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Ideas and Opinions |

When Most Doctors Are Women: What Lies Ahead?

Wendy Levinson, MD; and Nicole Lurie, MD, MSPH
[+] Article, Author, and Disclosure Information

From St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada, and RAND Corporation, Arlington, Virginia.

Acknowledgment: The authors thank Kristy Armstrong and Angela Ho for help with the manuscript.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Wendy Levinson, MD, University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada; e-mail, wendy.levinson@utoronto.ca.

Current Author Addresses: Dr. Levinson: University of Toronto, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.

Dr. Lurie: RAND Washington Office, 1200 South Hayes Street, Arlington, VA 22202-5050.

Ann Intern Med. 2004;141(6):471-474. doi:10.7326/0003-4819-141-6-200409210-00013
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The profession of medicine is becoming feminized: The number of women enrolled in medical school and residency programs has increased dramatically over the past several decades. Some researchers have examined how women are faring in the profession, but few have considered how feminization of the profession will affect patient care and health care systems, as well as the profession itself. We predict that notable changes may emerge in 4 domains: the patient–physician relationship, the local delivery of care, the societal delivery of care, and the medical profession itself. We also consider the potential positive and negative consequences of a predominantly female physician workforce on these domains.





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Male PCPs and Health Insurance
Posted on September 28, 2004
Jonathan M Zenilman
Johns Hopkins Bayview Medical Center
Conflict of Interest: None Declared

To the Editor: Levinson and Lurie contend that women physicians are more likely to serve uninsured patients and to support single payer national health insurance (1). I believe that these were made on incorrect interpretation of source data. The references cited are those of a national survey conducted of physicians' attitudes (2), and of a 1989 medical student survey (3). Both of these studies fail to stratify provider attitudes by practice specialty, which would be an important confounder. Women are more likely to be in the primary care specialties, but I believe had authors stratified their data, my suspicion is that male physicians in the primary care specialties are just as likely to support single payer health insurance.

Jonathan M. Zenilman M.D. Infectious Diseases Division Johns Hopkins Bayview Medical Center 4940 Eastern Ave, B3 North Baltimore, MD 21224


1.Levinson W, Lurie N. When most doctors are women: What lies ahead? Ann Intern Med. 2004; 141:471-474.

2.McCormick D, Himmelstein DU, Woolhandler S, Bor DH. Single payer National Health Insurance: Physicians views. Arch Intern Med. 2004;164:300-304.

3.Crandall SJ, Volk RJ, Cacy D. Longitudinal investigation of medical student attitudes towards the medically indigent. Teaching and Learning in Medicine. 1997;9:254-60.

Conflict of Interest:

None declared

When Most Doctors are Women
Posted on October 22, 2004
Janet Bickel
Faculty Career and Diversity Consultant
Conflict of Interest: None Declared

I thank Levinson and Lurie for their balanced forecast ("When Most Doctors are Women: What Lies Ahead?" Annals of Int Med. 2004; 141:471-4). I would only challenge one assertion.

They state that "there is widespread recognition that academic medical centers. ..must accommodate the needs of their workforce [in balancing career and family responsibilities]." The problem is that this rhetoric has not translated into systems changes sought by both men and women. While family-leave policies at academic medical centers are now commonplace, they rarely allow for more than three months and require faculty to use up annual and sick leave. Some schools have introduced less -than-full-time options; however, in many cases users sacrifice benefits and the flexibility to return to the tenure track. In any case, academic career development remains rooted in assumptions that individuals should devote themselves wholly to their work and never need extended time away, especially during their twenties and thirties. The US lags far behind other developed countries in these regards.1

Medicine needs all the leadership talent it can develop, thus finding ways to capitalize on women's intellectual capital is of growing importance.2 It is to be hoped that Levinson and Lurie's predictions will also focus attention on how much of this capital is still being wasted.

1) McMurray, J, et al., Women in Medicine: A Four-Nation Comparison, JAMWA, 57:185-190, 2002.

2) Bickel, J., Wara, D., Atkinson, B.F., et al. Increasing Women's Leadership in Academic Medicine: Report of the AAMC Project Implementation Committee. Acad Med 2002;77:1043-61.

Conflict of Interest:

None declared

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