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Your next gynecologist will probably be a woman

Women now dominate the ranks of ob-gyns and some men feel excluded. @NightshiftMD explains why.
According to a Canadian Medical Association survey, just under 60 per cent of Canada's ob-gyns are women. Some are saying men could disappear from the field entirely. (cliparts.co)

Women looking for a new obstetrician and gynecologist lately might have noticed a certain lack of men. Just under 60 per cent of Canada's ob-gyns are women. That's according to a Canadian Medical Association survey. Some are saying men could disappear from the field entirely.

There has been an unprecedented shift in the balance between female and male gynecologists over the past 20 years. The Royal College of Physicians and Surgeons of Canada says in 2012, 50 per cent of Canada's ob-gyns were women. Today, it's 58 per cent. That tracks with figures from the U.S., where 59 per cent of gynecologists are female. Eighty-three per cent of ob-gyn residents in the U.S., and 84 per cent of residents in Canada, are women.

Those figures are a far cry from 1970, when just seven per cent of practising gynecologists in the U.S. were women. The change that has taken place in just half a century is astonishing. There are several reasons why it's happening.

One is that women make up 41 per cent of Canada's physicians and rising. Just over 45 per cent of family physicians are women. But the total number of women physicians doesn't explain everything. Women have made some inroads into other surgical specialties, they dominate in obstetrics and gynecology. The most obvious reason why is that women gynecologists might feel more comfortable than their male counterparts dealing with gynecological problems in women, just as male urologists might be more at ease with male patients.

It's certainly not because of the hours, which are challenging, since babies are born anytime of day or night.

Explicitly or implicitly, at some medical schools, men are discouraged from becoming ob-gyns. Perhaps they look at the massive numbers of women in the field today and wonder what the heck they're doing there.

Patient preference is a factor. This is just about the only field where it's acceptable for a patient to demand a female provider. In an article about the lack of male ob-gyns in the L.A. Times, Dr. Barbara Levy suggested that women patients seek out female physicians because they're more likely than not to know what it's like to feel vulnerable during a pelvic exam. Survey data also indications a preference for women.  A 2012 review of studies concluded that patients felt women providers were more able than men to see things from the patient's point of view. A 2013 study suggested that women see female physicians as being less paternalistic than men.

Still, some women prefer male ob-gyns. A review of 23 studies found that eight per cent of women find men to be more gentle and better listeners. 

The study findings come from survey data. You can't be sure if they come from actual experience or from general perceptions and stereotypes. I suspect it's a bit of both.

The implications of male doctors disappearing from obstetrics and gynecology has been a hot topic since Dr. Jerome Chelliah told the L.A. Times he is often asked to step out in favour of a female colleague. Some men fear being excluded from the specialty entirely, which they say could lead to everything from a lower standard of care to reduced innovation.

I can't see the logic behind those arguments. I doubt very much that men are being driven from the field. I know of no other medical specialty in which anyone would have the audacity to suggest that gender balance has anything to do with innovation. 

Besides, women have been pushing up against the glass ceiling in medicine ever since they began entering the profession in significant numbers. Dr. Joanne Sivertson, an ob-gyn and current president of the Saskatchewan Medical Association, tweeted, "When I was a med student considering obstetrics and gynecology, a renowned male perinatologist told me it was unfortunate that mostly women were entering the specialty because 'the profession will lose all respect.'" 

Women in medicine have long complained legitimately that they have been underrepresented in almost every other surgical specialty. Maybe now, some men are realizing what it feels like. 

As we look to the future, more than 80 per cent of residents training to be ob-gyns are women. In the U.S., it's predicted that by the year 2025, two out of every three obstetricians will be women. That trend is unstoppable.

Still, I doubt that men will disappear from obstetrics and gynecology. Studies have found that 41 per cent of women prefer a woman or a man equally, a finding that has led some to say this issue has been blown out of proportion. No one is saying women and men differ in terms of competence. I think women should be able to have a choice in ob-gyns. In my opinion, both men and women should have equal opportunities, and neither should be excluded from any field in medicine.

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