Gender biases are extremely common among health care professionals

By Dr. Ananya Mandal, MDJul 8 2019

Enrolment data for medical schools in the United States has shown an almost equal representation of men and women since 1999. However, new research has shown that there is a discrepancy between the way that men and women are perceived in medicine and healthcare. Although several factors may have contributed to such gaps, the role of gender biases needs to be evaluated.

Researchers from Washington University, St. Louis published their recent work on estimating gender differences. They looked at records to check into both “implicit and explicit gender bias”. The results of their study titled, “Estimating Implicit and Explicit Gender Bias Among Health Care Professionals and Surgeons,” was published in the journal JAMA Network Open.

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Definitions and tools used in the study

Implicit biases are those that influence beliefs outside of one’s conscious awareness. These compel people to behave unlike their explicit ideas. These biases are influenced by our environment and affect the role of men and women in medical careers.

Direct evidence of such gender biases is unproven, though they exist in subtle ways. For example, women physicians are often addressed as “nurse” instead of “doctor” or by their first names. Studies show that women are less likely to be invited as speakers, less commonly awarded, considered less hirable and offered lesser salaries for identical qualifications as their male counterparts.

An Implicit Association Test (IAT) is a tool to measure implicit biases that exist in hospitals and health care systems. To estimate the degree of gender bias several thousand health care professionals were enrolled in the Project-implicit with a host of online IATs.  

For the study, a Gender-Career IAT was taken by health care professionals to assess how strongly career or family were associated with either male or females. A Gender-Specialty IAT was undertaken among surgeons attending the national surgical meeting, where surgery and family medicine were the two attributes instead of career and family. This was based on the hypothesis that men would be more commonly associated with surgery and women with family medicine. Upon completion of the IAT, explicit questions regarding gender biases were asked. Data from almost 1 million IAT records and 131 surgeons were reviewed to reach a conclusion.

Results

The results revealed that women were more commonly associated with family and men with career among women than men. In contrast, the association of men with highly demanding careers and women with family was less common among women than men.

The IAT scores for Gender-Specialty indicated a significant association between men and surgery, and women with family medicine. This belief was true for both men and women, however, explicit bias was more among men than women.

The data  suggests that healthcare professionals commonly see surgery as a male-oriented specialism and family medicine as a female-oriented career path. These biases were similar across all social categories, but the biases in were greater among men.

Explicit gender-specialty biases among male surgeons were similar to explicit gender-career biases among male health care professionals. However explicit gender-specialty biases among female surgeons were lesser than gender- career bias among female health care professionals.

Further studies are needed to evaluate whether these biases are caused due to existing gender inequalities. Earlier studies reveal that women are more likely to abandon surgical residency and gender disparity exists in leadership roles.

Tackling gender inequalities in healthcare and medicine

Equal representation of all groups is a requirement for a successful organization. Half of the population consists of women and ensuring their equal representation in the medical field would satisfy patients . Women should also be employed in leadership roles, as role models and mentors to ensure greater productivity and profit.

A better understanding of factors that lead to underrepresentation of women can improve recruitment and retention of them in organizations. Realization of existing biases is important to minimize their effects.

The current study is a step forward in raising awareness of gender biases in health care sector. The data will allow junior doctors to understand and prepare themselves for their future work environment, while organizations can use the data to encourage diversity and reduce gender inequality/biases.

The main purpose of this study was to understand implicit gender bias within the health care system. Further studies are required to evaluate the implications of such biases on gender discrepancy and discrimination.

There is research that assesses interventions to address gender bias like improving transparency of hiring and promoting, using diversity as a metric for organizations and allowing flexibility of leaves to women employees.

Understanding the implicit associations that are psychological obstacles to women’s success is important to device interventions that reduce gender inequality.

The article was accompanied by an invited commentary by Fahima Dossa, and Nancy Baxter, both from University of Toronto.

Knowledge of these biases will not automatically translate into behavior change. A starting point for change may be acknowledging that we all carry these biases and considering how they may be affecting our perception of reality.”

By understanding how our interpretation of situations varies based on the biases we carry, we can attempt to predict how these biased interpretations might affect our behaviors and identify tangible strategies to mitigate the effects of implicit bias."

Fahima Dossa, and Nancy Baxter, Authors