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The Harms of Female Dominated Medicine By Mrs Vera West

     It is one thing for women to dominate academia, which doesn’t count for much in the scheme of things:

     But another to dominate medicine. What is the long-term consequence of this? Here is an article that dares, Vdares, to ask that question:

“In 2017, more than 60 percent of physicians under 35 years old were female, and the percentage appears likely to increase in the future [The healthcare future is female, by Megan Johnson,, February 14, 2018]. Is this transformation a good thing? My own observations through 35 years of medical practice suggest that everyone will suffer—but no one will be allowed to notice in medicine’s Brave New World. I had the pleasure of working with many smart and capable women. But their temperamental and physical limitations provided a constant, subtle undertow of problems: They are 1) indecisive 2) lack professional focus; and 3) get pregnant and 4) burn out more easily than men. None of that bodes well for patients if the majority of doctors are women—or for the women doctors themselves.

•    Indecision

I worked in a private-practice radiology group in Baltimore County. When I joined, the doctors were all men, but we hired a number of women through the years. The first problem I noticed was their indecision. Referring doctors would call me or come into the reading room and complain that a report from one of my women colleagues was too vague. Diagnostic radiologists are famous for hedging. Such evasive locutions as “suggestive of,” “cannot exclude,” “technically limited examination,” etc. are our stock in trade because of the inherent uncertainty of translating a shadow, an echo, a radio signal, or a scintillation into a diagnosis. Hedging conveys uncertainty. But the radiologist then must recommend resolving the uncertainty as safely and cheaply as possible. Wishy-washy reports leave the patient and the referring doctor uncertain as to how to proceed, and could lead to unnecessary additional testing. In whispers, male colleagues have shared stories of waffling women colleagues, but evidence beyond the furtive anecdote is found in breast imaging, a specialty that is 75 percent female. Mammography is highly standardized and lends itself to quantitative study of interpreter performance. Patients undergo screening mammograms, which radiologists read in batches. The resulting reports call for either routine follow-up or additional evaluation such as special views or ultrasound. The latter are known as “recalls.” A 2009 study of more than 1 million screening mammograms found that women radiologists had a significantly higher rate of recalls and false positives, without a corresponding increase in cancer detection [Variability in Interpretive Performance at Screening Mammography and Radiologists’ Characteristics Associated with Accuracy, by Joann G. Elmore, et al., Radiology, December 1, 2009]. (The other factor significantly associated with high recall and false-positive rates was fellowship training in mammography, with an associated improvement in cancer detection.)

Another common test that lends itself to overinterpretation is the chest x-ray. Less-experienced radiologists and women excel in recommending unnecessary CT (computerized tomography)  scans to evaluate “radiodensities” that older men recognize as composite shadow artifacts. One of my women colleagues drove thoracic surgeons crazy with false alarms. My half-baked theory to explain the problem: Men are bolder and more decisive because of testosterone. As well, among our Stone Age hunter-gatherer ancestors, men were hunters, and so evolution has left men better adapted to spotting the animal in the brush while ignoring extraneous visual information. A false start spooks the game, and survival depends on a successful hunt. I can offer no data to support that conclusion, but then again, unlike mammography, data on chest radiography isn’t collected. No one is likely interested in inviting persecution by investigating sex differences on that count. (Computerized tomography, by the way, is fast replacing plain x-rays, and artificial intelligence may soon replace diagnostic radiologists.)

•    Lack of Professional Focus

The second problem for medicine if women are the majority of doctors. As Megan Johnson wrote for Athena Health, above: Anna Goldenheim, M.D., a 33-year-old pediatric resident at a Boston hospital and a mother of two, says her work life will always be dependent upon her children's schedules. “I think that as a woman, my job priorities are going to be really fluid for as long as my kids are home and will change again as my kids go to school,” says Goldenheim. “I'm hoping to tailor my job to those needs.” Time was, a doctor “tailored his job” to the needs of his patients. In other words, hiring  a partner whose “job priorities are really fluid” sounds like trouble. Dr. Goldenheim’s devotion to her children’s needs is absolutely commendable. But it’s a curious notion that admitting her to medical school and residency is the best way to support her maternal priorities. Yet it’s also a curious notion that cannot be criticized under the regime of inclusiveness. We are all interchangeable parts in the machine. To suggest otherwise is to be a Hater.”

     The author, Barton Cockey, obviously his real name, goes on to list other negative factors, but I think these are the main ones. It raises doubts abut the quality of medical service in general in the future, but I suppose that should be the least of our worries, because with mass migration and population expansion, the issue may become whether or not one gets any timely medical treatment at all. In America, if you can’t pay, you may die, and that could come to Australia, too.



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Monday, 25 May 2020
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