Commentary

Patients believe that two "X"s are better than one ...and more


 

WHERE HAVE ALL THE YOUNG MEN GONE? NOT TO OBSTETRICS AND GYNECOLOGY
LOUIS WEINSTEIN, MD
(COMMENTARY; JANUARY 2011)

Patients believe that two “X”s are better than one

Dr. Weinstein lives in an alternate universe when he says patients choose their physicians on the basis of attentiveness and respectfulness. In the real world, women prefer a female ObGyn. Period.

For more than 20 years, I have been in a group ObGyn practice in middle-class suburbia. It is a highly respected and extremely busy practice, currently consisting of five women and two men. As the number of women in our group has increased, so has the demand for their services.

The gender decision is made on the phone when booking an appointment—not after meeting the doctor. Almost every patient calling for an appointment specifically requests a female provider. Only if all the women are busy and it’s an urgent matter does a new patient want to see a male.

Some patients feel so strongly that they refuse to see a male under any circumstances. This has become such a problem that our office requires our patients to sign a form acknowledging that either gender may care for them after hours or in an emergency.

The female physicians in our office are so busy that they limit their practice, seeing only those patients who have the best-paying insurance plans. This leaves the HMO patients to the male providers. These patients see a male only because the women don’t accept their insurance. All that is left for the new male doctor in our town are welfare patients, for whose care he is paid about 30 cents on the dollar.

Discrimination is, in fact, acceptable in our specialty. Patients can refuse to see a man. Once, a female colleague needed my help with an emergency cesarean delivery. A couple of weeks later, I received a note from the patient declining to pay my fee because she had clearly told her doctor that she did not want any men involved in her care. I have seen countless ads for ObGyn job opportunities looking specifically for a female physician. Can any other business advertise a job stating that only men need apply? I don’t think so. Equal pay for equal work? I don’t think so.

Private practice medicine is a free-market economy. As more and more consumers request female ObGyn providers, the male providers will become extinct.

William Phillips, MD
Pleasanton, Calif

We should not tolerate discrimination in any form

Dr. Weinstein made some very good points about the gender inequities in the field of obstetrics and gynecology. When I first brought to light the rampant gender bias against male physicians in the leading women’s magazines in 2004, I remember that one of the reviewers did not believe that males could experience discrimination because, at the time, males were in the majority.1

Dr. John T. Queenan predicted our predicament in a commentary in 2003, when he wrote, “There is a risk that public perception could be exaggerated to a point where it becomes the norm to go to a female obstetrician-gynecologist. This could irrevocably tip the balance, making it almost impossible to recruit men to the specialty. If only a few men choose the specialty, and some women shy away because of poor prospects, the quality of obstetrics and gynecology candidates could plummet.”2

Sadly, his predictions seem all too true today.

Dr. Weinstein made some excellent recommendations, but I feel he overlooked the largest piece of this problem, a problem that has been ignored because of its sensitive nature—the problem of female physician discrimination against male physicians.

Perform an online search of any large city using the words: “obstetrics and gynecology” and “all female.” You will find physician clinic after physician clinic advertising its services with catch phrases such as “we have an all-female staff,” “women serving women,” and “women’s health-care with a woman’s touch.” It’s hard to count the number of all-female ObGyn groups that are using their all-female status as a marketing tool.

One can only wonder why this type of discriminatory marketing is tolerated. If the ads boasted “whites serving whites” or “we have an all-white staff,” there would be a fire-storm of justified protest.

When a group of female physicians decides that it will recruit and hire only women at the exclusion of all qualified male physicians, with this exclusion based solely on gender, it is wrong! ACOG, as our governing board, should have the moral courage to state, without question, that it is wrong. If physicians were being excluded from hiring consideration because of their race, ethnicity, or religion, there would be an outpouring of well-deserved moral outrage—but when women are the discriminators, there is a surprising reluctance to discuss the issue.

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