Sorry to have been out of action the past couple of days, I’m getting better now, after a visit to the doctor, got some medication, all things are well.
The experiences set me thinking about men and women and their roles in medicine. Some of this will probably be old hat, but I’m rehashing it anyway because it’s direct personal experience time again…
I am sure that the following sequence will sound familiar:
I rang up to book a same-day appointment with a doctor at the local GPs practice. The person who answered the telephone was a woman, and she booked me an appointment. When I arrived for my appointment, I was greeted by a receptionist, possibly the same woman as answered the telephone (there appeared to be a female secretary working in the open-plan space behind the reception desk). Then I was called to see the doctor, who turned out to be a man (I believe that at that practice, there is one woman doctor out of about six, and there is a Sister who handles “delicate” examinations of female patients). I received my prescription and made my way to the pharmacy. At the pharmacy, most of the people working there were women (this appears to be the norm in my home town, I am not sure about elsewhere). So I made my way home and pondered on this difference.
I am proud to be the descendant of two women who were among the first to gain high medical qualifications. My maternal grandmother (Grandma J) was a medical doctor during the second world war, some people have told me she was the first in London, and if not the first, then certainly among the first in London or anywhere in the country. I am not as clear on the story of my paternal grandmother (Grandma A), but I know she achieved the status she did (I never saw her name with “Dr.” in front of it, so I don’t know exactly what that status was) before most other women did, and that she was not a nurse in the sense of caring for patients before or after treatment (I’m not sure what that leaves!)
Grandma J gained her qualification over 60 years ago, Grandma A gained hers even earlier, possibly 70 years ago now. While there are a lot more women in high-level medical positions these days, it seems that it is still much more likely that you’ll encounter a man making the decisions (diagnosis and treatment) than a woman, and similarly, much more likely to be a woman doing te caring and dispensing roles. So much so, in fact, that I can recall clearly an incident a few years ago in which a male nurse was attacked because it was assumed that his job meant he was homosexual – prejudice about gender roles combining with homophobia with a particularly nasty outcome.
Now, I remember as a young child having a picture book in which the doctor was a woman, but I also remember at that early age having had the idea impressed upon me from other sources that ” medicine people who are men are doctors, medicine people who are women are nurses”. I did unlearn it later, and I didn’t actually know at that age that there was a difference in the roles of doctors and nurses – but the fact that I had already absorbed those labels as “the way it was” I now look on as quite shocking.
My last thought is on the family: I am sure that it is a familiar story: although when you go to see a professional to find out what’s wrong with you, you usually end up talking to a man, as a child the first person you asked for a diagnosis was: mother.
I recall a discussion of gender-divided roles within a field, (I wish I could remember where or who I was reading. might have been here). Someone made the point that in fields that are traditionally “women’s work,” the leaders in the field are still commonly men. For example, cooking is women’s work, but top chefs are commonly male. Sewing clothing designers. Teaching / the principal. Healing / ALL of mainstream medicine.
One area of healthcare is dominated from women from the top on down: midwifery (and doulsitry). There might be one male in there somewhere.
I assume by “delicate examinations,” you mean pelvic and breast exams? The kind where they look at your vulva and vagina, palpitate your ovaries, take swabs of your cervix, and check your breasts for possible tumors?
This is a feminist blog, no one’s going to faint at the mention of pap smears. Refusing to call them what they are just reinforces that they’re something to feel ashamed about.
I recently had surgery, and I found that the majority of people I dealt with in course of my examination, diagnosis, and treatment were women, though the surgeon was a man, as was the resident who assisted him in the surgery, and the colleague that helped him when he fell behind on seeing patients.
All of the following people I dealt with were women: my primary caregiver who referred me to a specialist, most of the desk staff who handled the clerical aspects of my treatment, my surgeon’s medical assistant, the nurse who prepped me after I checked in on the day of the surgery, the pre-op holding area nurses, the surgical nurse, the anesthesiology nurse, the recovery room nurses, all but one of the floor nurses who looked after me during my overnight stay, and the pharmacist who filled my prescription for pain medication.
By the way, I don’t mean to be an annoying pedant while my response is sitting in the moderation queue, but you mean to say that you are proud to be the descendant of women physicians, rather than the ancestor. Unless you went back in time somehow, in which case you really should post about that. :)
Just recently I read something about the shortage of nurses. Someone actually complained that girls had been encouraged for years to become doctors so no one wants to become a nurse anymore.
There is also another field where men are more prevalent than women (at least in Germany): Emergency medical technicians. Maybe that is just more interesting and adventurous than being a male nurse?
And no, not every physician has to have a doctorate.
Should read “Sewing / clothing designers.”
Because of the nursing shortage here in California, nurses are making very high salaries and men are getting back into the field. I know two male nurses socially and when I had my knee surgery last year, the nurse who held my hand and calmed me down as they anesthetized me was a man.
It’s interesting that as soon as salaries in a woman-dominated field go up, men start re-entering it. There’s also a pharmacist shortage, with high salaries that go along with that, so expect to start running into male pharmacists again.
Though, traditionally, the pharmacist is male because he’s an extension of your doctor.
Mnemosyne, just before I checked back in, I was just wondering whether, if / when midwifery ever becomes accepted and respected in the mainstream, men will make inroads into that field as well.
debbie:
Apologies, I should have made it clear in my OP – that was a direct quotation from the posters in the waiting room at the practice. You are right about what it means, of course, and the poster does clarify that in the smaller print.
Which just shifts your point one step further back: after all, if it isn’t even okay to use the medical terms openly in a GP’s practice, does that mean “propriety” is more important than health?
Women are more visible in medicine these days, and in some fields are a majority of trainees – but those fields have become the lowest-paid and lowest-status areas of medical practice. Primary care, in particular pediatrics and family practice but also primary care internal medicine, have the lowest average salaries in the US. When my grandfather became about the 300th board-certified internist in the country, internal medicine was a high- status specialty that attracted the top graduates from the best school. Now American grads, in droves, choose interventional specialties instead. The high-paying, high-status fields remain overwhelmingly male.
The insane American reimbursement system, which pays doctors to poke and cut and scan but not to listen or think, is partly to blame for this pattern but there’s also clearly a pink ghetto in medicine. The only exception is OB/GYN, which is becoming more and more female-dominated and continues to be fairly high-paying. But as someone upthread pointed out, the leaders are still male.
I chose a residency which had been designed to provide trainees with more balance and support than most of its day. One of my classmates said “oh, that’s a great program for women; they don’t mind if you don’t take medicine all that seriously”.
?
Um, yeah, it does. And by “propriety” I mean “the practitioner’s delicate sensibilities”. Although this serves me well, personally; I have lots of patients who’ve come to me because their previous male docs couldn’t tolerate discussions of “delicate” female parts.
For the most part, yeah. In my neck of the woods the doctors tend to be male, and most of the nurses/ other medical people are female. I have noticed more men going into nursing in recent years…
I’m a female doctor, currently 2/3 of the way through my pediatrics residency. The majority of my classmates are women. Among the attending physicians, there are roughly equal men and women. The majority of the nurses are also female.
During med school and after graduation, I used to introduce myself by my first name, and then explain that I am one of the doctors caring for such and such child. I used to not wear my white coat, b/c I think it is too often used as a status symbol (think about the docs you see at the grocery store wearing their white coats: in the supermarket, who cares if you’re a doctor?) However, now I introduce myself as Dr. Lastname and in the hospital, often wear my white coat. Why? Because otherwise, as a relatively young woman, everyone calls me “nurse.” It is an interesting cultural phenomenon.
I appreciate nurses and know that nurses do very important and great work. My own sister is an incredibly healing nurse. However, I am not a nurse. I have a graduate degree in medicine. I prefer that people know I am a doctor when caring for their family members, b/c I have that skill set. So, I wear the white coat (that says Myfirst MYlast MD in embroidery on it) and call myself Dr. Lastname. Even with these contextual clues, many folks still call me nurse.
The men in our hospital? Many don’t wear white coats, and introduce themselves by their first name. No one questions whether they are doctors.
Historically, women physicians had a tough time gaining acceptance, from both the profession and the community. In order to practice medicine, one woman established her own hospital in Chicago over 140 years ago. To make it more palatable to the establishment, the hospital cared for women and children. Later, to give other women opportunities, she established her own medical school. Graduate physicians denied jobs elsewhere got appointments in her hospital. Read about Mary Thompson and her hospital here. The staff was all female till 1972.
Interesting. I went to an engineering school that also had a pre-med program. I’d say that more than half of the women in science or engineering were either in the pre-med program or in biomedical engineering. Much, much fewer were in the other engineering or science fields. I’m hoping that as my generation finishes up with their medical schooling, we’ll see more women doctors.
I thought he was just quoting. It sounds like the clinic was catholic or something, since it was a “sister” who performed the “delicate” examinations. To call pelvic and breast examinations “delicate” examinations if the clinic calls them that is just adding to the irony.
I’m a nurse (female) and work with a good proportion of male nurses. The hospital where I practice is a teaching facility, with a special emphasis on neuroscience, neurosurgery, and complex internal medicine/diagnostics/pathology.
More than half of the residents are female. There are equal numbers of female and male residents in the more demanding programs, like neurosurgery and internal med.
Yet the training the medical students get on sexual harassment speaks only to a *male* doctor getting harrassed by a *female* nurse. We’ve made great hay of that one, you can be sure.
It’s a comfort to an old feminist (old in comparison to the students and residents, I mean) to see so many women in the tougher medical programs. It’s a bitch to see that the teaching establishment still doesn’t recognize that harrassment will more likely be from a male patient toward a female resident, or from a male student toward a female student (or vice-versa) than from a female RN to a male MD. The Establishment isn’t preparing the students and residents, male *or* female, for the realities of practice.
Quite frankly, I have much better things to do–like taking care of patients–than chase after residents who are, in some cases, only two-thirds my age. *sigh*
Sorry for jumping on you Snowdropexplodes – I find it mindblowing that medical professionals would be so squeamish (or at the very least would know that encouraging squeamishness about women’s bodies is bad for women’s health).
I’m glad you pointed this out. Since the beginning of my pregnancy, every medical person I’ve seen has been female, with one exception.
The one exception was an older male triage nurse when I went to urgent care. He introduced himself quickly as a triage nurse; until then I had assumed he was a doctor.
So it appears that when I see a man, I assume doctor. When I see a woman, I can make no assumption whatsoever.
My house for some reason gets the Alumni magazine from the local medical school — pictures from this year’s class reunions showed a clear trend from all men in the 1950s to about 60% women from the most recent classes. Practicing doctors as a whole still seems like it skews male, though.
After a night’s sleep, I have one quibble with this post, which is sorta, but not really, on topic:
The assumption that nursing is, as a profession, somehow subordinate to doctoring.
As metinperu points out above in her comment, the two professions have completely different skill sets. There is also a different approach in nursing to the care of a person; we train not to diagnose and help heal a pathology, but rather to support the person with that pathology and teach them how to deal with it.
At least in the United States, nurses have as large a role as doctors (and in some specific instances, a larger role) in making sure care is safe and appropriate. We’re the gatekeepers when it comes to test results, changes in a patient’s condition, and a patient’s overall safety. Yes, the doctor might write an order for treatment, but the nurse is the one who checks it, decides whether the order is appropriate, and decides how to implement it.
The trouble with a hierarchical view of medicine when it comes to the MD/RN relationship is that it ignores two things: first, that nursing is a profession that’s equal to medicine, although plainly different. The second is that it’s pretty damn cool to be a member of a profession that’s historically been primarily female, and thus in which women have made all of the major advances and changes.
Maybe my experience is unusual? In the past, say, ten years I’ve seen as many female as male doctors, if not more. I haven’t seen a male dentist in decades. I currently have most medical needs taken care of at the campus clinic, where both doctors are women. The last time I saw a male doctor outside of a minor emergency clinic setting was for a fairly invasive gynecological procedure (colposcopy). The last ER nurse I saw was male.
Yet my SO recently went to a female doctor for the first time in his life (he was 38 or 39!).
Slightly OT, but I know a couple: he’s a nurse (well, he’s now got his JD and is a practicing attorney more than a nurse — he said that nursing school is actually good prep for law school and the law school people like it when nurses apply) and she’s a physician.
People seem to be comfortable with the “gender role” switch (maybe it helps that he wears the skirt in that family — he has quite a collection of utility kilts ;), but they then defer to her whenever any medical thing comes up — if some kid falls or something, they immediately go to her with “you’re a physician, can you see if my cherub is ok?” … she always refers them to her husband if he’s around — since he is a nurse, he’s better trained to deal with any sort of first line “is everything alright” than she is, even as a primary care physician.
But people tend naturally to think “a doctor knows more than a nurse” … perhaps true if you need to figure out what disease is causing your malaise and what to prescribe for it or where to operate, but quite the opposite is true when it comes to basic patient care …
oh … I see Jo and others have beat me to the punch with the point of my previous anecdote, so I’ll give you another:
I remember a riddle that was commonly told when I was growing up as a way of examining your hidden sexist stereotypes.
A man and his son are in a car and hit by a drunk driver. The man is ok, but the son is badly injured. They take the son to the emergency room, but the trauma surgeon on duty says “I can’t operate on him, he’s my son”. How is this possible?
Even when this riddle was making the rounds only about 20 years ago, people (including I’m ashamed to admit, yours truly) were stumped by this — when what should be the obvious answer is “the surgeon is the boy’s mother”. You just don’t necessarily think of women trauma surgeons (or at least you didn’t even as recently as 20 years ago).
who handles “delicate” examinations of female patients
I remember when I had a tick in my groin that died stuck to me and couldn’t be removed, the doctor at the campus health clinic to whom they sent me was a woman (actually, I was worried that, given how hawt she was, I’d, um, respond … but I guess her wearing a great big diamond ring put a stop to that response — I guess this is also then on topic in regards to the whole “diamond ring” discussion? ;) ).
She and I together couldn’t remove the drasted thing, so another doctor, also a woman, was called in. The other doctor mentioned her daughter once had a tick in the equivalent area (I presume her daughter would have loved to have known this was mentioned to some random guy with a tick on the base of his penis). Anyway, the 3 of us managed to get that tick out (without causing any spill-back into me) …
but if a horny grad student can handle a hawt doctor feeling around the base of his penis without, um, responding, I should think that sometimes medical need kinda overrides certain other concerns and responses …
My doctors are about 50/50. I don’t think I’ve ever encountered a male nurse outside of an inpatient setting, which makes me wonder if most male nurses work in inpatient hospitals and ERs, rather than doctors’ offices, where most of people probably get most of their care. (My doctors are all attached to a teaching hospital, but they work out of an outpatient section of the hospital. I don’t know if that’s an ordinary set-up or not.) I’ve had a few male audiologists, and I think I once had a man perform a bone scan on me, but otherwise most of the non-nurse medical professionals I’ve encountered have been women. So I would say that while it’s not true that most of the doctors I encounter are male, it is true that most of the men I encounter at the doctor’s office are doctors.
I have to say, though, that the really big disparity I’ve noticed has to do with race, not gender. Most of the people I see in the waiting room are African-American, but I have never had a black doctor, and that includes the vast number of residents with whom I’ve dealt. (Otherwise, my doctors have been very diverse and quite international. There’s a notable absence, however, of U.S.-born Latinos, as opposed to doctors who have immigrated from Latin America.) On the other hand, a lot of the nurses, most of the receptionists, and all of the phlebotomists are black.
Well, that’s unclear! By that, I mean people who are neither nurses nor doctors. For instance, the people who do blood draws or administer various tests.
libber
Exactly. Except, not catholic. Sister (at least in Britain) is a title given to a senior nurse, usually in charge of a ward in hospital.
As a fellow pedant, I must hang my head in shame! ;-)
OP now corrected.