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- Page navigation anchor for Need caring, compassion or comfort? Sorry, I’m a doctorNeed caring, compassion or comfort? Sorry, I’m a doctor
Ms. Manzoor and Dr. Redelmeier’s article on sexism in medical care introduces seven strategies a female physician might employ when mistaken as a nurse by a hospitalized patient. Although well intentioned, we believe the article perpetuates harmful gendered discourses about nursing and nursing work (e.g., hygiene, comfort, empathy, nutrition, mobility, information) that are important to critique.
The authors depict nursing as a series of ‘mundane’ interventions such as scratching backs, fetching basins, and delivering blankets. These delimited accomplishments obscure the diversity and importance of nursing in the contemporary healthcare environment. Readers are made to understand the ‘basic’ work of nursing is not equivalent to the important ‘cognitive’ work of medicine. Nurses, who remain primarily women, have long face difficulties in their work environment as a result of centralized male positions of medical power. Difficulties include gender biases and role stereotypes that retain the notion that nursing comprises unskilled feminine tasks that are beneath the status or concern of the physician.
Patients and families expect clinicians, regardless or their gender or profession, to intervene in the bodily and social dilemmas that accompany serious illness and dying. The complex needs of the contemporary hospital patient require the collaboration of multiple professions. Sexist discourses of ‘mundane’ nursing care impede this imperative. Social denigration...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: "Nurse, can you get me another blanket?"RE: "Nurse, can you get me another blanket?"
I'm a nurse, also a PhD, but the reason that I'm responding to this is because my husband recently had an extended hospitalization with a lot of specialists entering our hospital room. We often did not know who they were or why they were there. This situation can easily be avoided if the provider introduces himself (more than once - we forget) AND his specialty when he enters. An awareness of who is in the room is also important. "I'm Dr. so-and-so and am here to _____" - can you tell me how you're related to this patient, before throwing covers aside.
Competing Interests: None declared. - Page navigation anchor for It's very hard to challenge a prevailing discourseIt's very hard to challenge a prevailing discourse
This article, and the Editor's apology, are yet more proof of how difficult it can be to challenge a prevailing discourse. In many cases, we simply end up consolidating the very set of assumptions we were hoping to disperse, or another related set. I notice so many instances where we in the medical profession try to eliminate barriers and become more inclusive, but instead end up creating new forms of othering. Maybe Habermas should become part of our first year curriculum? Wouldn't that be awesome!
Competing Interests: None declared. - Page navigation anchor for RE: Sexism in MedicienRE: Sexism in Medicien
When I was a young physician in the early 1980's a patient told me a funny story. Her children were playing "doctor". Her daughter insisted her brother could not be the doctor as only girls were doctors. I had delivered the daughter and her mother said she had never seen a male physician. This was not sexism but exposure. Lets hope that the exposure to more women doctors and more men nurses that people become less likely to make assumptions.
Competing Interests: None declared. - Page navigation anchor for Apology from CMAJ’s Editor-in-ChiefApology from CMAJ’s Editor-in-Chief
Sexism is one of the most important issues facing the medical profession. Women are less likely to be promoted, less likely to attain positions of leadership, are paid less than men and more frequently experience micro and macro aggressions at work. (1)
CMAJ recently published a piece in our Encounters section called “Sexism in medical care: Nurse can you get me a blanket?” (2) Using the example of a patient assuming a female physician to be a nurse, its authors suggest strategies to address sexism in the health care workplace, which they intended to be both humorous and helpful.
Unfortunately, the article did not hit the mark.
Although the authors recognized the important role of nurses in caring for patients, it is entirely understandable that nurses and many others found the article’s focus on the mistaken identity with nurses to be offensive.
And, as has been pointed out in some letters to the editor (3), female physicians face many more important and ingrained manifestations of sexism within the medical profession itself and in society. (4) This article appears to make light of those problems. The suggestion that “… a credible masculine [physician] voice can be quite convincing for some patients” reinforces rather than addresses sexism within the profession.
The article went through CMAJ’s peer review process for the Encounters section. As Editor-in-Chief I had the opportunity to stop publication and I did not do so. That was a mis...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: Reflections on sexism in medicineRE: Reflections on sexism in medicine
I wish to comment on the recent article on Sexism in Medical Care by Manzoor and Redelmeier. My own concerns about the commentary have been reinforced by several women residents who approached me in my capacity as an internal medicine site program director. By way of disclosure, I am a colleague and former trainee of Dr. Redelmeier, the senior author, and have shared with him my own views as well as some of the concerns shared with me by others. I also provided him a draft of this letter for his feedback prior to submitting it.
I recognize that the authors wished to draw attention to the issue of sexism in medicine, but the commentary misses the mark in several ways, and overlooks valuable opportunities to promote allyship and advocacy for women in medicine.
First, its whimsical tone makes light of the real day-to-day struggles of women in medicine. These challenges are not easily overcome by a few pithy phrases crafted by a senior male colleague who, by virtue of being a man, has never had to contend with sexism or the toll it can exact. Likewise, as a straight white woman, I have little insight into the difficulties faced by colleagues of different racial backgrounds or orientations.
Second, the piece involves a woman medical trainee being mistaken for a nurse. This situation is hardly a rarity, and women physicians do not need to be told how to manage it. For most of us, an appropriate response is something along the lines of, “Actually I’m your d...
Show MoreCompeting Interests: None declared. - Page navigation anchor for Sexism, racism and ageism in medical care - it depends on the contextSexism, racism and ageism in medical care - it depends on the context
I commend the authors and collaborators for speaking up against being misidentified and discriminated at work.<1><2> However, I am also concerned to see the flurry of responses from readers, some of which seem to be shaming the whistleblowers.
I, despite being a male doctor wearing his name badge, have been misidentified as a nurse at work. Is it simply because I do not fit the stereotype of a white male doctor?<3><4> Perhaps, only the faulters themselves would know the real reason behind this.
I have seen patients mispronouncing Asian doctors' last names, such as Dr. Ng, Nguyen, Cheung, and Leung. I myself have been called Dr. Young, Yuen, and even Yang, possibly due to the influence of the television series Grey's Anatomy. When trying to correct their pronunciation, I was told, "I do not have your accent" and "you should work on your English." On some rare occasions, I have been called Dr. Chan and Dr. Wong. I am not prejudiced against any Dr. Wong and Dr. Chan, but it makes me feel uncomfortable to be misidentified. I have been greeted with Ni Hao and Xie Xie, even though I do not speak this language; I have been requested to recommend Chinese medicine and acupuncture, even though these are not my scope of practice. Could this be due to some people being genuinely ignorant about geography? Or could this be their ways of impressing ethnic minorities? Nobody knows.
In my previous career as a pharma...
Show MoreCompeting Interests: I have been paid for working as a resident physician, but not writing this letter. Opinions expressed are my own and not the views of my employer. - Page navigation anchor for RE: Nurse is an epitome of empathyRE: Nurse is an epitome of empathy
One of the professions where gender discrimination is reported to be minimal or none is medical profession. It cannot called a profession of male chauvinism. It is a humane and noble profession where respect and reverence are unifying concepts of a team of health professionals who deliver healthcare to the needy patient. The pivotal role in this team work is shouldered by the nurses. They represent to the patients a true representation of care and understanding. Rather empathy is cornerstone of nursing service. Bringing sexism into this domain of service defeats the very purpose of holistic healthcare. Service is the motto of nursing profession. They bring humanity, altruism and nobility to the medical profession. The causal remarks of " bring the Blanket", scratch my back by the patients may seem sexist to some though it may truly mean the patient wants a humane care. Super-specialization have brought fragmentation and limited consulting hours from super specialists. The consultants have very little time to comfort the patient. The nursing personnel bring that comfort and solace to the patients. Therefore, Nurse is an epitome of empathy and service.
Competing Interests: None declared. - Page navigation anchor for RE: Sexism in Medical CareRE: Sexism in Medical Care
We read Ms. Manzoor and Dr. Redelmeier’s article on sexism in medical care with great interest. Their article tackles the important issue of gendered perceptions in medicine, which is a pressing issue in the medical profession and a topic of increasing interest to researchers. The article offers independent strategies that female physicians can employ when they are mistaken as nurses or other healthcare professionals in the clinical setting. While well thought out independent strategies can be useful tools for combatting socially constructed perceptions of gender and identity, we worry that the authors have missed the larger problems of sexism in medical care by focusing almost exclusively on physician-patient interactions. For example, while existing research(1,2) has shown that mischaracterizations (e.g. unequal naming practice) can feel frustrating and demeaning for female physicians when interacting with patients, research from our team and others(3,4) has also shown that it is the prevalence of gendered norms and subtle microaggressions between medical colleagues that principally reinforces the perception that women physicians are of a lower status than men and negatively impacts their careers and well-being. Ms. Manzoor and Dr. Redemeier appear to suggest that we hold patients to a higher standard of accountability than male clinicians given that the single paragraph that discusses clinician-clinician interactions is titled “collegial humor” and puts forth the assum...
Show MoreCompeting Interests: None declared. - Page navigation anchor for RE: sexism in medical careRE: sexism in medical care
I can't help but wonder why people feel it is insulting to be mistaken for a nurse - perhaps the more important point to be taken from this is that as medical professionals we all need to introduce ourselves to each client
Competing Interests: None declared. - Page navigation anchor for RE: sexismRE: sexism
As valued as this article may have been, it could've been written with respect and common courtesy.
Not only did you devalue nursing, you devalued female nursing.
Are you aware that the majority of nursing is formed by caring, educated, hardworking female nurses. Those who provide physicians with the information, hands on perspective most physicians don't take the time to retrieve. We are the clinicians who choose nursing because we knew we were the ones who actually make the change for the patient. We are the ones getting the blood work so you can see the lab values, we are the ones administering/monitoring the medications that helped improve their current status. We are the ones who are there when they are at their worst, listening, providing, just being. We are the ones who assessed, created and initiated the plan that will help them walk, heal, breathe.
All clinicians should be honored to work together. You're responses to patients laid out as jokes about nurses is disrespectful. The next time either of you is unfortunately ill, it will be the nurse there much longer/supportive than the physician.Competing Interests: None declared. - Page navigation anchor for RE: Response from a nurse .......RE: Response from a nurse .......
I am a nurse and honestly your comments on nurses wouldn't make us happy. The patient probably thinks you are a nurse because 98.5% of the time that is who they see when a physician is there a fraction of a sliver of the time. They ask male physicians the same thing . Not because they think you are a nurse always but because they need help. And why can't you scratch their back as a doctor ? Is this below you ? The ego of female physicians the the way they treat female nurses should be discussed as this happens all the time. Being spoken down to by female physicians where male physicians give you respect . And this article reflects that .
Competing Interests: None declared. - Page navigation anchor for RE: sexism in medical careRE: sexism in medical care
I am at 60 y/o white surgeon. I knew times were changing last year when my patient thought I was the nurse.
Competing Interests: None declared.