Gender Disparities in Medicine

Gender disparities in careers and education are as relevant today in America, as in 1970.  This type of discrimination increases the likelihood that employers will deny women promotions and positions of leadership, due to the possibility that they might move or need a sabbatical after marriage or childbirth.  As a result, women are given jobs with few opportunities for advancement.  The term ‘glass ceiling’ has been coined to describe this systematic type of discrimination.  Features of the glass ceiling include any practice that favors men over equally qualified and motivated women.  As the glass ceiling analogy implies, a transparent or artificial barrier exists which keeps women from achieving substantial leadership roles.  Historically, earnings discrimination has been a part of the pollutions theory.  This theory suggests that a career looses technical expertise as women are admitted to the field.  In essence, the field has lost clout and men will soon leave.

Women entered the workforce in America, in large numbers in the 1960’s, however, careers still remain categorized by gender.  Librarians, customer service representatives, and teachers are female dominated fields, and pilots, executives, and engineers are considered male dominated fields.  The income disparity has closed some, but still exists.  Women’s earnings have increased and men’s earnings have reached a plateau.  Just because the cavity is not as deep does not imply that the void is insignificant.

Historical data should assist in the comparison of progress for women and diverse populations.  (Note:  The term diverse populations will be used as a substitute for the term minority.)  In 1965 only 5% of the enrollees in professional schools were women, however, the percentage increased to 40 % in 1985 in law and medicine, and 30 % in dentistry and business.   Highly effective oral contraceptives have allowed women to defer family additions and pursue careers of their choice.  This represents significant progress for a twenty-year time frame, while on the contrary may explain why disparities exist today.  In a historical sense,  the movement to correct the disparities is in its infancy.  Women are still underrepresented in executive leadership positions and boards of large corporations.  Medicine in its delivery, training, and education is not exempt from gender disparity.  We often expect disparities in incomes and careers in developing countries, but act shocked that this problem still exists at home.

A study conducted by Andra L. Blomkalns, M.D., et al, was printed in The Journal of the American College of Cardiology in March, 2005.  This study entitled “Gender Disparities in the Diagnosis and Treatment of Non–ST-segment Elevation Acute Coronary Syndromes: Large-Scale Observations from the CRUSADE (‘Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation’ of the American College of Cardiology/American Heart Association Guidelines) National Quality Improvement Initiative, gives a current analyses of gender disparity in medical treatment.  Blomkalns, et al, hypothesized that significant differences treatment exist between male and female patients presenting with non-ST-segment elevation (NTSE) acute coronary syndromes (ACS).

Women represented 41% of the participants of this study, of 35,875 total, and were older.  The median age of women was 73 vs. 65 for men.  The women of this study more often had diabetes and hypertension.  They were less likely to receive heparin, glycoprotein IIb/IIIa inhibitors, angiotensin converting enzyme inhibitors, and statins at discharge.  The use of cardiac catheterization and revascularization was higher in men.  Among patients with significant coronary disease, percutaneous revascularization was performed in a similar proportion of women and men.  “Women were at higher risk for unadjusted in-hospital death (5.6% vs. 4.3%), reinfarction (4.0% vs. 3.5%), heart failure (12.1% vs. 8.8%), stroke (1.1% vs. 0.8%), and red blood cell transfusion (17.2% vs. 13.2%), but after adjustment, only transfusion was higher in women.”  Blomkalns, M.D. et al.  In conclusion, women with NSTE ACS were treated less aggressively than men, despite presenting with higher risk characteristics.  This is just one example of a well defined study outlining gender differences in the delivery of care.

Explore the data regarding the admittance of women and diverse populations in medical careers.  Over 800,000 physicians practice in America.  Approximately 30,000 or 4% are African-American according to the U.S. Census Bureau.  Women have entered the field of clinical medicine in record numbers, However, women are underrepresented in academic medicine.  As the medical community prepares for the shortage of primary care physicians by the year 2020, women physicians are being covertly blamed for working fewer hours due to family obligations.  (Note this century’s adjustment of the pollutions theory:  High tech fields lose clout after women enter!)

As a leader in academic medicine, I am highly opinionated, but strive to deliver the facts.  It gives me great pride to allow my sophisticated readers to make the necessary inferences.  I reiterate that our job has just begun at the American Council of Women and Diversity in Medicine, Science, and Business.  Please support our non-profit women’s advancement organization as we live by the philosophy, “Necessity is the mother of invention.”  We are active in four states, and would love to start a chapter in your home town.  We are building female directed enterprises; closing gender, financial, and diversity gaps in the most technical and difficult careers.  This summer, I plan to enjoy the first summer of strict publishing, fundraising, and devotion to women in medicine, science, and business.

Dr.  Danna McKella

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One response to “Gender Disparities in Medicine

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