UO > Feature > Respect More than Money

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While many female physicians feel they have something more to prove than their male counterparts—whether they want to advance in pay, rank, or level of respect—others report that although they do work hard, they feel a standard of excellence applies to all doctors, regardless of gender.

When Elsa-Grace Giardina, the director of the Center for Women’s Health and a cardiologist at Columbia Eastside in New York, began medical school in the 1960s, she knew she would be expected to work hard.

“There was probably some skepticism on the part of the guys—‘Is she going to be able to do this?’” she says. She comes from a family of three women, all of them doctors. “But I think that skepticism is for everybody—is that guy going to be able to do this? I think the way you prove to people you can do it is you do it and you do it well, as well as anyone could expect you to do.”

Jill Rutherford, MD, agrees. “I always knew it was something I was going to do,” Rutherford says of her medical career. A radiologist affiliated with St. Vincent’s Hospital in Birmingham,

Alabama, she graduated in the top 10 from medical school in 1992, was voted best medical student by her peers, and was chief resident.

“Everything I’ve gotten, I got because I worked hard and earned it,” she says. “I don’t think I’ve gotten or not gotten something because I’m a woman. I’ve never felt like I’ve been discriminated against.”

Marie Fidela Paraiso, MD, an ob/gyn surgeon at the Cleveland Clinic Foundation in Ohio, feels the same.

“I never felt that I was at a disadvantage, being female,” Paraiso says. She recalls being “harassed” by a male surgeon in medical school, and another in residency, but she finds that to be due to “their character flaws” rather than “man versus woman.”

Paraiso’s main gender-related complaint is the fact that her patients expect her to “be the touchy-feely one, the one who’s supposed to have time to listen to all their problems and angst” while she maintains the same tight schedule as her male colleagues. She wishes she had more time to spend with her patients, she says, but she wishes that for all physicians, regardless of gender.

“I don’t think discrimination exists,” says Paraiso, who is Filipino-Spanish and, she says, used to being in the minority. “My mother always said that if others can do it, you can do it better. Discrimination is a state of mind. You really can make the best out of any situation.”

Indeed, most female physicians are happy in their jobs.

According to the Women Physicians’ Health Study as described in the 2004 Student JAMA article, Career Satisfaction in Female Physicians, 84 percent of American female respondents report being “usually,” “almost always,” or “always” satisfied with their careers. Even with long hours, less work control and a belief that motherhood had slowed their careers, 81 percent of women in academic medicine also report being satisfied with their careers.

Women physicians seem to have developed various coping strategies that help them deal with whatever their problems may be.

“I think what a lot of women do in medicine is develop an area of interest that is unique and makes them a resource,” Giardina says. “For example, I do women’s health. One of my friends does primary pulmonary hypertension. Another one leads nuclear cardiology. Each has developed a niche so that their value as a resource to the rest of the faculty is enormous.”

She also feels that being passionate about her work helps her do her best. “I have always maintained a level of excellence, but I haven’t done it consciously,” Giardina says. “I happen to love what I do. I never felt anywhere along the line that I was making a sacrifice.”

Regardless of sacrifices they might have made, women have worked as physicians since the late 19th century. However, it wasn’t until fairly recently that women have begun to show up in great numbers; indeed, statistics show that every decade since 1970 has seen a 10 percent increase in female medical school applicants.

And women now are choosing, on a more frequent basis, specialties that once had been the domain of men.

“More and more women are going into procedure-oriented lifestyle specialties,” Giardina says. “More women are doing endoscopy. More women are working in cardiac cath labs.”

Something to consider, too, is that fewer men are choosing medicine these days as well.

“The men have gone to business school and the financial world,” Giardina says, noting that there’s not only more money in those fields but also that in the increasingly bureaucratic medical world, “people who want to be in control of their lives”—most often, men—are choosing careers which allow them that freedom.

Doubtless, though, the face of medicine is changing.

Andi James, MD, the director of the women’s hemostasis and thrombosis clinic and an assistant professor of ob/gyn at Duke University Medical Center, started her medical career as a nurse (and remembers mixers for doctors and nurses), then attended medical school later. “When I was in nursing school, wanting to go into medical school, probably five percent of the students in med school classes were female,” she says. “Now, half of them are.”

Including her daughter. Although James never encouraged her daughter, Star Schreier, to follow in her footsteps, Schreier has done just that. James says—not without pride—that her daughter will graduate from medical school in 2006. g

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