A physician's experience with gender stereotyping

June 29, 2017 4:22 PM

Washington Post: "I’m a young, female doctor. Calling me ‘sweetie’ won’t help me save your life."

From the Washington Post article by Faye Reiff-Pasarew: "These patient biases have been well documented, and are unfortunately reinforced by the healthcare system. Even though studies have shown that female providers produce lower mortality rates among older patients and are more patient-centered than men, our effectiveness is not reflected in patient satisfaction scores that wind up influencing doctor compensation: Female doctors earn 74 percent of what male physicians do. Even in the relatively new field of hospital medicine, which skews younger and closer to even on gender, women are still underrepresented in leadership positions and scholarship."

posted by jazzbaby (18 comments total)

My female colleagues do have to take a lot of shit in the course of patient care that I don't have to. Inappropriate comments from patients when they're at bedside, patients exposing themselves and masturbating in front of them, having to wear their white coats constantly in an area of medicine in which it's not typical just to avoid patient confusion -- and still having to hear "when's my doctor going to be in here?" But I'm glad they persevere, 'cause they're awesome.
posted by killdevil at 6:45 PM on June 29, 2017 [4 favorites]

Mod note: Deleted several comments. I get that this is an intensely upsetting subject for a lot of people on a personal level, but we need to keep it on the level of I-statements and not angry railing, or there's just no way to have a conversation. Thanks.
posted by restless_nomad (staff) at 7:14 PM on June 29, 2017 [2 favorites]

If you're not a woman, a queer person, a person of color or neurodivergent, you cannot know the terror of going to see the doctor. You cannot know the relief of seeing the person in a lab coat being female or not white. The relief that says, oh god, maybe I won't be told its all in my head today! Maybe I won't be accused of drug seeking! Maybe today I won't be treated by a doctor who will touch me WITH UNGLOVED, UNWASHED hands. And its not that all female doctors are great and all male doctors are bad. Its just that my personal experience tells me, AND the studies from this very post tell me, that I am going to get astronomically better care from a female GP.

Seriously. Don't "not all men". Just don't.
posted by Homo neanderthalensis at 7:14 PM on June 29, 2017 [36 favorites]

So. At the risk of outing my real-life identity, I am a female doctor in leadership. I made partner in less than half the usual time in my group. I am the president of my state society. I take care of people who are too sick for my partners to care for. I out-earn most of the men in my group. I am, without being overly self-congratulatory, a badass.

I still take endless amounts of shit. "But what's your FIRST name, baby?" "You're too pretty to be smart." "Well, I think we all know why people like YOU."

Medicine has a lot going for it. It does not tend to be a haven for forward thinking people. And it definitely shields bad actors to a remarkable degree.
posted by LittleMissCranky at 7:45 PM on June 29, 2017 [77 favorites]

My current GP is an old family friend who takes great care of me. His partner in the practice is a woman who is a smidge younger than I am.

Darlene is an incredible physician, and she put up with an immense amount of bullshit until she went into practice with Mark. If you "sweetie" her, she'll give you a talking to, and Mark will give you one for good measure. Her patients know they are lucky to have her.
posted by MissySedai at 7:53 PM on June 29, 2017 [4 favorites]

You cannot know the relief of seeing the person in a lab coat being female or not white.

I've had a lot of absolutely wonderful male doctors in my life - male nurses, technicians, and every other stripe of health care worker, too.

But still. The last surgery I had, I looked around and noticed that the surgeon, anesthesiologist, and nurses were all female. And I felt a level of relaxation that I'd never felt going under the knife before.
posted by The Underpants Monster at 8:15 PM on June 29, 2017 [18 favorites]

I'm a female physician - just about to enter my final year of training (med school plus three years of residency and a three year fellowship). I introduce myself as Dr. LastName, as I always have.

I will never forget begging my program director to let me take my first name off of my white coat, because patients just assume that it's okay to call me by my first name. When you correct them, you look... petty? I ended up covering my first name with black tape for the rest of that year, because it would be another year before I could get new white coats.

I've had patients who adamantly refer to me as their nurse. I've had patients mock my weight. I've had patients expose themselves in front of me and laugh about it, or comment on various other physical attributes.

When I was in residency, I discovered that wearing dresses and skirts, a nice set of pearls and bold red lipstick seemed to age me just enough to get a little more respect from patients. This came at a cost of an extra half-hour of sleep (already sorely limited by virtue of the job itself). The engagement ring helped a lot, too - it turns out that a ring on your left hand will get a lot of creeps in hospital gowns to stop hitting on you. When I moved to the South, I had to adjust to people calling me "sweetie" because you can't just get. them. to. stop.

I'm 32, and the youngest person in my fellowship program because I basically went straight through, haven't stopped since kindergarten. Because I look young, my "Hi, I'm your doctor" shpiel has evolved into a well-rehearsed speech about where I'm from, where I went to college, where I went to medical school, where I went to residency, and how I got to fellowship - all because it's the most effective way to convince patients that, even though I don't have grey hair or male genitalia, I belong here. After literally 27 years of nonstop grind, and $400K in student loans, I belong here.
posted by honeybee413 at 8:21 PM on June 29, 2017 [60 favorites]

My wife is a doctor. We'll introduce ourselves as "Dr. and Mr. Lastname".

Many people then ask me what kind of doctor I am.
posted by Groundhog Week at 9:08 PM on June 29, 2017 [30 favorites]

My mother told me about the daily routine of patients exposing themselves to her and masturbating in front of her when she was a candy striper. But I guess I kind of assumed that it was mostly because she was a teenage girl in a vulnerable position. Hearing that it happens to female doctors, too, ffffs, even after all these years, is just too damn depressing.
posted by The Underpants Monster at 10:09 PM on June 29, 2017 [4 favorites]

I'm a (male) ED nurse and almost every shift need to correct patients who call me "doctor," despite me introducing myself as their nurse literally in my first words to them and often after they have meet their actual ED physician. I haven't tried to track whether this happens more often with the female physicians since there's the additional complication of Black physicians and a patient population which has a substantial number of, for lack of a better term, rednecks. The notion that a white man in scrubs is automatically a physician seems incredibly ingrained though, despite any re-orientation on my part. I'm always impressed by the incredible patience of the MDs who find themselves having to justify their near decade of medical training.
posted by Panjandrum at 1:22 AM on June 30, 2017 [4 favorites]

My best friend is pre-med and her undergrad majors are chemistry and neurology. She's brilliant, a genius, astoundingly feminist, social justice warrior and... she's gorgeous. She's pretty much the most beautiful looking person that I've ever known and that includes my truly gorgeous children.

I dread the day that she has to interact with patients because I know what will happen. I've sent her this article. I hope that she'll have the grace to listen and be effective but, honestly, if women doctors just told those old geezer to shut the hell up, it'd be okay by me.
posted by blessedlyndie at 2:30 AM on June 30, 2017 [1 favorite]

the article comments are so disheartening.
posted by BekahVee at 5:39 AM on June 30, 2017 [2 favorites]

I'm a female medical student. To add my anecdata to the conversation, yes, all of these things happen, often. A patient I took care of in the hospital for an entire month told my attending that I was "the greatest nurse in the world." A patient once groped me with his foot because he couldn't reach me with his hand.

I find those incidents annoying and frustrating and occasionally sad, but medicine is, for me, about meeting people where they are and taking care of them without regard to their [sometimes horrible] beliefs. It's a mitzvah to do so and one I take very seriously.

I don't feel a professional responsibility to put up with sexist doctors, so maybe I'm more sensitive to it and notice it more, but that's the sexism that I experience much more frequently that really grinds me down. I've been mislabeled as a nurse or nursing student about as frequently by my supervising physicians as I have been by patients. Attendings who think they're taking an interest in me and being sensitive to "unique female needs" ask me about my plans to get married and have children when we're supposed to be discussing my career path. Supervisors "guess" that I'm interested in OB or pediatrics based on some ineffable quality they can't put their finger on. There's been a roughly even split between people who simply won't believe I'm interested in surgery and people who congratulate me for being "surprisingly serious" about surgery (compared to my female classmates). Neither one feels good -- actually they both feel terrible.

I don't need patients to be thoughtful or respectful in order to do my job and I often don't expect them to be. I do need physicians to be and their patients need them to be, too.
posted by telegraph at 5:40 AM on June 30, 2017 [18 favorites]

I am a female surgeon, now in my forties.
I definitely got a lot more of this crap earlier in my training/practice. Some from patients, some from other medical professionals. I especially remember a lot of "tone arguments" moments in training ( not that I had the language for it then); I had several occasions when senior staff would talk to me bc a nurse complained I wasn't "nice". Let's be real: I never yelled, never swore, I would just ask for what the patient needed. While my male colleagues could yell/curse and it was just OK.
It is less of an issue now. Partially because I am obviously not young, so I think people just don't try shit. Also because my threshold for Taking Shit is way lower, as in nonexistent.
posted by maryrussell at 6:23 PM on June 30, 2017 [3 favorites]

maryrussell's experience is unfortunately still happening in the UK but far less than when I started working in Surgical training.
One of the factors that really helped was the introduction of the e-portfolio for all surgical training programmes. When you state openly what you expect trainees to get from a rotation, when both trainees & trainers have to engage with uploading large amounts of observations in practice and other assessment tools, 360 degree appraisals, etc., etc., you find that quite a number of the dinosaurs in the profession refuse to engage.
They initially feel they don't need to because lets face it, they are the world leader in left toenail surgery!!!

Eventually after 5 yrs of its introduction I can honestly say we were left with a majority who were very committed to genuinely training the next generation. At the same time we introduced a very unpopular blind way of shortlisting for interview. The first page with name, University and any identifying markers was not seen by the people shortlisting. You could still see the odd marker, a comment in a Duke of Edinburgh Gold award "Rakesh has an extraordinary ability to team-work...yada yada" but for the most part it really increased the diversity of those interviewed.
The published work of the amazing Scarlett McNally however shows that even though we are appointing more diverse applicants to programes, we are losing the women faster than all other groups before completing.

Within our School of Surgery I made a note during the interim Review (3 months before your final year review of progress) an interview that is meant to give anyone struggling some pointers on what they need to do to help them get to progress. They were some slackers who literally had strips removed for not engaging with the programme, not getting to theatre enough, etc., and in 12 years only one of those was female. I started to make notes after my second year operating the new e-portfolio and interview system (these interviews are conducted by surgeons from other units randomly allocated) when I noticed female surgical trainees using minimising modifiers in describing their research. (That pesky linguistics degree!) You see, as Med students they have already internalised maryrussell's experience about being nicer, sounding nicer, and so they say things like "oh there's this little paper I wrote, small presentation I made, I did a bit of.....

on one ocassion the female trainee in Q had a ground breaking Phd work while she intercalated in Med school which was now getting international recognition and she had a paper accepted at THE international Urology meeting! It broke my heart. Luckily the evidence was there in her portfolio so I quickly pulled it up on screen and there was an audible reaction from the rest of the panel

As soon as I had 2 years of findings, I presented it at each year's induction of the new trainees. There would be almost silence in the hall, as i put up example after example of real phrases, then discomfort, a few giggles, a few snorts, and then almost zero questions. I realised quite quickly I was the wrong person to deliver this, you see I sit on those progressions panels & these brilliant people thought this was some kind of mind-fuck. They thought I was telling them what we didn't want to see this language in those panels. So I always finished by saying I knew why female trainees felt the need to do this, it was due to the daily pressure on wards and in theatres they had experience as Med students. But that I expected better from the trainees in their day-to-day training and I expected the male trainees to be allies when they see nursing staff, patients or other residents putting women down in these ways.

I don't know if it helped, and I for a multitude of other reasons am now managerial but it is relentless and some women deliberately cultivate a persona to cope.
posted by Wilder at 1:04 AM on July 1, 2017 [5 favorites]

there's a good sampling of the experience of UK female surgeons in this article
posted by Wilder at 3:23 AM on July 1, 2017

It's sad that this is still something that female physicians have to deal with. At least most physicians going into the field now don't hold this belief system. Maybe in 20 years we can look back and confidently say there are no longer gender stereotypes in medicine.
posted by atlantic_health at 12:22 PM on July 10, 2017

At least most physicians going into the field now don't hold this belief system.

Assumes facts not yet in evidence…
posted by Lexica at 1:28 PM on July 10, 2017 [1 favorite]