WOMEN AND DOCTORS
Women have been doctors’ strongest critics, and perhaps I know why. Between puberty and the mid-fifties, women consult doctors far more than do men. The majority of women’s consultations are about pregnancy, fertility control, and problems of the reproductive and urinary systems. These concern behaviours and parts of the body that most of us (including the doctors) were brought up to regard as very private.
Until recently the majority of doctors were men (this is not the case for the future: today half the medical students are women), most of whom would have been just as embarrassed and awkward as their patients in consultations about the reproductive and urinary systems. Remember all those things that we learned not to mention in mixed company? The men would also have learned ‘not in front of the ladies’. No wonder they were awkward in discussions of ‘intimate’ matters. Many would have had little experience or confidence in dealing with women, except in the family or as carers or teachers. And a patriarchal society and their training would have taught doctors that it was their responsibility to make all decisions! It’s hard to be authoritative when you’re sweating with embarrassment: the awkwardness often came across as being cold, uninterested or dismissive.
There was also a lack of training in some aspects of women’s health. When I was a I student in the 1950s there were university by-laws that forbade teaching us anything about contraception, and sex wasn’t I mentioned except that we were warned I always to have a nurse present to chaper-1 one women undressing and gynaecologi-1 cal examinations (on the assumption that I all doctors were men: it wasn’t suggested I that we women needed chaperones when I we examined male patients). To ask about] sexual function when taking a health history would have been viewed as impertinent and prurient. Now it’s routine.
If you’re aged under 35 you may find it hard to understand these attitudes. You will have grown up during the ‘sexual revolution’ with a new frankness about reproduction and sex. You’ll have had more access to information and discussion about these matters than your parents would have imagined possible. Today’s openness has made it easier for all of us to deal with sex, but it’s still hard to change attitudes and behaviour influenced by taboos learned in childhood. We must remember this and respect people’s feelings.
Am I being too defensive of my profession? Perhaps. We all know that the criticisms have been justified in some cases. They have had the effect of making the medical profession take a good look at itself and lift its game to provide what the consumer wants.
Communication skills and social medicine have been added to undergraduate and postgraduate training. Practicing doctors flock to out-of-hours courses on counselling, effective listening, stress management, relaxation therapy, sexuality, and many other subjects that might expand and improve their practice skills. Some doctors also study hypnotherapy, acupuncture, massage, yoga and other alternative therapies not based on conventional science.
*37/31/5*
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March 11, 2009 - 4:33 PM