Don’t Call Me Lucky: on female physicians’ experiences of gender bias from patients

I recently came across an eye-opening passage on gender bias by the author Chimamanda Ngozi Adichie. The excerpt from her book is as follows:

This struck home, as I experience something similar in the exam room on a near daily basis. Patients, and/or their family members, tell me how lucky I am that my husband is home with the kids while I am at work.

I highly doubt this conversation has ever happened to any male physician in practice anywhere.

I should consider myself so lucky, for my husband allowing me to work.

And, indeed, it has been the rare patient who has not shown some level of discomfort when they hear of the “reversed” roles of me and my husband.

My patients see me as an aberration, and I have to show them that I have a humble, domestic side. To reassure them that I am not.

It is the fault of society, not mine, that in the case of a physician-parent with a stay-at-home spouse, a woman is called “lucky,” while for a man, it’s taken for granted as the status quo.

To female physicians, these kinds of comments from patients and their families, overt or disguised, constitute gender bias. And gender bias is a form of sexual harassment.

Dr. Esther Choo and colleagues recently published in NEJM a powerful piece on the need to end sexual harassment in medicine — Time’s Up for Medicine? Only Time Will Tell.

As I read, wrote and researched this piece, a tide of memories from my training and early career years surged. Here are just a few:

  • The time as an internal medicine resident. When the family member of an unconscious patient wouldn’t get off the phone to answer my questions. He stared me in the eyes, the phone to his ear, and continued his phone conversation as if I didn’t exist. Deaf to my explanations that I was the doctor, the senior resident on the team. Until I, humiliated, had to let the male intern take over the questioning. Lucky for that patient and his family I was there to supervise the intern perform the LP (lumbar puncture, aka spinal tap).
  • The innumerable times that, even after introducing myself by my doctor title, patients and family members referred to me as the nurse, social worker, fill-in-the-blank-with-a-non-physician role…. And the innumerable times I was told that I didn’t “look like” a doctor. As if that made their comments okay…
  • The time in my first year of practice, when I entered the exam room to have an older male patient scold me as if I were a child. Scowling and tapping his watch, his voice raised to a threatening tone, “Where have you been, young lady?”
  • The time I was stalked by two men, “friends” of a patient, during a late-night ER shift as a 4th-year medical student on an away rotation. So that I had to ask for security to escort me to my housing at the end of my shift. The sleepless night of staring at the flimsy locks on the windows in the student housing.
  • Another episode as a 4th-year medical student, physically cornered by a patient in a deserted hallway. The visceral memory of his fist out of nowhere pressed into my side, just above my right kidney. Trapped against the wall, hateful words whispered in my ear. Then the double trauma of the embarrassed looks of the residents and attending physician when I fled to the team (comprised of men and women) for help. Being made to feel silly and weak. Like I was exaggerating what happened. “Don’t worry, he’s being discharged tomorrow.” As if that solved the problem.

Why would I? When the message I received loud and clear from my team was that this wasn’t something one complained about. If one was a female student. As if, it was somehow my fault it happened at all.

My examples may seem so disparate that one has nothing to do with the other. But I would argue the opposite, they are all related. The minimization by my supervisors of the trauma of my experience as a student at the hands of that patient exists in a continuum with the dismissals female physicians make on a daily basis of the belittling and marginalizing comments made by patients and families in the exam room.

In another insightful perspective from earlier this year, JAMA Internal Medicine March 2018, the editor’s note sums it up well: “The impact of a cascade of small injustices that women physicians deal with every day undermines our daily work and collectively sends a demeaning message about our worth in the workplace.”

But I think those of us in practice can evoke a culture change as well. For those of us in clinical practice, let’s all, women and men, commit to zero tolerance for gender bias from our patients. There’s no such thing as an ‘innocent’ comment when it comes to gender bias.

Because we, together, can be powerful. We don’t have to diminish who we are.

References:

  1. Chimamanda Ngozi Adichie. Dear Ijeawele, or A Feminist Manifesto in Fifteen Suggestions. Alfred A. Knopf. New York and Toronto, 2017. Page 21.
  2. Chimamanda Ngozie Adichie. Dear Ijeawele, or A Feminist Manifesto in Fifteen Suggestions. Alfred A. Knopf. New York and Toronto, 2017 Pages 22, 24.

--

--

Get the Medium app

A button that says 'Download on the App Store', and if clicked it will lead you to the iOS App store
A button that says 'Get it on, Google Play', and if clicked it will lead you to the Google Play store
Jennifer Lycette, M.D.

Jennifer Lycette, M.D.

Physician/writer. Essayist, published in NEJM, JAMA, JAMA Oncology, Journal of Clinical Oncology, and The ASCO Post. Doximity Op-Med Fellow.