The following manuscript was submitted to the September 2017 Women in Medicine theme issue.
“You’ll catch more flies with honey than vinegar,” the attending said.
I must have looked confused, because he followed by saying, “You do know what that phrase means, don’t you?”
Funny. I must have been sick the day we went over this in med school. But what a relief to know my attending can identify important gaps in my medical training.
Another example of this thoughtful guidance came from an emergency physician who suggested I freeze my eggs. How lucky am I to be surrounded by colleagues who have studied fertility in addition their chosen specialty?
The first situation described above occurred after informing my attending of how I handled two recent professional disagreements. The second situation occurred with no prompting, no inciting discussion, but genuine concern from a senior physician. The insinuation of it all cuts me deep. The insinuation that being assertive is synonymous with demanding. The insinuation that flattery is the better way to get what I want. The insinuation that my body is open for indiscriminate discussion. The insinuation of a general distrust in women, without which we might have a female president.
I wanted to know how other females in medicine felt on the subject of misogyny in medicine. I compiled a survey with 10 questions and space for comments. I used SurveyMonkey to create it, shared it publicly across social media, and trusted that only those who identified as female would complete it. I admit to a complete disregard to the rules of research. The results are as follows:
When asked if gender played a role in missing out on a raise, promotion, key assignment, or a chance to get ahead, 33% or women responded “yes” and provided the following comments:
“The men who worked with me in the ER made more money than I did and got more bonuses.”
“Pregnancy prevented my promotion to charge nurse.”
“I was in line to do compressions in a code. A resident told me that women were not allowed to do them. When I asked why, they said ‘women were weaker and bad at it.’ I was outraged and demanded that I get to participate like my fellow male students. I was kicked out of the room.”
When asked if they ever felt pressured to play a stereotypically feminine role at work, 46% of participants answered “yes” and had this to say:
“You’re a cute girl, go talk to him [the patient]. Maybe he will be less confrontational with you.”
“We had a female medical student with a body odor problem, and my chairman (a man) thought that the conversation [with that medical student] would best come from a woman. So even though the director of medical students wanted the conversation to come from the chairman, it came from me.”
When asked if they have ever been mistaken for someone in a position other than their own, such as administrative or custodial staff, 71% of participants answered “yes” and among female physicians, the following theme emerged:
“Patients assume that I am the nurse, even in instances where I have been professionally dressed in a white coat.”
“About daily, I am referred to as a nurse or ‘lady.’ Patients speak to my junior male residents when I ask them questions as the chief resident leading rounds.”
“Almost always assumed (by men and women) that I am a nurse.”
“I was and am constantly called a nurse. Even when I walk in and introduced myself as a doctor.”
“Nurse.”
Of the 21 participants who identified as female and an ethnic minority, 66.7% answered “yes” when asked if they have had to provide more proof of competence than others at work, including white females.
“I’ve often been told to rely on being a black female to get ahead in life or that my placement in a residency program would fulfill affirmative action quotas.”
“I wear a Muslim headscarf, so I obviously stand out. I’ve always felt that I have had to work harder than other women to prove myself and my competency.”
“I will say that being Hispanic was not an issue anywhere I have ever lived until I moved to Colorado Springs.”
“As an Indian-American woman, I would say yes and no to this. Southeast Asians are a significant proportion of the medical community so though I feel that patients do not require more evidence of competence, but I feel that those in positions of power do. I am lucky to have worked in diverse environments and have felt less pressure to carry the weight of minority than female.”
When asked if they have ever experienced sexual harassment in the workplace, 44% of participants answered “yes” and shared the following experiences:
“Yes, but never by staff. Usually older men thinking it is okay to touch your butt or put your hand on their penis.”
“One of the surgeons in my core rotation was horribly inappropriate. I did not report him of course. I tried to avoid scrubbing in with him but at times it was unavoidable. It was the only ‘B’ I received during clinicals.”
“I’ve had lurid comments made, but luckily in my capacity as a medical practitioner, nothing comes to mind. The problem with that is, that I may be so used to the subtle instances that I don’t even recall them as abnormal or inappropriate.”
When asked if they felt females supported one another in the medical field, 39% of participants answered “no” and had this to say:
“Not always. Some women are catty, the old saying that ‘nurses eat their young’ is true in many settings.”
“I don’t think this is a yes or no question, but in my experience, I lean more towards no. I’m not sure if this is because medicine is so competitive, especially during medical school and residency, or because women are generally more unsupportive of other women. Or maybe it is because of the types of women who are in the medical field are more competitive in nature.”
“I feel like the environment is so cutthroat that people in general don’t look out for one another. It’s mostly about who can get ahead and who can outperform one another. The medical field can be a toxic community for those up and coming and I feel like this needs to be changed.”
“I have great female colleagues now. There are very supportive of each other and empowering.”
When asked about the importance of the role the President and Congress play in addressing female issues at work, participants responded as follows:
Extremely important: 34%
Very important: 27%
Somewhat important: 21%
Not so important: 13%
Not at all important: 4%
“Our current president’s role modeling about attitudes about women and bragging about sexual assault is actively culturally damaging. His blatant sexism and racism normalizes this behavior in others.”
“If our president can admit to blatant sexual harassment and assault on national television with no repercussions, we’re all in a bad place.”
“When Trump won, the boldness of racist and sexist healthcare workers instantly surfaced. There were three people I worked with who in early November, seemed like tolerant people. By mid-November, they openly discussed their bigoted ideals.”
“Let’s be real, with the current administration, these issues would never be addressed because they don’t believe they are happening.”
Why bother practicing chest compressions when you’re a woman? Why assert yourself in a flourishing culture of sexism and racism? I’ll tell you why — because until enough of us agree that enough is enough, the cycle continues.
Humans have been blessed with the ability to communicate, connect to, and understand one another’s experiences. Yet, we turn our heads in favor of protecting individual agendas, instilling fear, and stamping out well-deserved confidence. Tell your story. Listen to someone else’s. Seek and speak a truth outside your own. And be a little demanding if you must.
Resident Physician Contributing Writer
Providence Hood River Memorial Hospital
Morgan is a family medicine resident at Providence Hood River Memorial Hospital in Hood River, OR. Her interests include the social determinants of health, rural medicine, and women's health. Outside of medicine, she enjoys writing, traveling, and nature.