Gender Inequality in the Medical Field

Introduction

The medical field is consistently one of the best job fields to enter because of the positive job outlook and high salary. This may not be true for women, however. The large amount of gender discrimination and harassment may be enough to keep women away from the medical field, specifically female doctors. In this day and age there is no reason why women cannot become doctors and they are not lesser than their male peers, especially in the 21st century.

This literature review will look at the problem of gender discrimination both in the United States/Canada and throughout the world. It will also highlight specific solutions given by experts, leaders, and women in the medical field.

The Problem

Women doctors are underrepresented, discriminated, and harassed simply because of their gender. There is no evidence that suggests that men are smarter than women or more capable doctors. The question still remains, why is gender bias and discrimination still present within hospitals and academic medical institutions and how does it affect those women? Kazumi Kawase et al.’s article highlights the underrepresentation of female surgeons and the barriers present in the medical field. Researchers conducted a study to find the reasons for the lack of female leadership and the attitudes toward career advancement. They used findings from a previous questionnaire to create the survey, which included important factors for career advancement, three strengths of female surgical leaders, and the three most barriers for women surgeons (Kawase et al. 259). The study found that women surgeons are strongly motivated to pursue a surgical career, even if it impacts their life style. It also found differences in gender equality depending on the culture. For example, female surgeons in Finland showed the highest rate of negotiating to improve inappropriate conditions. The Nordic countries have long been known for their gender equality ideologies. On the other hand, women in Japan report high levels of exhaustion because they are responsible for domestic duties as well as their career and in their culture, women are expected to do all the housework. Although the number of female surgeons is increasing, the gender gap is still present and needs to be addressed in order to find solutions (Kawase et al.).

Gender bias not only affects doctors, but patients as well. An article by Gaetan Cousins et al. seeks to understand if gender affects patient outcomes when physicians express uncertainty regarding the diagnosis or treatment. Cousins’ article takes the results of previous research done on patients harshly criticizing female physicians as opposed to their male colleagues. The researchers predicted that female physicians expressing uncertainty would have a negative effect on patient satisfaction. Through the research conducted, the researchers’ hypothesis was confirmed. This brings up the question as to how female physicians should bring up uncertainties in medical conditions and what they can do to counteract the negative impact uncertainty has on their patients. This study can be very useful to female doctors and help inform them of their communication habits and how to improve patient satisfaction. This can also inform hospitals and other institutions of the double standard of female doctors and how to combat them (Cousin et al.).

Opening up about sexual harassment, especially in the workplace, has become a widespread movement affecting many different fields, including the medical field. The article by Sophie Soklaridis et al. addresses the #MeToo movement which has become a widespread campaign for the fight against sexual assault and harassment. The article focuses specifically on the movement in the medical field and how more and more female doctors have been challenging the inappropriate treatment found in medical school and the workplace. In response to this movement, many men in positions of power have voiced their concerns about mentoring women. They are afraid to be accused, which could compromise their reputations and careers. Because of this mindset, women are unable to advance far in their careers due to a lack of mentorship and statistics show that medical workplaces do not sufficiently support women in their career advancements. Men’s fear of being accused contributes to these statistics and this source offers explanations as to why. This source also provides different scenarios of men in power being afraid to talk to their women subordinates and provides different approaches to potentially sexist situations (Soklaridis et al.).

These articles highlighted the overarching problems affecting female doctors, including gender bias, discrimination, and harassment. The articles by Kawase et al. and Cousins et al. both talked about the gender bias present in the workplace and how it affects women. Kawase et al. focused more on the worldwide problem and used specific cultures as examples as opposed to Cousins’ which was focused more in eastern Europe. It also concluded that women should try changing in order to change patients’ perceptions. Soklaridis’ article disagreed with this and said that things need to be changed on the leadership side of medicine. The article by Sokaridis et al. also focuses more on sexual harassment and how it disadvantages women in medicine. I really liked how these articles gave statistics and not only highlighted the overall problem, but also how it specifically affects women. These articles lacked specific, central solutions to the gender inequality problem present in the medical field, however, which is something I explored in the next articles.

First Step to Equality

One of the solutions given by many experts and leaders regarding gender equality is bringing awareness to and addressing the problem. The purpose of the article by Rochelle Jones et al. is to address of lack of diversity in radiation oncology and how to best promote equality and inclusion. Researchers conducted phone interviews with radiation oncology department chairs to gain insight into the role of women and underrepresented minorities in these positions and potential solutions to promote diversity and inclusion. Through these interviews, researchers found five common themes: commitment to diversity/inclusion promotes health care, gaps still remain, women continue to face challenges, the realities of gender need to be acknowledged to find solutions, and the career pipeline needs to expand. Researchers also found that current department chairs are committed to these initiatives. Some specific solutions discussed were recruiting and supporting diverse medical students, growing the female workforce, and bias training that discusses intersectionality and gender inequality. All in all, these findings supported the notion that addressing these issues is important to finding solutions and improving quality healthcare (Jones et al).

In comparison to Rochelle Jones et al.’s article, Roxanne Keynejad et al.’s article provides a broader perspective. It focuses on gender equality in the field of global health. Surveys were done in Somaliland and the United Kingdom to measure diverse experiences in the workplace including leadership, missed opportunities, workplace barriers, and expressing views. Many respondents described experiences such as gender-related barriers, pay gaps, and unequal treatment regarding females in healthcare roles. The respondents also proposed solutions to the gender equality present in the medical field. One common theme throughout these solutions was community awareness and better legislation and policies. Many respondents think that more awareness in both the community and government would instill a sense of duty to change the workplace environment for women. The purpose of this study was to understand gender roles and inequality in healthcare all over the world and “taking the crucial first step of starting a conversation” (6). The researchers hope that medical centers around the globe can use this information to change workplace environments and address the gender inequality present within the medical field (2018).

Both articles supported the overall claim that the first step to gender equality in medicine is more awareness. Keynejad’s article focused more on the world, which provides an applicable solution for all cultures, while Rochelle Jones’ focuses more on culture in North America which is more applicable to me. I think these solutions are good starting points for solutions for gender inequality.

Women in Leadership Positions

The idea that putting women in positions of power will decrease the amount of gender discrimination is another solution proposed by many doctors and experts. This is easier said than done, however, but it is good to bring attention to the lack of women in leadership roles in the medical field. Dr. Rebecca Allen accomplishes this in her article. She highlights the ongoing gender discrimination in medicine and how women need to be put into positions of power in order for things to change. The author specifically focuses on the consequences of women’s actions, the disparity in salary and promotion, and the childcare responsibilities of female doctors. She begins by talking about how strong women are perceived, such as Hillary Clinton, and how women in positions of power are scrutinized more harshly than their male peers. She also points out that scientific potential and achievement are perceived differently depending on the gender and that women are discouraged from negotiating for higher pay. They are seen as “dominant and arrogant” (2) if they speak up, but “weak and gullible” (2) if they say nothing. Dr. Allen concludes by pointing out that women have made many advancements, but expectations of women need to change and that will only happen if women are put in leadership positions. This article provides applicable points that can be used by hospitals and administrations that can help solve these problems and that have the power to put women in leadership positions.

This author had many intriguing points regarding the presence of sexism in medicine, although she did not offer any specific solutions. She said we have to put women in leadership positions but how do we make that happen? Overall, this source is very relevant to the medical field today and provides important insight to the disparity between men and women doctors not only in medicine but in other fields as well (2017).

Reena Pattani’s article explores the impact of the underrepresentation of women in medicine and more specifically in leadership roles. Research was done to show the impact by gaining the perspectives of faculty members in a department of medicine and trying to identify how the gender gap affects effectiveness and workplace culture. Many of the subjects interviewed were aware of the gender gap and its impact on organizational effectiveness and workplace culture. They specifically highlighted social exclusion, reinforced stereotypes, and unprofessional behavior. These can have direct effects on workplace cultures and patient care. Some potential solutions provided were improvements to recruitment and hiring, changes to the work environment, and better mentorship opportunity. Overall, this study found that the existing gender gap in medical centers has a negative effect on patient care and workplace culture. This information can be useful to medical centers and can help implement better conditions for female doctors to fight this negative effect (2018).

Both of these authors agreed that putting women in leadership roles within the medical field is a great, overarching solution to gender inequality. These solutions provide a great start for change in the medical field and even throughout the world. Dr. Rebecca Allen’s article provides a nice base for Reena Pattani’s article, but Pattani’s article provides more specific solutions to the overall problem. Pattani’s article also focuses more on the workplace environment and how it affects more than just the female employees. I liked how Pattani’s article went more in depth.

Specific Solutions

The only article to focus on and give specific solutions is Dr. Anna Morgan’s article. She proposes five solutions to address gender-based bias in the medical field and influence those in power to instill change. This article recognizes gender bias as the “elephant in the room” (Morgan et al. 966). This saying refers to the slow-moving progress towards equality. The first solution proposed is simply addressing the lack of gender equality. The author says that by publicly identifying the problem is the first step to solve it. The second solution is the support of those in positions of power, particularly men. Dr. Morgan points out that simply publicly supporting female medical leaders can influence other leaders to do the same. The third solution is incorporating anti-sexist training. Studies have shown that programs have begun producing improvements in gender bias. The fourth solution is working with diverse groups of people to discuss how to make workplace environments more receptive for women. The final solution is to study the drivers of gender discrimination within medicine in order to figure out how to end it. These five solutions can help medical communities address and combat gender discrimination and bias (Morgan et al.).

I really liked how Morgan’s article gave specific solutions to the overall problem of gender bias in medicine. It covered not only addressing the issue and women in leadership positions, but also more specific solutions such as anti-sexist training and working with diverse groups to brainstorm solutions. Many of the other articles such as Dr. Anna Morgan’s and Roxanne Keynejad’s, just highlighted an overarching solution, but specific solutions were up to the interpretations of the readers and especially medical leaders. This can prove to be ineffective because many leaders could make the excuse that there are no solutions. By highlighting specific solutions, it gives medical communities no choice but to instill these solutions into work environments.

Conclusion

Gender bias and discrimination is still a major problem in healthcare systems throughout the world. Many studies have been conducted to prove that the discrimination exists and that it not only affects women, but also the workplace environment and patients themselves. Although women are making huge strides in gender equality, it is not enough and requires action from men, and more specifically medical leaders.

Many solutions were given by the authors of these research articles and one common theme was that the more female leaders in medicine, the fewer the problems. Authors also said that just simply addressing the problem can make a huge difference in the treatment of women. By taking these potential solutions into consideration, the lives of many female doctors can improve and gender bias and discrimination can be eradicated from the healthcare system.

I would like to explore these topics and solutions in the local context, especially within the medical school. I think it would be interesting to compare the statistics of the UND medical school with medical environments all around the world. It would also be interesting to see if there are any disparities between the experiences of male and female pre-med students.

Works Cited

1. Allen, Rebecca M. “Gender Inequality in Medicine: Too Much Evidence to Ignore.” Psychiatric Times, vol. 34, no. 5, May 2017, pp. 1–5. EBSCOhost, ezproxy.library.und.edu/login?auth=cfl&url=https://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=123250047&site=ehost-live&scope=site.
2. Cousin, Gaetan, et al. “When Physician-Expressed Uncertainty Leads to Patient Dissatisfaction: A Gender Study.” Medical Education, vol. 47, no. 9, Sept. 2013, pp. 923–931. EBSCOhost, doi:10.1111/medu.12237.
3. Jones, Rochelle D., et al. “Qualitative Assessment of Academic Radiation Oncology Department Chairs’ Insights on Diversity, Equity, and Inclusion: Progress, Challenges, and Future Aspirations.” International Journal of Radiation Oncology, Biology, Physics, vol. 101, no. 1, May 2018, pp. 30–45. EBSCOhost, doi:10.1016/j.ijrobp.2018.01.012.
4. Kawase, Kazumi, et al. “Factors That Can Promote or Impede the Advancement of Women as Leaders in Surgery: Results from an International Survey.” World Journal of Surgery, vol. 40, no. 2, Feb. 2016, pp. 258–266. EBSCOhost, doi:10.1007/s00268-015-3332-x.
5. Keynejad, Roxanne C et al. “Gender equality in the global health workplace: learning from a Somaliland-UK paired institutional partnership” BMJ global health vol. 3,6 e001073. 7 Dec. 2018, doi:10.1136/bmjgh-2018-001073
6. Morgan, Anna U., et al. “Eliminating Gender-Based Bias in Academic Medicine: More Than Naming the ‘Elephant in the Room.’” JGIM: Journal of General Internal Medicine, vol. 33, no. 6, June 2018, pp. 966–968. EBSCOhost, doi:10.1007/s11606-018-4411-0.
7. Pattani, Reena, et al. “The Perceived Organizational Impact of the Gender Gap across a Canadian Department of Medicine and Proposed Strategies to Combat It: A Qualitative Study.” BMC Medicine, vol. 16, no. 1, Apr. 2018, p. N.PAG. EBSCOhost, doi:10.1186/s12916-018-1032-8.
8. Soklaridis, Sophie, et al. “Men’s Fear of Mentoring in the pass:[#]MeToo Era – What’s at Stake for Academic Medicine?” New England Journal of Medicine, vol. 379, no. 23, Dec. 2018, pp. 2270–2274. EBSCOhost, doi:10.1056/NEJMms1805743.

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