Last week, I saw this brochure laying around the common workspace. It is allegedly used to help with the mental status orientation of our elderly patients at the hospital.
What stands out to you in this image? Tell me in the comments section (preferably before you read the rest of this post).
The first thing that stood out to me was the fact that the doctor was depicted only as a male figure. Right after seeing this, the thought about the origins of subconscious bias and unrecognized influences as it pertains to gender roles in medicine began to simmer in my brain.
I equally respect all those, like myself, with the XX chromosome whom I work with. Some are RN’s, LPNs, techs, doctors, phlebotomists, social workers, case managers, clerks, janitorial staff, chefs, administrators etc. I believe we each play a uniquely vital role in facilitating the lives of those we serve.
That being said, I am a woman and a Hospitalist and for one reason or the next, I often get mistaken for a member of staff that is NOT the physician. On one occasion I had to be from the hospital kitchen and was at the patient’s bedside to pick up the empty dishes, on another day I was the biomedical company representative and was at the bedside to check my device’s functionality etc. Of course, these assumptions always came up prior the proper introductions I make once I enter the hospital room. It often amuses me and I never take offense because I know my true identity.
If you haven’t noticed, I have a subtle interest in sociology and psychology. So when I saw this image I couldn’t help but wonder if unintentional imagery to assess cognitive function could create or facilitate pre-existing unconscious thought processes. Or thought patterns such as —the doctor has to be male.
Before you get sensitive about this post; I must declare that my current coworkers are male. We work well as a team, there is mutual respect and so this is NOT a “male doctor bashing post”. What I want on the other hand is to shed light on the individuality of gender and the power each carries within. I also want to bring forth the argument of traditional bias in medicine.
Anyways, later that afternoon I was loitering the floors, checking on patients. An adult male was stalling there too. He had on him; the usual white and blue gown that our patients wore so I figured he must be someone waiting on his discharge papers from the hospital.
I happened to stop at the pod adjacent to his room, probably in an attempt to follow up on blood test results on the computer that stood there, unoccupied. I tucked my stethoscope in my long white coat pocket and simultaneously pulled out a piece of paper from my pocket, which always happens to be the list of the persons under my care on a particular day.
The gentleman stopped what he was doing and gave me a long stare and asked: “ So, are you a student or a nurse?”.
I have been a student and can be a nurse. I admire the nurses I work with; they multitask well, show extreme tenderheartedness to patients and are exceptional at caregiving activities. So nothing wrong there, but why couldn’t the guess be the doctor, at first? #subconsciousbias #tradtionalbias.
But, I gently responded : “Neither Sir, but do you need anything?”
He proceeded to disclose his concern with needing to be home on time. Our conversation was interrupted as his discharging doctor arrived to discharge him.
I smiled to myself and walked away, thinking about the booklet (above) that I took a photo of earlier.
Photo of myself from 2014, midway through residency training
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Two days later, I was rounding on that same floor. This time I had two gentlemen behind me, they followed me everywhere I went. One was a third-year osteopathic medical student learning during his first Internal Medicine clerkship on my service and the other is a “Foreign Medical Graduate” mentee who was shadowing to gain U.S. clinical experience.
We walked into the next person’s room as part of our routine, after I lectured extensively about her condition outside her door. We were discharging her home. I began to offer appropriate discharge instructions and came to the point where I had to instruct her to follow up with her Family Doctor in one week from the time she left the hospital.
I said: “Ma’am I will like for you to go back to see Dr. X and HE will need to check —.”
She quickly interrupted me. “ You mean SHE, Dr. X is a woman …”.
Her facial expression gave away her disappointment in the fact that I did not know that. It was almost as if she assumed all the female doctors within a 10-mile radius would know each other and stick/work together. Maybe we should?
I felt ashamed. The image of that photo chart came to mind. Just like that, I had become victim of the unconscious bias that her primary doctor was supposed to be male.
At that point; I had a flashback to my conversation with the gentleman in the hallway and my internal reaction to the poster I saw on the ward.
So, who is to blame?
Maybe our subconscious biases exist because of the prevalence of what has been and so no one is at fault. But it’s 2017 and there are many more female physicians today than ever before so is that still an excuse?
Could it be that one way to shift the current cultural perspective on the women in medicine will occur when there are many more women boldly choosing medicine? For those of us who have already made the choice, maybe we can make our impact felt and not only our voices heard.
Above all, the change we expect to see in others starts from inside of us. I choose to be boldly feminine in my daily encounters with patients to encourage the idea that there are many of us out here who will activate a new wave of thinking about the XX chromosome carriers and their role in the healthcare delivery. Irrespective of how young or old we look, how sweet or kind we are, how big or small, we can equally do great things! We can lead, coach, protect, nurture, heal, be parents, children, siblings and still be professionals and even doctors!
Maybe you have a bright idea to share on how WE can overcome this gender and other traditional bias?
Tell me your experiences or thoughts below.