians are more likely to work as employees and in managed care.…”