Tuesday, June 26, 2007

Women in Medicine

Dear reader: you probably think this is going to be some sexist rant - well, worry not - and what's wrong with being sexy?

Back in the Holocene Epoch, when I was a med student, women made up about 10% of the class. Today, the total medical student population is about 55% women and 45% men and still about 90% nerd. "So what?", you say. Well, in 20-30 years, women will be the majority of practicing physicians and I wonder how this will change the field. (yes, I know the Holocene continues to the present day - that was a subtle joke for the geology geeks out there - wow, I'm a dork).

Let's start with Larry Summers, former Secretary of the Treasury and President of Harvard, who dared suggest that it may be an interesting thesis to explore that men and women have some innate differences. How dare he?! In the words of Joseph Conrad, memorably mumbled by Marlon Brando: "the horror, the horror". Now I'm no Freudian - anatomy does not necessarily equal destiny - but I quickly learned during my first GYN examination (ahh, memories...) that there are some differences no one can deny.

Actually, I figured it out way before this speculum enhanced moment, when I had sex with my sister (I'm kidding - it was my first cousin). The point? Men and women ARE different, and if you deny this you are an idiot (see, a woman would never say that).

Has the practice of OB-GYN and pediatrics, now with a majority of female MDs, changed? Peds... I'm not sure. My sense is that women generally like to go to women about women problems - so, in the case of OB-GYN, a double-X majority has probably improved the field (no, not a bra size, perverts - I'm talking chromosomes).

Can women do the 'macho' jobs: hip relocations, endless cardiothoracic nightmare surgeries, Gracie jiu-jitsu on the drunk in the ED? Undoubtedly, the answer is yes. Why they would want to go into clinical medicine at all is another question, best answered by a psychotherapist or, at a minimum, Oprah.

Is it even reasonable or helpful to try to make any generalizations about this? I don't know - but it is an approaching reality. My field (pathology) has alot of women. Some are great. Some suck ass and couldn't tell the difference between a fibromyxoid sarcoma and a myxoid fibrosarcoma (we are really good at naming things in a clear way). I realize generalizations can be hurtful, but they can be interesting: why are 41% of California public university students Asian; why are there very few women scientists in academia; why are all Catholic high school girls sluts?

Bottom line: women and men are different; woman-dominated medicine will probably be different from man-dominated medicine; no one can predict what this new landscape will be like; and who's going to fetch me my coffee?


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  2. wow. coherent and readable stuff from you ETOTHEIPI. i see you have danced right past the bottom line issue and have left it for schmucks like me to take the NEXT STEP. let me ask you sir, out of your medical school class...
    1. how many women?
    2. how many completed residency?
    3. how many completed residency without maternity leave (which kills the other residents who have to cover for maternity leave)
    4. how many are practicing full time?
    5. how many are practicing part time?
    6. how many are not practicing?
    7. were women given preferential admission over men at your institution?

    suck on that dude and try to take a stand. i know that as a dude who claims to be white you deserve to be assumed to be a bigot and a sexist. let's see if you are.

  3. Of course I'm leaving it to the reader to take the next step... I'm not on a suicide mission here.

    I think we all know the answers to your questions - actually, they are essentially rhetorical. I think, however, #7 is going to be reversed in the near future.

    High school girls are simply more responsible and study harder than high school boys, ergo, they get into better colleges, ergo, med school, etc... that's why we are here now. It's the fucking testosterone dude - we can't help thinking of having sex with both animate and inanimate objects at all times. I'd fuck a dead sheep when I was 18. Now it has to be alive. I've matured.

    There is no question that women, as a group, are less likely to complete a residency, practice full time etc... I'm just throwing it out there to see how people will respond to these obvious facts - and how the practice of medicine will change.

  4. oh yeah, thanks for the 'coherent and readable' comment. I guess that means I'm usually incoherent and unreadable. wiseass.

  5. Etotheipi:

    Well, I don't know the answers to your issues except for one....

    The reason many Catholic high school girls are sluts is obvious.... (and I'm a double whammy because I also went to a Catholic convent nursing school.)

    Which is: in the Catholic high schools and the convent nursing school I went to, there were no men. We became very bored. I mean, hanging out with stupid, innocent girls 24/7 was stifling.

    So those of us with a little guts would inevitably "sneak" away to go play pool at Joe's Bar. Only "bad boys" are at Joe's Bar.

    And "bad boys" are fun....

    And we naughty girls would then go back to school and drunkenly tell the cowardly girls about how fun the "bad boys" were--thus recruiting them into the Catholic School Slut Club. (Which is kind of like the Skull and Bones deal---one day we will rule the world, if we're not already....)

    Thus, we all developed a taste for "bad boys" and became sluts.

    (And pool sharks, too---I can clean the table after breaking, and can chug shots as good as any man....)

    Why do you think I'm a biker chick?

  6. Um, to be fair, any employed woman in any profession would likely have to have someone "pick up the slack" for them while they are on maternity leave.

    As an unknowing person, what does someone do [or what does someone have to do] when they have an "MD" but "don't complete their residency". That sounds like the pinnacle of wasted time.

  7. I'll fetch you your coffee, Etotheipi.

    No, 911Doc, I won't fetch you yours.

  8. Hmmmm, can I fetch you your coffee while I am wearing my catholic school girl's uniform ?

    Men and women are clearly different.
    Has that already begun to change the practice of medicine ?
    Not that I see. A brain and ability have nothing to do with gender.
    On the other hand, if I was a guy, I wouldn't want to go to a female to discuss my prostate problems...

  9. As far as prostate exams go, I think I may prefer a tiny, sparrow-boned girl sticking her finger up my ass as opposed to some former NFL lineman turned urologist.

    Thanks to all for the offers of coffee fetching - and I prefer a french maid outfit. I'll wear a full stormtrooper get-up with leather chaps. That's hot.

    The Catholic girl thing, well, it's true - I think I know where BRN went to school...

    Lastly, it is rare for men to not finish a residency and go on to practice. I can't really criticize women for making a choice to 'bag it' and do something else like raise a family. I'm actually all for it. BUt this WILL change how medicine is practiced. For example, should I consider this when hiring someone? Should a school consider this when making admission decisions? Medical training is funded largely by the government - do we want to pay taxes to support training that won't be used?

  10. On more than one instance in my residency training, the single males were assigned to cover for the people with families (to be fair males and females, but mostly females) because "their children are more important than your time." Which was a direct quote.

  11. After I had my last baby and was all drugged up, I remember telling my male doctor that I prefered him doing the exams to his partner (a woman). He asked me why, and I said something about how she didn't seem to really know what she was doing down there, and it felt so much better when he examined me. I am blushing right now remembering that I actually said that to him. But it was true. He seemed to know what would hurt and what wouldn't and she was all Dr. Pinchyfingers.

    I wanted to be a psychiatrist, but decided against any kind of medical career because I knew I wanted a million kids and also knew myself well enough to know that I could not be good at both. My mom went to medical school, but never quite finished because at that time, it just wasn't something very many women did. Interesting topic here.

    I went to a Catholic college...does that count for the slut thing, or only for Catholic high school girls?

  12. Opinions are like assholes, everyone has one; so here is this asshole's opinion.

    I'm not a doctor, I'm a nurse. I make the worst coffee in the world because I hate coffee and I don't drink it.

    The coffee issue settled, I do love my job most of the time. Medicine is a co-adventure. I compliment you; and you, by nature, should be able to trust me to give you the information that you need to care for your (and my) patient. That's certainly not admitting that there are some nurses (and I'm not going to say they are all NP or PA; some are just "Dr. Nurse" who know more than the average bear about everything.

    Now, the issue of equality in the medical field...Let me think about this ONLY from a nursing standpoint. When men began to flock towards nursing, our pay scale went up, our benefits increased and our vacation time increased. I'm sure most would say that is merely coincidental, but they would be wrong. When men entered a workforce that was historically a woman's career things began to change. Admit it or not it was BECAUSE they were men and they had more of a "Man" mentality. No longer could admistration give us women the sob story of, "Do it for the patient." Men knew before women that this was big business (unfortunately.)

    Hopefully, women entering the predominately male profession of "Doctor" will help to equalize things as well. Perhaps more men will understand human emotions, and more women will understand things about business.

    I hate saying it, men and women are different creatures. We look different, we think different, we pursue our prey different and we approach life differently. Personally, I like the differences. Who knows, perhaps because of these differences, one day when we least expect it; the patient might even benefit. (But that's merely an untested theory clearly left to those people who research the human brain to a much more vast extent than I do.)

  13. RadG: I think your GYN probably had to take a cold shower and think about Margret Thatcher after your comment. Poor bastard.

    MOW: It's hard to find anyone who admits that men and women are really different animals - and quite common to get demonized for admitting as much - what a fucked up state of affairs.

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  15. There is no difference between women and men... only those differences imposed by the capitalist pig-dogs whose mothers were hamsters and fathers smelled of elderberries. therefore, as of today, I decree that;

    1. All professional sports teams, especially the american football teams, play at least %50 women at all times.
    2. Likewise, all NASA scientists now need to be %50 women.
    3. Likewise with the world chess grandmasters.
    4. Unfortunately, this means that exactly %50 of men will now have to bear children. Sorry gentlemen... goes with equality, as does the need for %50 of you to start dressing for each other.

    вверх по с людям и женщинам специально

  16. Bouncing and giggling, like a Catholic School Girl, Dr. X! I've missed you! It's so good to see you have returned from whatever nefarious deeds you have been up to.
    But I'm afraid I must disagree with your decree. Men can't handle simple illnesses like a cold or the flu, how can they be expected to survive the rigors of pregnancy, much less LABOR and delivery? Sorry, guys, but I've birthed two babes, and had three husbands, four brothers, a Daddy and 4 Step-Dads...there's NO way a Man, Gawd Love y'all, could live through pregnancy!
    AS for 50% of men dressin' for each other? Puhleeze! Most of them do THAT already, especially on huntin' or fishin' trips.

  17. Gentlemen (as I presume you are based on your comments);

    I might suggest that before you start throwing stones, take care to look after your own house.

    I would like to say that as a female physician, it looks like I might last a lot longer than my husband in the field of medicine.

    And no, I didn't take time off in residency. Interestingly enough, though, my husband did.

    I will be the very FIRST to agree that men and women are different, but do believe that ALL should be required to succeed based on merit.

    And yes, I can put in a hip dislocation, and no, I am not a tank, nor a FemiNazi. I am a 115 pound proud doctor & mother of three.

    Go girls go, tbird

  18. Tbird - your comment on "ALL being required to succeed based on merit" is really the bottom line. I, too, am a female physician, but my present lifestyle would only reinforce a male dominated medical field as I have taken off almost 6 years to be w/my young children. I live off the good graces of my ER MD husband (who just happens to look and sound a whole lot like S. Cat). I make no apology for this as I feel it has been time well spent and I do plan to go re-enter the medical world in the future. I, however, did complete med school, residency w/no time off and took only 6 weeks off during my time in private practice after the C/S birth of our first child. Anyway, I applaud you for being a mom of three and your committment to medicine!

    I'm going to go out on a limb here and suggest the following reason for why women would want to get into the field of clinical medicine...because it's a respected profession and motherhood is not (so much.) Even though the majority of women believe and know that raising their kids is probably the most important job they will ever do, society does not agree. Becoming a physician, though, that is something that society rates quite highly! I propose that women who have gone through the training of becoming a physican, who choose to stay home/not practice are obviously intelligent enough to recognize their importance as a mom, but not quite confident enough that society would accept them as "just a mom."
    You have put this issue out there, and have had time to think about it, how do you think female dominated medicine will differ from the current climate?
    I will be happy to fetch your coffee...I also work with a "female" doc who is so extaordinary that I would be not only happy, but HONORED, to fetch her coffee!

  20. Glad to hear from all the ladies out there... This was the whole point of the post - stir up some debate about a sensitive issue, and be obnoxious.

    I think men and women are equally capable of being an effective physician. Period. I can also tell you that some people (not me, of course) resent when someone insists on equality but then asks for special treatment. The girls from the prior comments are obviously NOT in this camp - I can tell you from experience, however, some girls (and, to be fair, some boys) ARE. These people 'poison the well' and create the conditions for sexism - an 'ism' that is, itself, an unfair overreaction to a few bad eggs.

    Lastly, I have endless respect for women who 'sacrifice' a career to raise a family - I think this is the pinnacle of selflessness.

    In the words of 'Cube: "Ho's gotta eat too". I'm not sure how this is relevant.

  21. snoop, THE playa, sez, 'you got to control yo ho.'

    i will endeavor to persevere with that in mind.

    ps. name the movie with the quote, 'endeavor to persevere'... pretty obscure.

  22. Is that from a Clint Eastwood movie?

  23. rad girl. go wake your husband and tell him that in my humble opinion you are one of the coolest chicks on the planet(my wife in the group of course). i think you two would be fast friends doing triathlons and raising the ankle-biters. yes, clint eastwood, now, the movie? (clint does not say it, one of the co-stars does).

  24. I can picture the movie in my head, but I am going to need to think about the name of it.

    I think I would love to hang out with your wife. I bet she is very cool. Does your wife do triathlons? I just signed up yesterday for one in September. Nothing too exciting, just an Olympic distance in a very nearby state but it sure felt good to sign up again!

  25. Outlaw Josey Wales.

    Just Googled it.

    Yeah - fucking obscure.