Tuesday, April 11, 2006

Male teachers being discriminated against? What about male doctors?

Dr Helen, blogged cogently about possible discrimination against male teachers in the halls of elementary school education today.

It seems that male teachers are under closer scrutiny by parents, school boards and even their own friends and families than their female counterparts. Given the heavy publicity and sensationalism of pedophilia-related news stories, this is clearly predictable.

Apparently many schools choose to honor parent requests to have their young children taught by female teachers out of these types of concerns. Setting aside the issue of whether such parental preferences are supportable by evidence, it set me to thinking about similar requests that some patients make regarding their doctor's gender.

Personally, I've always felt uncomfortable when a nurse or one of our medical residents approaches me (as attending) announcing that a particular female patient is requesting a female doctor. (Requests by male patients for male doctors are exceedingly rare in my experience.) I never know quite how to handle such situations.

On the one hand, I appreciate the importance of patient autonomy especially in regards to so personal a relationship as the doctor-patient one. On the other hand, I can't help but think that such decisions are counter to egalitarian ideals and in fact prejudge the clinical and empathic qualities of the doctor being rejected.

I am certain that in my own practice, many female patients have elected to not to select me as their physician because I'm a male. I cannot deny that that reality in no way disturbs me. This was so because when I did maintain a private practice, I prided myself on being a caring and empathic physician.

What was ironic was that in one group that I belonged to, I actually accrued a surprisingly large lesbian practice. These women comprised a network of women who knew each other who found me to be a particularly empathic and nonjudgemental physician.

It therefore hurts me that some patients would not allow a subset of our medical residents the opportunity to demonstrate their ability to appropriately care for them in a manner deserving of the dignity of all patients. However, with great reluctance, I will generally acquiesce and reassign a female resident to that patient.

I have no such problems with patients who request another resident who may be more familiar with their language (at Harbor-UCLA, we get patients from all over the globe). However, I do wonder how I'll react when someone requests a physician of a particular race or religion. Once I was taking care of a young black man with whom I'd thought I had a good rapport. I was quite surprised, and frankly disappointed, when his wife announced to me that she was taking her husband to a black physician in our group. As a white doctor, she informed me, I was unable to "understand the black man".

Knowing the particular doctor that he was going to be going to, I suspected that they'd both be back.

A month later, they were. Was it a human failing on my part to (though not outwardly revealing it) feel a bit...smug?


Blogger Helen said...

No, I don't blame you for feeling a bit smug! I might also. At one point in my psychological practice, I had a number of psychologists working for me--all male. Women would come in and see a male therapist was going to evaluate them and plead with me to see them. What a mistake that was! The male psychologists were much more empathetic and patient than I would ever be.

April 11, 2006 5:35 PM  
Blogger CardioNP said...

When I worked as a nurse practitioner in a VA primary care clinic, I frequently had patients wanting to see a male provider. Mostly because they wanted viagra and did not wish to discuss this with a female provider. When they were informed that they could see a male provider - about 3-4 mos later - they usually aquiesced and sheepishly asked for viagra.

April 17, 2006 8:22 PM  

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