Women in Surgery Italia: National Survey Assessing Gender-Related Challenges.

BACKGROUND: In 2019, women accounted for 46% of surgical residents. Despite the international debate on gender disparities, no literature regarding the experience in Italy is available. The aim of this survey study was to assess satisfaction among female surgeons in Italy, and determine whether they encounter gender-based discrimination. STUDY DESIGN: An anonymous, 83-item web-based survey was distributed among female surgeons working in Italy, from November 18 to December 31, 2020. Gender equity, satisfaction, and factors associated with higher satisfaction and work-life balance were explored. RESULTS: There were 3,242 volunteer respondents, 1,833 of whom completed at least 50% of the specific questions and were included in the study. Approximately 54% of female Italian surgeons reported being satisfied with their job, but only 34% with their work-life balance. Among residents, 67% thought they were not adequately trained. The majority of respondents were responsible for most of the housekeeping (60%) and childcare duties (53%), regardless of their partner's workload, and 62% reported that gender affects the way they are treated at work, with most of them experiencing microaggressions. Sexual harassment was common (59%), but only 10% of women reported it. CONCLUSIONS: Most Italian female surgeons are satisfied with their professional choice. However, they face gender discrimination, including incidents of sexual harassment and microaggression. Due to the fact that half of surgeons working in Italian hospitals will be females in the next few years, actions are urgently required to build a culture that supports a gender-neutral environment.

Mitigating the gender gap: How "DOCTOR" badges affect physician identity.

OBJECTIVES: Patients and their families frequently misclassify female physicians in the Emergency Department (ED) as non-physicians. Physician misidentification impacts the environment of care on multiple levels; including patient satisfaction and physician well-being. Implementing "DOCTOR" badges may be a low-cost tool to rectify these problems. METHODS: The study was conducted in a large urban academic medical center. Badges with the title "DOCTOR" was distributed to 83 Emergency Medicine (EM) residents and 28 EM Attendings in the department. After 3 months, the residents and Attendings were surveyed to assess the efficacy of the intervention. Descriptive data, univariable, and multivariable analyses were conducted. RESULTS: There were 98 respondents to the pre-intervention survey and 87 respondents to the post-intervention survey. 91% of EM physicians reported that they were misidentified by the patients and their families. Compared to male EM physicians, female EM physicians were disproportionately more likely to be misidentified as a non-physician 43% vs 97%, respectfully, 95% CI: [37,66], p < 0.0001. After wearing the "DOCTOR" badges, a postintervention survey showed decrease in misidentification of female EM physicians by patients and their families to 81.6%, a 15.4% decrease, p = 0.03. Being more valued was reported by 73.7% female physicians vs. 44.9% male physicians, 95% CI [7.9,46], p = 0.007. Similarly, 64.3% EM physicians felt less frustration with misclassification, 81.6% female physicians vs. 51% male physicians, 95% CI [10.5,47], p = 0.0033. CONCLUSIONS: Female EM physicians are disproportionately misidentified by patients and their families and are more likely to feel undervalued when clarifying their roles. In only a span of 3 months, we found that the use of "DOCTOR" badges decreased misidentification and improved outcomes that may enhance physician wellness. Having EM physicians wear a "DOCTOR" badge may be a simple and effective long-term solution to this issue.

[The 'feminine' in the history of medical didactics]. / Il "femminile" nella storia della medicina.

Women are present in the 'long' history of medicine both as patients and as healers specialising in curing and caring. The nowadays existing attempt to define a female specific medical knowledge (discussing, for instance, the quality of a supposed 'female' cultural and professional training; the role of women in medical research as well as in discussing bioethical subjects; the relationship between women-physicians and other medical professionals; the female approach to important bioethical issues such as euthanasy, 'therapeutical fury' for the incurable sick, female genital mutilations) is here analyzed in a broader historical context.

Smoking cessation counseling by primary care women physicians: Women Physicians' Health Study.

OBJECTIVES: The Women Physicians' Health Study (WPHS) offers a unique opportunity to examine the counseling and screening practices of women physicians. The objectives of this study were to: describe the prevalence of self-reported smoking cessation counseling among primary care women physicians and determine the association between physician demographic, professional, and personal characteristics and smoking cessation counseling. METHODS: Conducted in 1993-1994, WPHS is a nationally representative cross-sectional mailed survey of U.S. women physicians and included 4,501 respondents representing all major specialties. Primary care physicians included 5 specialty areas and were grouped into 3 categories: (1) general primary care; (2) obstetrics/gynecology (ob/gyn); and (3) pediatrics. Frequent counseling was defined as having counseled patients who were known smokers at every visit or at least once a year. RESULTS: Women physicians in general primary care (84%) and ob/gyn (83%) were more likely to frequently counsel their patients about cessation than were pediatricians (41%). Perceived relevance of counseling to a physician's practice was significantly associated with frequent counseling. Personal characteristics (current smoking status, personal or family history of a smoking-related disease, or living with a smoker as an adult or child) were not significantly correlated with counseling. CONCLUSION: The majority (71%) of physicians reported frequently counseling their patients. However, there was significant variation by physician specialty. In addition, perceived relevance of counseling was strongly associated with counseling behavior. Physician counseling on cessation can reduce tobacco-related morbidity and mortality. Increasing perceived relevance, implementing system changes, and creating accountability can facilitate cessation counseling by physicians.

Characteristics of female psychiatrists.

OBJECTIVE: This study assessed within-gender differences between psychiatrists and other physicians by using data taken from a large national sample of U.S. female physicians. METHOD: The authors used data from the Women Physicians' Health Study, a large, national questionnaire-based survey conducted in 1993-1994, to compare characteristics of female psychiatrists (N=570) with those of other female physicians (N=3,875). RESULTS: Psychiatrists were older, in poorer health, less likely to be married, more likely to be current or ex-smokers, and more likely to be politically liberal than were the other female physicians. Psychiatrists were somewhat (although not necessarily significantly) more likely than the other female physicians to report having had personal or family histories of various psychiatric disorders. Psychiatrists were more likely to have a solo practice and less likely to be in a group practice. They worked fewer hours than the other female physicians but reported comparable hourly incomes. Psychiatrists did not differ from the other female physicians in perceived work amount, work stress, work control, or career satisfaction. Their satisfaction with their specialty was, however, greater than that of the other female physicians. For nearly all of the 14 preventive health care counseling practices examined, the amount of preventive counseling psychiatrists reported performing, the clinical relevance they ascribed to those practices, their self-confidence in performing the practices, and the amount of training they reported receiving in preventive counseling practices was significantly lower than that of primary care practitioners and lower than or comparable to that of other specialists. CONCLUSIONS: Female psychiatrists significantly differ from other female physicians with regard to a number of personal and professional dimensions.

Characteristics of women surgeons in the United States.

BACKGROUND: Women surgeons are becoming increasingly prevalent. Despite this, there have been few studies of personal or professional characteristics of US surgeons of either gender. METHODS: Data were taken from the Women Physicians' Health Study, a nationally representative random sample (n = 4,501 respondents) of US women physicians, and data were analyzed in SUDAAN. RESULTS: Surgeons were younger, and more likely to be US born, white, unmarried, and childless than were other women physicians; their personal health behaviors were similar to those of others. They worked significantly more clinical hours and call nights, but were not more likely to report feeling that they worked too much, had too much work stress, or had less control of their work environment. Their career satisfaction was similar to that of other women physicians, and satisfaction with their specialty was greater. They were less avid preventionists than were primary care practitioners, and somewhat less avid than other specialists. CONCLUSIONS: Women surgeons differ in interesting and important ways from other women physicians.

The impact of nonclinical factors on practice variations: the case of hysterectomies.

OBJECTIVE: This study investigates the role of nonclinical factors (physician characteristics) in explaining variations in hysterectomy practice patterns. DATA SOURCES AND STUDY SETTING: Patient discharge data are obtained from the Arizona state discharge database for the years 1989-1991. Physician data are obtained from the Arizona State Medical Association. The analyses are based on 36,104 cases performed by 339 physicians in 43 hospitals. STUDY DESIGN: This article measures the impact of physician factors on the decision to perform a hysterectomy, controlling for a host of patient and hospital characteristics. Physician factors include background characteristics and training, medical experience, and physician's practice style. Physician effects are evaluated in terms of their overall contribution to the explanatory power of regression models, as well as in terms of specific hypotheses to be tested. DATA COLLECTION: The sources of data were linked to produce one record per patient. PRINCIPAL FINDINGS: As a set, physician factors account for a statistically significant increase in the explanatory power of the model after addition of patient and hospital effects. Parameter estimates provide further support for the hypothesized effects of physicians' background, experience, and practice characteristics. CONCLUSIONS: Overall, the results confirm that nonclinical (physician) factors play a statistically significant role in the hysterectomy decision. Substantively, however, these factors play a smaller, secondary role compared to that of clinical and patient factors in explaining practice variations in hysterectomies. The results suggest that efforts to reduce unnecessary hysterectomies should be directed at identifying the appropriate clinical indications for hysterectomy and disseminating this information to physicians and patients. This may require such intervention strategies as continuing clinical education, promulgation of explicit practice guidelines, peer review, public education, and greater understanding and inclusion of patient preference in the decision process.