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The Changing Face of Medicine

The Changing Face of Medicine: Women Doctors and the Evolution of Health Care in America

Ann K. Boulis
Jerry A. Jacobs
Copyright Date: 2008
Edition: 1
Published by: Cornell University Press,
Pages: 280
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  • Book Info
    The Changing Face of Medicine
    Book Description:

    The number of women practicing medicine in the United States has grown steadily since the late 1960s, with women now roughly at parity with men among entering medical students. Why did so many women enter American medicine? How are women faring, professionally and personally, once they become physicians? Are women transforming the way medicine is practiced?

    To answer these questions, The Changing Face of Medicine draws on a wide array of sources, including interviews with women physicians and surveys of medical students and practitioners. The analysis is set in the twin contexts of a rapidly evolving medical system and profound shifts in gender roles in American society.

    Throughout the book, Ann K. Boulis and Jerry A. Jacobs critically examine common assumptions about women in medicine. For example, they find that women's entry into medicine has less to do with the decline in status of the profession and more to do with changes in women's roles in contemporary society. Women physicians' families are becoming more and more like those of other working women. Still, disparities in terms of specialty, practice ownership, academic rank, and leadership roles endure, and barriers to opportunity persist. Along the way, Boulis and Jacobs address a host of issues, among them dual-physician marriages, specialty choice, time spent with patients, altruism versus materialism, and how physicians combine work and family.

    Women's presence in American medicine will continue to grow beyond the 50 percent mark, but the authors question whether this change by itself will make American medicine more caring and more patient centered. The future direction of the profession will depend on whether women doctors will lead the effort to chart a new course for health care delivery in the United States.

    eISBN: 978-0-8014-6349-5
    Subjects: Health Sciences

Table of Contents

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  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Acknowledgments
    (pp. ix-xii)
  4. 1 Introduction
    (pp. 1-14)

    Betty Friedan was very proud of her daughter the doctor. Friedanʹs 1963 book The Feminine Mystique helped to spark the second wave of the womenʹs movement during the 1960s, and Friedan went on to help establish the National Organization for Women. Her daughter, Emily, entered Harvard Medical School in 1978, just as the number of young women in medical school classes began its rapid ascent.

    Encouraging oneʹs daughter to pursue a career in medicine is no longer an unusual idea restricted to feminist leaders who happen to be Jewish. In fact, Americans are now more likely to report that they...

  5. 2 Feminization of an Evolving Profession
    (pp. 15-40)

    Over the past several decades health policy researchers and social scientists have debated the status and prestige of the medical profession. While there is nearly universal agreement that medicine enjoyed a uniquely privileged place in our society during the 1950s and 1960s, in the 1970s some policymakers and social researchers began to observe and forecast declines in the earnings, autonomy, control, and prestige of physicians in the United States (McKinlay 1977; Haug 1973). Although the voices predicting that the sky is about to fall on modern medicine have grown in number over time, until recently they have been matched by...

  6. 3 Applying for Change
    (pp. 41-64)

    In Chapter 2 we asked whether a decline in the status of the profession precipitated a decline in menʹs interest in medicine, thus paving the way for womenʹs entry. Despite the many challenges to the profession, physicians remain highly respected and well compensated. There was a drop-off in the number of menʹs applications to medical school during the 1970s and 1980s, but this was followed by sharp increases during the 1990s. Government efforts to reduce discrimination played an important role in opening doors for women, as did the growth in the size of medical school classes. In this chapter we...

  7. 4 The Gendered Map of Contemporary Medicine
    (pp. 65-85)

    Thus far our focus has been on womenʹs entry into the medical profession as a whole. Now we turn to the question of how women are faring once they enter the profession. Substantial gender-based disparities remain within the medical profession. In the following chapters we examine how such differences have changed since women began entering medicine in significant numbers, and what factors are responsible for the persistent gaps between the career experiences of male and female physicians. In contrast to much prior research which emphasizes individual choice, we suggest that a more complete account requires a discussion of structural changes...

  8. 5 Gender, Sorting, and Tracking
    (pp. 86-112)

    In the previous chapter we offered a detailed portrait of womenʹs place in the medical profession. It is clear that women are not distributed equally across all segments of medical work. They continue to cluster disproportionately in the lower tiers of the medical hierarchy. There has been significant absolute growth in the number of women at all levels and in all facets of American medicine. While womenʹs distribution across specialties has become slightly more even, the numbers of women in research and in leadership positions have not kept pace with the growing numbers of women physicians

    In this chapter we...

  9. 6 Work, Family, Marriage, and Generational Change
    (pp. 113-131)

    Over the previous chapters we have covered a great many aspects of womenʹs dramatic entry into medicine and the enduring differences in the practice patterns between male and female physicians. Women doctors continue to be underrepresented in certain specialties and in the upper echelons of the profession, and they earn significantly less than their male counterparts.

    Now we turn our attention to how gender affects physiciansʹ lives outside of work. We explore how differences in the family life of male and female physicians have evolved as womenʹs presence in the profession has grown. What kinds of personal lives do male...

  10. 7 Women Physicians Caring for Patients
    (pp. 132-152)

    In this chapter we examine how gender is related to the nature and quality of care provided to patients. As the presence of women in American medicine has grown, researchers have repeatedly speculated about their impact on the practice of medicine. As an article in the New York Times Sunday Magazine once posed the question, ʺAre Women Better Doctors?ʺ (Klass 1988). Discussions in the medical press and among academic researchers have been drawn to the same question (Bluestone 1978; Hayes 1981; Abel 1992; Lorber 1984 and 2000; Levinson and Lurie 2004). One prominent theme in these discussions is that women...

  11. 8 Medicine as a Family-Friendly Profession?
    (pp. 153-186)

    Many have suggested that as the presence of women in medicine increases, the prevalence of family-friendly working conditions will also grow. For example, Levinson and Lurie maintain that ʺwomen are changing the profession itself. The effects can be seen in the work-family balanceʺ (Levinson and Lurie 2004, 472; see also Croasdale 2002; Croasdale 2004b; and Wardrop 2004).

    As we saw in chapter 6, women physicians remain unlikely to have stay-at-home husbands. As a result, these women rarely have the kind of family support system that allows some male physicians to work seventy or eighty hours per week. This type of...

  12. 9 Conclusion: A Prognosis for Gender and Medical Care
    (pp. 187-212)

    Since 1970 American medicine has been in a state of constant flux. As the overall size of the profession has grown, so too have its complexity, capacity, and diversity. Todayʹs physicians have a much larger arsenal of treatments, and as a result, they spend more years in training and specialize more than their predecessors.

    The funding and oversight of medical practice have also changed dramatically over the past generation. Todayʹs physicians must assume a larger portion of the cost of their education, and they must justify their professional decisions more than at any other time in the professionʹs history. Cost,...

  13. Appendix
    (pp. 213-228)
  14. Notes
    (pp. 229-234)
  15. Bibliography
    (pp. 235-260)
  16. Index
    (pp. 261-266)