Women in medicine: toward a conceptual understanding of the potential for change.

In 1959 only 6% of Canadian medical school graduates were women, but by 1989 44% of graduating classes were female. Recent data indicate that women are more likely than men to work as general practitioners, in groups, in urban settings, and on salary; to work fewer hours per week and to see fewer patients. In this paper we address the ongoing discussion of the impact of women's progressive entry into medicine. We suggest that a shortcoming of the discussion thus far has been its preoccupation with a descriptive examination of women physicians' professional characteristics and practices; sufficient attention has yet to be paid to the development of a clearer conceptual understanding of the nature of gender differences and the potential for change they imply. Using data from quantitative and qualitative phases of a national study of Canadian physicians, we address the relationship between gender differences in practice and underlying attitudes and values and identify alternative hypotheses about the potential for change created as more women enter medicine. We suggest that this potential goes beyond professional demographics and workloads to the doctor-patient relationship, but that the extent of change will be mediated by the socializing impact of medical school and the extent to which women physicians are included in or excluded from positions of power within the profession. We suggest also, that to meaningfully understand and document change, greater attention must be given to arguments that women and men view the world in qualitatively different ways.