Listening, collaborating, rebelling
against long work hours, women physicians are redefining the
good doctor. What does it mean for you?
When Nancy Hardt attended Loyola University medical school back in
the mid-'70s, there were just enough women in her class to fashion
a nucleus of close friends who supported and commiserated with each
other. "We were," she says, "right at the beginning of being more
Women in medicine are token no more. The ratio of men to women in
the profession, 12 to 1 in 1970, shifted to about 3 to 1 by 2000.
The balance is even closer in U.S. medical schools, where a
continually steady increase in the number of entering women
students has yielded a near-equal gender split. As the recently
minted director of the University of Tennessee's Institute for
Women's Health in Memphis, Hardt sees firsthand how a small corps
of female pioneers has multiplied - and, in the process, forced a
not-so-subtle change in the way medicine is practiced in the United
For decades, the medical field was dominated by one central
archetype: the im-perious, job-addicted male delivering rapid-fire
diagnoses and rushing from case to case. But now that Type A doctor
shares the stage with women who are credited with being more
team-oriented than their male colleagues, better at taking time to
communicate with patients, better at striking a balance between
career and family. And often, just better doctors.
"I think it's creating a softer side of medicine," Hardt says.
Dr. Rodney Meeks knows firsthand that women doctors often possess
better one-on-one communication skills than men. He's seen them in
action. That makes it easier for him to consult a woman doctor when
he's in need of care, because he's confident that women are as
capable as men when it comes to practicing medicine.
"On a personal level, I don't have a preference [for women]," he
says. "I just like to see a doctor I have confidence in and can
talk with. I find it very easy to have women look after me."
So do many others, and perhaps just in time. The 78 million-strong
baby boomer generation is edging into their mid-50s, and they are
demanding more medical help to deal with aging. As a group, baby
boomers aren't satisfied with a prescription and quick advice. They
want dialogue. That's not always easy to offer, either, as doctors
of both sexes complain that health insurers force them to choose
between seeing more patients - and devoting less time to each one -
or losing income.
But according to a fresh study by University of California-Davis
researchers, women doctors manage to give more time to their
patients than their male colleagues do. Conducted by UC-Davis'
Health Services Research in Primary Care, the survey of 509
patients and 100 doctors concluded that women doctors are more
likely to take time to counsel their patients. They're also more
likely, the investigators found, to order preventive screening
tests, which lead to advanced warnings of disease.
Meanwhile, a separate study found that women doctors emphasize
compassion in their work, while male doctors believe their
competence is more important.
It seems that it's this combination of time and compassion that
patients desire. In the UC-Davis study, patients of women doctors
were 27 percent more satisfied with their physicians than were the
patients of male doctors - even after adjusting for the patient's
gender, age, and other demographics.
The historical role of women as caregivers might also factor into
that preference, says Peter Franks, one of the UC-Davis
researchers. If male physicians are perceived as authority figures,
then patients may be less threatened by women and therefore more
likely to voice their satisfaction with women doctors. "Women have
traditionally been identified as having a more nurturing role," he
The best male doctors have been quick to imitate their nurturing
female colleagues. "Men are more focused on the goal or endpoint of
therapy and not necessarily the progress to that goal," Meeks says.
"[Women have provided] a different perspective, and I think it has
altered the interaction men have with patients."
Though it appears that male doctors have much to learn from their
female counterparts - and though more women enter the profession
each day - full, professional equality remains elusive.
In fact, women's desire to balance their work and personal lives
has cost them in income and advancement. Hardt notes that women are
less likely to study surgery or other specialties that still demand
grueling workloads. Women are also less likely to be tapped for
academic promotions, and their average earnings suffer. The AMA's
Center for Health Policy Research concluded that female physicians
earned $120,000 on average in 2000, well behind their male
colleagues' $195,000 average.
In part, says Hardt, that may just be a reflection of women's
hesitancy to sacrifice personal needs for professional advancement.
Or it could also be a sign of the old-boy network dynamics at work
when male doctors go to the golf course and women go home to their
families. "If you don't do things guys do," she adds, "you miss
that business opportunity."
At the same time, though, women's insistence on reasonable working
hours may be essential to improving healthcare. With an average
workweek of 48 hours, women doctors are less likely to push
themselves into burnout than men, who clock, on average, 57 hours a
week. While medical residents' work hours are now capped by law,
the large concentration of women in medical school has helped curb
demands for near round-the-clock service from bleary-eyed
That emphasis on controlling work hours and balancing work and
personal concerns, says Lynn Epstein, president of the American
Medical Women's Association, is at the heart of today's efforts to
reduce medical errors and increase the quality of healthcare.
Which is a big change for the better for the entire profession,
says Meeks. "All of medicine has changed a little bit," he says.
"Understanding that working long hours should be tempered is a real
positive thing for men and women."
Women doctors also are changing medicine in ways patients don't
immediately see. Case in point: In one notable study by Harvard
Business School, younger physicians who took extra time to work
with teams of colleagues in learning a new method of cardiac
surgery mastered the process much faster than their older, more
experienced counterparts, who preferred to give orders rather than
That accelerated learning was true for everyone, regardless of
gender, but for women, the personal approach necessary for teamwork
just comes more naturally. "Most people would say that a stereotype
of women would be that they take the time to listen, validate what
they hear, and make sure there is agreement and understanding of
what was recommended," says the AMWA's Epstein. "That's good
medical practice. The best doctors do that."
Meanwhile, the growing legions of women doctors have pushed a
long-overdue refocusing of medical research, says Dr. Nanette
Wenger, a nationally prominent cardiologist and professor at Emory
University School of Medicine. "There was so much emphasis on the
health of men in this country, that in some respects women's health
was neglected," says Wenger, a 1954 graduate of Harvard Medical
School. "Women in medicine are becoming the advocates for getting
They're also becoming advocates in the political arena, which could
be the acid test of Venus' influence on medicine. The American
Medical Association - historically dominated by older, white, male
physicians - has long opposed healthcare reform that would create a
single source of health coverage for all Americans, under a
government-financed model similar to Medicare. But Epstein says
that a recent survey of her AMWA members - women doctors - shows
their growing warmth for single-payer reform.
If women doctors could push such sweeping change in healthcare,
then their power would go far beyond the one-on-one influence they
now have on their patients and colleagues. But if more male doctors
simply follow women physicians' example of a collaborative,
patient-oriented approach to their jobs - as well as spend more
time with their families and sleeping, and less in the O.R. - then
we might all be better off.