Boston drivers know that even the most well-paved road can occasionally surprise you with a big, fat pothole. The road of a woman in medicine can feel the same way. Thanks to the many who have gone before us, we are no longer trailblazers. But sometimes you can cruise along what seems like a smooth, multilane highway and suddenly feel that awful thud as your wheel jams into a giant hole.
I want to be quick to admit that I have been fortunate to have had my own road smoothed out quite nicely and know that many others experience more challenging paths. And, let’s face it, being a doctor isn’t easy for anyone these days. Everyone hits painful speedbumps from time to time. However, on some of our roads, these jolts come with a prickly question: Is this hazard there for everyone or is it a menace just for us?
My first introduction to the bumps in the road of a career in medicine came early on in residency, and it was obvious that this particular obstacle was specific for ladies. A patient reached out to the patient advocacy office, which was not an easy thing to do back then, complaining that she had never seen a doctor during her entire hospital stay. Spoiler alert – it turned out this was because all the doctors she saw were women.
Our chair approached this problem zealously. Looking back, I find it both adorable and refreshing that this was seen as something that could be solved, and not just an immutable cost of doing business in the changing, female-dominated landscape of ob/gyn and medicine in general. Business cards with our names followed by “MD” were commissioned. We were instructed to circle our names and hand them out to all patients, thus assuring everyone that actual doctors were on the case. Of course, any approach that depends on residents carrying around objects and distributing them to patients is destined to fail, and quickly, the cards were abandoned.
More recently, and many years after the residency cards incident, I noticed a different type of bump in the road. I realized that my patients’ partners often ignored me. It would happen in the office — patient on exam table, partner in chair looking at phone. Sometimes they might engage a little, but often I would see a downcast face scrolling a phone. In the hospital, it was the same: Walk into a labor room, a room where a woman is usually in the process of having a baby, and the co-parent-to-be of said baby would ignore me and my team. Did this happen every time? No, of course not. Did it happen often? Yes. And it happened regardless of whether or not we made a sincere effort to engage, to learn names, and to introduce ourselves. As I noticed this phenomenon more and more, I couldn’t help but think this is not respectful behavior, nor does it seem like a smart move for achieving good care.
This phenomenon played out recently during an obstetrics office session in such a dramatic and comical fashion that I couldn’t help but laugh — in the way that we as humans laugh instead of cry. I was having an important conversation with my patient about her concerns that the dangerous condition she had in her first pregnancy might recur. Meanwhile, her partner was engaging with their toddler daughter. This specific toddler-father interaction would have been endearing if it had occurred at half the volume or in a completely different location. At the end of our discussion, my patient wrested her partner’s attention back to her medical visit, asking him if he understood. He looked blankly and tried unsuccessfully to summarize what we had discussed. I repeated the conversation.
Now, all on the same page, we moved on to the next issue: obtaining a copy of her prior C-section operative report. “I have all that information,” he said and took out his phone. The thought that he might pull up this information so that I could attest to it in her chart, thus saving myself and my team so much administrative legwork, was irresistibly enticing. My patient and I both waited while he looked at his phone and she took her turn distracting the toddler. Enough time passed just waiting that I think we both began to feel a little awkward. “Did you find it?” she asked. “What?” he replied, “Oh, no. I don’t have it. I was replying to an email.”
This is a stunning example and one that has not occurred frequently. But here’s the thing — unlike patients not recognizing their doctors as doctors because they are women, I’m honestly not sure if this is a special, pink-colored pothole specifically for women or an example of modern day lack of civility and respect. After all, cell phones these days can be all-consuming and addictive.
To answer this question, I started fantasizing about running a study in which doctors of all genders would record family members’ reactions when they entered the room. I’m not a researcher, though, and there are more critical questions to investigate. I also thought, quite frankly, that the results might be too depressing. In lieu of quantifiable data, I tried to imagine these scenes replaying when my male partners walked into the room. It’s an interesting thought experiment, and really, I just can’t see it happening. Try to imagine the most esteemed male colleague you know talking to a patient and having their partner completely ignore them, play with their toddler, or respond to emails. It’s hard to see it.
The cards our chair made in residency were short-lived, but the incident itself stuck with me. After all, it is somewhat of a shock when you learn that you can introduce yourself as a doctor, perform doctor duties, be a doctor, and yet not be seen as a doctor to the very patients you are doctoring. I choose not to forget this experience and it is a large part of why, 20 years later, I am the one who introduces myself as Dr. Boyle, and not Jenny, during the time out introductions we do before a C-section. These introductions are done in the presence of an awake patient. I just can’t help feeling that I must stave off a future patient advocacy report that no doctor was present at the time of someone’s C-section.
In today’s medical landscape, all-women teams are common, especially in ob/gyn. The idea that, if she’s a woman, she’s not a doctor, should have faded far into the sunset. However, it may not be as deeply settled in the past as we might think. Sometimes people report feeling unsafe during their surgeries or deliveries. There are a lot of reasons for this, and many things we can and must do better, but sometimes I wonder if the introductions — when everyone uses their first name and most of the team looks young and female — adds to the feeling of being unsafe. When things are spiraling, do you want Mia or Jenny or even Steve to help you, or do you want Doctor X? And when you think of the doctor you want to save you or your baby, what does the person you imagine look like? Again, an interesting thought experiment. After all, we are all shaped and influenced by the same biased culture that we now must work to change. We all drive on the same roads, and although we may not all experience or even see all of the obstacles, that doesn’t mean they’re not there. In the end, we just need to fix the potholes, all of them, and for everyone.
How would you describe your road as a woman in medicine? Share your experiences in the comment section.
Dr. Jennifer Boyle is an ob/gyn in Boston, MA. She also works as a soccer coach and a cheer, hockey, and lacrosse mom. To stay sane, she runs, reads and bonds with her fourth baby, a labradoodle named Teddie. Dr. Boyle was a 2022-2023 Doximity Op-Med Fellow, and is a a 2023-2024 Doximity Op-Med Fellow.
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