During the past 40 years, women have become physicians in ever-increasing numbers. In 1964, according to the American Association
of Medical Colleges, 6 percent of medical school graduates were female. By 1984, that number had risen to 28 percent, and
by 2004 it was 46 percent.
The trend is as inexorable as it is unsurprising. Medicine is, after all, a line of work in which practitioners take care
of people. And if stereotypes are at least partially grounded in fact, women have long been seen, and see themselves, as nurturers.
Once women started entering the professional world in large numbers, the practice of medicine—especially family medicine,
pediatrics, and obstetrics/gynecology—seemed a natural fit.
Females, however, aren't represented equally throughout the profession: Gastroenterology, neurology, and most of the surgical
specialties remain male bastions. And men still dominate medicine as a whole. In 2003, according to the AMA, women comprised
just 26 percent of the total physician workforce. But that's up from less than 8 percent in 1970. Indeed, according to the
AMA the total number of physicians in the US increased by 86 percent between 1980 and 2003, while the total number of female
physicians increased by 315 percent.
What does this mean in terms of patient care and the future of medicine? We looked at studies and anecdotal information to
get some answers. Does gender influence practice patterns?
Power Points
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In their study on the effects of physician gender on patient care, FPs Klea D. Bertakis and Peter Franks of the University
of California Davis School of Medicine found that female physicians spent more time with patients and were more likely to
order certain preventive services such as Pap tests and blood pressure checks. They were also more likely to offer counseling,
and make follow-up arrangements and referrals. (The study was published in the January 2003 issue of the Journal of Women's Health.) Surprisingly, when Bertakis and Franks controlled for patient gender and health status, they found that differences in the
amount of time spent with patients were statistically insignificant. "Female physicians have more female patients," says Bertakis,
"and female patients report themselves as being in poorer health than males and require more time. Women physicians also see
more new patients, and we all know that first visits are longer than follow-ups."
That's certainly the experience of Karen B. Weinstein, an internist in Oak Park, IL. Weinstein spends more time with patients
than her two male partners do, but 80 percent of her patients are women, so naturally she does more Pap tests and breast exams.
Other physicians think that differences in visit duration reflect personality more than gender. "I know of many male and female
doctors who are in and out of the exam room quickly, and several of both sexes who take the time to sit and listen," says
Rivka Stein, a pediatrician in Brooklyn, NY. Stein, who likes to spend time with patients and their parents, educating and
just chatting, adds that she thinks patients gravitate toward physicians who are like them. "I have had patients leave my
practice because they prefer not to spend much time on a visit," she says.
Sherri L. Morgan, a family physician in Yellow Springs, OH, believes that patients expect women doctors to be more conversational
and empathetic. Those who meet these expectations, Morgan says, do so because it comes naturally to them or because they've
learned how to be better listeners. In her own case, if a patient, complains of, say, stomach problems, she'll do her usual
workup and at the same time ask about the patient's family, marriage, and work situation to determine if the problem has an
emotional component.
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