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The Truth About Gender Effects on the Attitudes, Work Habits and Experiences

House of medicineThe medical literature is rapidly expanding in all directions, and especially so in regards to research and opinion pieces on women in medicine.  We know so much more about how women compare to men in medicine than ever before.  And most of the news isn’t good.  Not for women, not for the healthcare system and certainly not the patients we serve.

Why?  Because the way men physicians designed this healthcare system.  Lots of good, but not enough to last 100 years.  From architecture, to construction, interior design, and moving in, women were not consulted, not at the table.  Result:  A House a Medicine that cannot accommodate women, and cannot expand to save itself and cannot be a system with values, processes and work habits to which we could all aspire.

Put that sentiment side by side with the widely held belief that our healthcare system is broken.  While many of us might not believe it is “broken,” there are none of us, I am sure, who don’t think it could be made better.  And who better to make it better?  The women who are ever more rapidly coming up in the ranks.  Women who are likely to have a different world view about what it means to take care  of people, our patients.

We must find out what this is and what can bring about this about?  In partnership with the Women’s Physician Congress of the American Medical Association and the Giambalvo Memorial Scholarship, the Gender Equity Task Force of the American Medical Women’s Association has been given a grant to write a grant to study women physicians–how they work, the attitudes about and by them, and their experiences e.g. leadership, discrimination/harassment, and everyday life in the trenches.

“Why?” you might ask.  “There are lost of surveys out there.  Don’t we know enough yet?  Women are behind the eight ball.”

While there have been a number of surveys which are out there, none has provided actionable information. Their methodologies are flawed in many ways.  Count at least four or five.

First, women tend to underestimate what they do.  They minimize their impact.  They often do not account for those hours which are not direct face to face patient care contact hours.  Surveys do not give accurate information.

Next, the topics and questions asked are not relevant to the way women work.  What does the workday really look life?  When does it begin and end?  Many of us forgo lunch or the hanging out in the hallways between cases or patients in the office, so that we can take care of our mail, our charts, and the hundreds of other details that are not factored into direct patient care.

Perhaps the most difficult to tackle is being shackled by the definition of “productivity.”  It is not driven by clinical, satisfaction and patient satisfaction outcomes, but by through-put of patients, either in the number of hours worked, RVU’s, or procedures done.

Finally, what women do well, often is not counted as “productive,” e.g. teamwork, committees, etc.  In fact it is often devalued–it doesn’t count as heavily as research papers published, often with multiple male authors, buddies, er, I mean colleagues.

The House of Medicine was created in a time when the structure of society and the structure of the workplace were very, very different.  Each worker (the man) usually had an assistant (the woman) who received no pay to make sure that his career was successful, he had children to love and adore him, and a sanctuary in which to rest, not to take on a second job.

So what we are proposing?  Stay tuned for the next post and learn what we have learned and why you need to be part of remodeling the House of Medicine and how to do it.


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