The healthcare future is female

  | February 14, 2018

The face of medicine is changing – and so is its gender.

Statistics show women now constitute a majority in the ranks of younger doctors, a transition that is likely to put pressure on healthcare institutions to change their practices around scheduling, supporting and promoting female physicians.

From January to June 2017, athenahealth surveyed 18,000 physicians at 3,500 practices on its network, and determined that more than 60 percent of physicians under the age of 35 are female, while just under 40 percent are male. In the next-highest age bracket (35 to 44 years of age), women are the dominant gender as well – just slightly – coming in at 51.5 percent. As each age bracket gets older, the percentage of female physicians drops, with 82.4 percent of physicians over the age of 65 being male.

The trend shows no signs of slowing down: In 2017, the number of women enrolling in U.S. medical schools exceeded the number of men for the first time, according to data from the Association of American Medical Colleges.

As women become a major force within the medical community, healthcare executives and administrators, many of whom are men, are tasked with creating an environment that prioritizes retaining and supporting female physicians in order to maintain a robust workforce.

Unfortunately, there is often a disconnect between executives and practicing physicians. "Doctors need to feel that their system understands their needs. They want to be included in decision-making," says Danielle Ofri, M.D., Ph.D., associate professor of medicine at New York University and author of "What Patients Say, What Doctors Hear." "The worst feeling for a doctor is when a mandate is handed down from on high from an executive who has clearly never set foot in an exam room."

Scheduling is one area where administrators can make a big impact. "Flexibility in scheduling is critically important," says Ofri. "If you allow your medical staff to work a schedule that doesn't force them to sacrifice family or clinical time, they will be much more productive. Luckily for the system, motivation is rarely a problem – most doctors want to do excellent clinical work and just need their employers to make that possible."

Anna Goldenheim, M.D., a 33-year-old pediatric resident at a Boston hospital and a mother of two, says her work life will always be dependent upon her children's schedules. "I think that as a woman, my job priorities are going to be really fluid for as long as my kids are home, and will change again as my kids go to school," says Goldenheim. "I'm hoping to tailor my job to those needs."

Supporting physicians, minimizing burnout

Scheduling improvements are only one component to developing a culture that's more supportive of female physicians.

In an industry where physicians have to gain the trust of their patients and colleagues in highly stressful, sometimes dangerous situations, bias can come into play – on the part of both patients and peers, says Elisabeth Poorman, M.D., 33, a primary care physician with Cambridge Health Alliance in Massachusetts.

"From medical school awards, to residency, to the rest of our careers, women and minorities are less likely to be recognized for the same accomplishments and more likely to suffer abusive treatment and mistrust from patients," says Poorman. "Traditionally, we have asked individuals to face this reality alone, without institutional support."

Research from athenahealth indicates stressful work environments may be taking a toll. Specifically, female physicians, particularly younger women, are more likely than their male counterparts to report symptoms of burnout. In a 2017 survey of 1,029 practicing physicians, 54 percent of women under the age of 45 reported symptoms of burnout – emotional exhaustion, depersonalization and sense of low personal accomplishment – compared to 31 percent of males of the same age.

One of the best ways to make the needs of female physicians heard is to place them in executive roles. "Female physicians are still underrepresented and underutilized in positions of power, especially at the most senior levels," says Deborah Shlian, M.D., a medical management consultant in Florida. "We need to eliminate those double standards that penalize women for traits and behaviors that are rewarded in men, like assertiveness, daring, risk-taking, and bravery. Yes, we need to 'lean in,' but we also need to push back."

The changing face of healthcare

Those double standards are visible to many female physicians. "We have robust data that demonstrates that women are rated more poorly in medical school and residency, and that gaps in their evaluations actually grow through their training," says Poorman, who cites a 2010 study that found men are more likely to be seen as "quick learners" than comparable women.

"The area where [women] are most likely to fall behind is in personality traits like decisiveness. And even more troubling, the feedback they get is much more likely to be contradictory. In other words, supervisors send the message to women in training that there is no good way to be a woman in medicine," Poorman says.

Similarly, it would be irresponsible to not recognize that not only gender, but race, often determines the way female physicians are treated, Poorman says. "I think of the 'changing face of medicine' in terms of more women and more people of color," says Poorman. "Anybody who doubts the existence of racism should follow a black woman physician around all day."

While many older patients are used to the stereotype of a white man as their physician, the dropping number of male physicians means they'll have to learn to adapt to medicine's changing face. This means accepting that their physician may in fact be younger, a woman, a person of color, or all three.

While that may represent a significant shift in mindset for some, the good news is that quality of care generally trumps other considerations in determining how patients feel about their physician, says Ofri. "If you ask patients, they'll say they just want a doctor who is competent, caring, and dedicated," she says. "While many may start with a stereotypical image of the older, white, male doctor, as soon as they spend time with a doctor who is committed and enthusiastic, the old stereotype usually just fades away."

Megan Johnson is a writer based in Boston.

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Many men with gender specific illnesses won't speak to a female doctor nor do they want female support staff attending to their care. The medical community to date has been unable to or just refuses to grasp this concept. No matter how pretty, educated, or clever a female healthcare worker may think she is, she cannot ever totally empathize with a male patient when the issue at hand is gender specific. Without male doctors and male support staff for men, Many of us already have seen and envision even more guys in the future who want their dignity and privacy protected will see that their only choice to avoid being degraded and humiliated by a pro woman system is to choose to walk away from needed care which in turn, will send them to an early death. Something their families can thank our healthcare system for. Gender scales across the healthcare industry must be balanced so the system can work for both genders. Regards, Raffie
Name: 
Raffie
Email: 
raffie326@gmail.com
Raffie, about 90% of the urologists in the United States are male. (I have one that's in the 10%, by personal preference). So it's a bit disingenuous to suggest men are dying in the U.S. because they don't want a female doctor examining their genitals. Records show that men have had a lower life expectancy than females in the U.S. for more than one hundred years, at least. That obviously isn't because of a glut of female doctors because even as recently as 1990, only 17% of doctors in the U.S. were female (source: Women in Medicine: A Review of Changing Physician Demographics, Female Physicians by Specialty, State and Related Data - by Staff Care, a company of AMN Healthcare (NYSE: AHS). Re: your comment "No matter how pretty, educated, or clever a female healthcare worker may think she is, she cannot ever totally empathize with a male patient when the issue at hand is gender specific." That's pretty silly when you think about it. It's true that neither my regular doctor (female) and urologist (female) can't ever experience my difficulties with erectile dysfunction and prostate issues, nor can their female support staff who seems to always be in the room when I'm exposed, examined or when my issues are discussed in detail. But that's like saying one would never want to be treated by a doctor after a heart attack unless that doctor has had one too. Or to be treated for severe vision or hearing problems unless that doctor has suffered from similar problems. Or for a loss of a limb unless that doctor lacks one. Women have for the entire lifespan of this country sought and received intimate care involving life and death issues mostly from men because until only in recent decades they pretty much had no other choice. Yet some men continue to say they won't see a doctor because a woman might see his penis? As for more men working in the nursing field, just as you and I may have sex preferences for care, working men have preferences, too. But if you understand economics, then you understand the laws of supply and demand. There is neither a great supply of male nurses (about 10%) nor seemingly a great demand. One solution may be to mandate triple the pay rate of women for male nurses and office support staff to increase supply and mandate the firing of half of the female nurses and office support staff in this country to satisfy your "demand" for equalized staffing levels. You think the country's already fragile health system could handle that? You think that would be constitutional, also? Or, if then not to have unequal pay for male nurses to encourage more men to enter that field then I would ask, are you in the nursing field? If not, are you willing to switch your vocation (and possibly a pay cut) to help with the supply problem? While I completely agree with the notion that it would be preferable for ALL persons, men and women, to be able to have the doctor and support staff of their preferred sex (and not necessarily those of the same sex as their own), it's a much more complicated issue than just blaming the health care industry. Unless this issue is resolved to everyone's satisfaction (to which I would refer you to a quote by Abraham Lincoln), in the meantime men who stubbornly refuse to accept the gracious care of females to help save their lives need to hold themselves accountable for their own actions - and the results.
Name: 
PV
Email: 
phillip.virgencito@mail.com
Men have a lower life expectancy partly due to our healthcare system. If the healthcare industry ever took the initiative and outside of a medical setting actually took the time to just ask men to be brutally honest as to why they don’t take better care of themselves, they would be surprised at the answers they got. Many men are treated like objects not human beings and they are tired of it. They’re expected unlike female patients to hand their dignity and respect over at the door then put up, shut up, and do as their told. Men are tired of being embarrassed and humiliated by the medical community so their only recourse, is to sue and/or walk away. The healthcare system’s business model is based on two stereotypes. The male stereotype is eons old and should have been revised years ago but to save money, the system chose to ignore men’s healthcare needs and concentrate on women’s. Case in point, the government has an Office on Women's Health. Where’s the men’s office? It’s not existent. One sees women’s healthcare clinics going up all over the country. Where are the all-male clinics? You won’t find a male mammographer doing women’s mammograms. Why is that you suppose? It’s because women spoke up & said NO. Just like in L&D. No men allowed. Now men are saying in certain situations, especially urological ones, men want their dignity respected and privacy protected so some men choose not to have women involved in their care. Their request should be honored by the system as it honored the women’s request. What’s good for the goose is good for the gander. The healthcare system cannot give one gender preferential treatment and ignore the other. That will lead to a class-action discrimination lawsuit that nobody wants and the industry cannot win. Whether one’s personal preference is for either same-gender or opposite-gender medical care, their choice should not only be respected by all but also accommodated by every healthcare provider and their affiliates. The system is trading men’s lives for the almighty dollar. When women lose their fathers, brothers, husbands, and sons to an early death, maybe then they’ll see the light and speak up. My comment about not putting a female healthcare worker with a male who is going through a male specific issue is spot on as she doesn’t have the same plumbing & will never be able to truly empathize with him. Logically he should be offered male care if he wants it. The system can never be truly patient-centered like they say they want it to be while male patient’s preferences are being ignored. The system has problems. It’s proven beyond any shadow of a doubt they cannot fix it themselves. It’s going to take a mutual effort by the medical community and the general public working together to fix it. Two things the healthcare system knows about. Do No Harm and CPR. Two have a patient-centered healthcare system, each patient must be given Choice, Privacy, and Respect. Without Do No Harm and CPR, you cannot build a healthcare system that works for everyone. For now, it’s time to put a choke collar on the healthcare system and hand the leash back to the patient’s where it should be.
Name: 
Raffie
Email: 
raffie326@gmail.com

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The healthcare future is female