Have you heard this classic riddle before?

A father and son are in a horrible car crash that kills the dad. The son is rushed to the hospital; just as he’s about to go under the knife, the surgeon says, “I can’t operate—that boy is my son!”

Who is the surgeon?

Hopefully, the answer is obvious: the surgeon is the boy’s mother. However, the majority of adults answer this question incorrectly. It’s 2016, and women in health care are still fighting for gender equality. This makes it more critical than ever to spread awareness about unconscious gender biases that plague health care professionals and affect your practice’s success. Read on for more about how you can recognize and combat gender biases in your institution.

Systemic sexism still prevails in health care

To say that systemic sexism is a complicated topic would be a substantial understatement. While gender bias, sexism, and systemic sexism are naturally intertwined, they each have distinct definitions that are important to understand:

  • Gender bias is defined as “the unequal treatment in employment opportunity (such as promotion, pay, benefits and privileges), and expectations due to attitudes based on the sex of an employee or group of employees”
  • Related to gender bias, sexism is defined by the Oxford Dictionary as, “prejudice, stereotyping, or discrimination, typically against women, on the basis of sex”.
  • Systemic (or institutional) sexism is more complicated, but can be generally defined as “the conventional practices or structures of institutions that have the effect of excluding or discriminating against individuals or groups.”

 

Consider the current state of female physicians. The evidence suggests that women and men are enrolling in medical school at comparable rates, and we now know that women make up about one-third of doctors in the US, as recently reported in April 2016. Yet men are still dominating leadership positions, especially in academic medicine. Women in academic medicine only make up 24 percent of division chiefs, 21 percent of full professors, 16 percent of deans, and 15 percent of department chairs, according to a recent Association of American Medical Colleges report.

When female doctors are underrepresented in leadership roles and left out of decision making processes, it has larger implications than the day-to-day struggle of being female in a male-dominated industry. As Dr. Yvette Canaba at St. John’s Episcopal Hospital puts it, “In the end it’s the patient that loses. Our patient population as a whole definitely benefits from a more diverse group of doctors that is in charge of their care.”

How to recognize gender bias

Gender bias can take on many forms, which might make it challenging to recognize in your institution if you don’t know what to look for. One form (that female readers are likely familiar with) is that countless female doctors are accused of being cold, bossy, or unfriendly, even though their male counterparts practice medicine under the exact same guidelines. As Cabana notes, “It’s very interesting how even in this day and age when you’re an assertive female it’s not something that’s applauded. It’s something that’s automatically attributed to a woman’s emotional state.” This isn’t a phenomenon specific to health care. Women in general have been known to alter everyday behaviors – down to how we write an email – for fear of being perceived as overly assertive or domineering.

A relatively common form of gender bias in health care, as self-reported by female doctors, is that patients and fellow doctors will continually mistake female doctors for nurses or other staff. Perhaps the most frustrating form of gender bias is that women in health care simply aren’t paid as much as men in health care. According to a recent 2016 Glassdoor report, the adjusted (after applying statistical controls such as education and experience) pay gap is the most pronounced in health care when compared to all other US industries. Men in the same health care careers are on average paid 7.2 percent more than women even though both male and female doctors have to go through the exact same education and training to earn their medical license.

If we dig even deeper, we find that gender biases start early on in female doctors’ careers. According to a 2015 JAMA report, women receive significantly less institutional support (e.g., equipment, technicians, supplies) when it comes to conducting biomedical research. In fact, only 30 percent of funded medical researchers are women, and women have significantly less peer-reviewed publications than their male counterparts. Furthermore, the Journal of the American College of Surgeons reports that women (and minorities) are significantly more likely to fail board certification exams than their (white) male counterparts, for “uncited reasons”.

Combat gender bias through education and awareness

The statistics are alarming and may seem overwhelming, but there are things we can do to combat gender bias and sexism. Whether you work at a large academic institution, hospital, or run an independent practice, we have some suggestions on how to educate your staff and promote awareness.

Some solutions are more straight-forward than others, such as stronger, more supportive maternity leave policies for female doctors in order to ease the anxiety of falling behind or losing their career that many pregnant and/or soon-to-be pregnant women report. We can also take to the internet to reach a larger audience with social media campaigns like #ILookLikeASurgeon that bring visibility to women who save lives in surgery every day, and emphasize the message that “Surgeon” is not a gender-exclusive title.

There are also ways to make sure your staff is aware of their own personal biases, because we all have them. Try posing the riddle we started this post with to your staff in an anonymous environment where there won’t be repercussions for answering one way or another. Regardless of their answers, it’s important to talk about what the results mean with your staff so they are able to recognize their own personal biases.

Recognizing unconscious biases, such as confirmation bias, can prevent people from reinforcing negative stereotypes about women. “As a patient and as a consumer, becoming more aware of your biases and what you are preferential to may allow you to make more informed decisions in terms of providers,” says Diana Lautenberg from the Association of American Medical Colleges. Some medical colleges – such as The University of California-Davis School of Medicine – have implemented programs to train promotion panels in unconscious biases. Other institutions, namely the University of Massachusetts Medical School, have implemented mentoring and career development programs for women.

Get creative. If you’re not in a leadership role but want to ensure women’s voices are heard, consider adopting ingenious methods like amplification, in which one woman makes a point in a meeting and her statement is repeated by other women and credited to the originator, thus ensuring the message is heard and that proper credit is given. Over time, it can help leaders recognize and overcome their own biases to seek input from a broader team of colleagues. This method proved effective for female staffers at the White House, and the technique can be applied across industries, and certainly in health care.

There are a lot of ways for women to support one another when dealing with gender bias, but true change comes down to everyone recognizing their own biases and providing mentorship and support to make space for more women at the table. 


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