WE NEED MORE MEN IN HEALTH CARE

Medical Economics, the magazine for “the business side of medical practice,” usually has its finger on the pulse of happenings within the medical profession. The editors and writers of the magazine are quite successful at informing physicians about changes in medical practice that affect the financial stability and societal relevance of their businesses/practices. The November-December 2024 issue is no exception because of an article I just couldn’t pass up!

That article was one titled “The Care Deficit: Why we need more men in health care.” What I took the title to mean was the authors were going to make some disparaging comments about women in medicine, which they didn’t do in the least. They found a far different reason for the deficit.

Men make up 49.5% of the U.S. population while the remaining 50.5%, of course, are women. The ratio of men to women is 97.23 men for every 100 women. In spite of a very small edge percentage-wise, women receive 40% more bachelor’s and postgraduate degrees than men at American universities. This deficit has led to a shortage of men in healthcare professions, especially nursing and the medical profession. Only 12% of nurses and 31% of physician assistants are male. Depending on the medical specialty, the percentage of male physicians has had an impact on the ability to care for our aging population. Only 30% of pediatricians and 17% of OB-GYN’s are male. The Association of American Medical Colleges projects a shortage of 86,000 physicians by 2036. They also predict a shortage of 1.1 million nurses in the coming years.

Why, then, are there so few males entering healthcare fields? The article presents a perspective I had not personally entertained. Societally, women have been encouraged to enter male-dominated fields such as nursing and physician specialties, but men have not been encouraged to enter female-dominated areas. Male nurses face ridicule and misunderstanding so fewer males are inclined to pursue that career. But the opposite does not seem to occur when women choose to become physicians. They are revered and respected once the patient realizes his doctor is female. Also male role models have not been produced who replace those who have retired.

The authors purport than since females exceed males in the general society, we should encourage less male, and more female participation in health care professions to better “reflect(s) the diversity of the patients we serve.” What the article doesn’t say is that many schools have gender quotas obligating them to take a certain percentage of women even if there are better-qualified males available. Qualified males become excluded when med schools  are required to have a percentage of enrollees be female or a minority. 

My opinion on this issue is not one that will earn me the doctor of the year award. Importantly, my opinion is based on many years of historical and experiential events occurring during my years of training and private practice. These influential experiences follow next.

1. My med school class of 206 students had 20-25 females. All of them, but one, were good students and worked hard. The outlier, however, was an older woman who took 6 years to complete the 4 years of med school. To avoid spending a night on call in the hospital she paid classmates to take call for her. Somehow she got away with it, and after graduation, she never practiced medicine that I know of.
2. A colleague in solo practice hired a female partner about half his age. She frequently expressed jealousy toward her older male partner, was always suspicious he was cheating her out of money, and was very disagreeable most of the time. When she left the association, to start her own practice, she reneged on a financial obligation to the older doctor. 
3. A young female physician acquired the general practice of a retiring physician. She practiced for 8 years before marrying, and not long after had a baby. After the baby’s birth she worked sporadically, but later closed her practice and never returned.
4. On the positive side, I’ve personally been to many female practitioners with whom I felt very comfortable and feel I was treated appropriately. A female interventional cardiologist performed my wife’s ablation competently and successfully.
5. As resident on pediatrics at Denver General Hospital, I worked for a month with a 9-months pregnant pediatric resident who worked harder than any of her male counterparts, took no time off, and worked until the minute she went into labor.
6. The female maternal instinct has a strong effect on a woman’s desire to work full time at her practice. Having children sometimes causes early retirement or limited, abbreviated practice hours.
7. A nurse working for a family doctor underwent in vitro fertilization three times without taking any time off work. When she became pregnant, she continued to work until her due date. Then after delivery, she was off on maternity leave for only two weeks. 
8. A female biochemist started med school at age 50. After earning her MD and completing an internal medicine residency she began practice at age 57. Twenty-seven years later she is still practicing at age 83. 

There, I’ve shared my experiences, both positive and negative. Males and females are different. Men don’t bear children and regrettably can easily divest themselves of the responsibility for child rearing. Women have a very difficult time separating themselves from that. Many struggle with relinquishing child rearing to surrogates. I think maternal instincts are a big factor for many women in maintaining a career in medicine and working full time, part time, or not at all.

To my mind correcting the imbalance in health care takes re-evaluating the concepts on which they are based. Is it really that critical that health care professionals’ demographic mirror that of society? I don’t think it is. I think health care providers should be chosen from among the brightest students who have proven they will finish what they start. Health care needs people we can trust to be there when they’re needed. “The future of health care depends on our ability to attract and retain talented professionals from all backgrounds. By addressing the growing shortage of men in health care,……..we’re enhancing the quality and comprehensiveness of patient care…..The health of our nation depends on it.”

Reference: Shah NK, Furlong M. THE CARE DEFICIT: Why we need more men in health care. Med Econ 2024 November/December:24-25.