Hold on--it's just starting. Women will absolutely change the face of medicine. About time.
Across the board, more physicians than ever are female, and it's changing medicine...finally. The GOBs are horrified, of course. But most interesting is yet to come.
Here’s an interesting question: What happens if it takes 11 years at minimum to train someone for a career in which there are significant shortages, and then make that person the gateway for all other services…and that person refuses to play by badly outdated spoken and unspoken rules?
A bit of background before we talk about her.
If there’s any industry dominated by the ‘live to work’ ethos of Boomers, medicine would be it. I’ve had [male] physicians on four continents complain to me about how “young doctors don’t want to work hard.” They mean young doctors of either gender, but they are particularly incensed about women’s perspectives on balancing family and career.
That “work hard” of course is a defining difference between Boomers who, even well past retirement, are still divorcing in record number, and Millennials, who confound Boomers with a ‘work to live’ mentality…AKA “My Boomer parents divorced when I was a kid and I’d really prefer not to do that to mine.”
Medicine today is another canary in our traumatized national coal mine. Health economist and analyst Jeff Goldsmith has a great post on just how badly the US thirst for profit is decimating great clinical care, IMO a primary reason our once-vaunted ‘best in the world’ health system is frustrating an entire nation, something recent events vividly demonstrated.
Medicine itself is not without blame for the mess. “Helping people” is still the dominant theme among those going into medicine; there are quicker studies and easier careers with better hours and pay. However, smart med students do quickly figure out which specialties make a lot more money than others, and that discovery rapidly feeds into specialty selection. [Note this specialty income data is from “the most widely-read, physician-specific personal finance and investing website in the world.” See particularly the comment about physician salary increases “not enough to satisfy them.” — italics mine])
As you view the AAMC gender article, keep in mind the big bucks for doctors are in surgical specialties, rewarded most by our national policies, where glory is rewarded more highly. There’s a reason for severe shortages in primary care—medical specialties like pediatrics, OB-Gyn, and internal and family medicine, where pay is significantly less. In the data, note the growth of women in those medical specialties—the ones that prevent problems, not head straight to the OR first. Remember, primary care is also the gatekeeper for access to all other specialties. PCPs are the ones who approve, or not, referrals to surgical specialties. It’s power without pay, an as-yet unrecognized potential for disruption in a staid field firmly rooted in the past.
While female physicians have long shown they can adapt negative stereotypes of often primarily male mentors, contemporary anecdotal and quantitative evidence supports generally higher patient satisfaction with female physicians. As one study put it, “Female physicians conduct longer visits than male physicians, with negative implications for their compensation. Yet patients often report higher satisfaction with female physicians.”
Specialty medicine is really only a century old, largely designed and dominated by men; most careers in the 1900s were. Pioneering is always respected. But as my colleagues in Japan have long noted, continuing that approach means we’re only getting the best of half of the population.
Like just about everything else in our current Fourth Turning chaos, US medicine and healthcare are predictability in turmoil. I’d suggest it will be women who will get the ‘care’ back in healthcare, overturn default work hours most closely resembling permanent fraternity hazing rituals safe for neither patients nor providers, and put “prevent” and “connect” back into the equation. If it takes 11 years to become a specialist in an underserved specialty, and you dominate that specialty, and you won’t play by outdated rules…there’s some interesting power there. Stay tuned.