Sexism in Clerkship

I’m going to point out that frequently during your clerkship, you will experience sexism. Sometimes these moments will be not too bad, a patient thinking you’re a nurse (are you kidding? I wish I knew that much in clerkship!)

Most times, it will be subtle. It will be everyone ignoring the suggestions made by the female clerk. It will be judging her outfit or flirting with anyone. It will be interrupting her, presenting her ideas as their own. It happens. It becomes common. Everyone will act like this is just how it is. Your job, male or female, is to make sure this is no longer common. Your job is to make sure that clerk feels supported. This is your team, you all need to be strong.

Here’s how to do it without waving a flag and making everyone on the team afraid of you.

When she is interrupted or ignored, wait until the interrupter is finished speaking, then say “I think that Meredith was making a good point, did everyone get to hear it?” When derogatory comments are made, ignore them and change the topic to whichever patient was being discussed prior to the comment. If someone is presenting Meredith’s ideas as their own, be subtle, this one is tricky. Something along the lines of “It’s a great idea, I thought as much when Meredith said it this morning at rounds. Maybe you two should work on it together!”

Everyone on your clerkship team deserves to feel supported. Everyone deserves to be able to show what they know and learn. When your colleagues thrive they bring you with them.

Be the colleague you want to have.

My online appearance is more important than my physical appearance

I had a great time today reading posts and comments on Twitter about physicians' appearances.

Things I've learned:
1. Some docs really like this article from 2005 (!!!!) on the importance of dressing well for your patients. Remember it can take up to 3 years to publish an article so this data is from 2003 at the latest. Think track suits and Queer Eye for the Straight Guy.

2. The BBC would really like doctors to generally judge everything about their outward selves. This article looks at "scruffy doctors", overweight doctors, and doctors who smoke. They also acknowledge that many patients are expecting the white coated doctor to be male. 

Which brings me to...

3. A separate discussion has been playing out today on Twitter about how young female physicians are perceived spurred by this blog entry. Female docs are often (VERY often) mistaken for nurses. Even after introducing themselves as Doctor SoandSo. I know I've blogged on this before but I can't find it. We are also assumed to be the assistant, the secretary. As an older than average resident, I was usually mistaken for the social worker or my pediatric patients' mother DESPITE wearing an ID badge and my stethoscope. One intelligent staff member asked me 6 times during my 2 month pediatric rotation to fill out the insurance forms for "my child". She was shocked every time that I was *still* a physician. I was once blocked from a code by the nurse who called me to it because she thought I was a family member (again, with stethoscope and badge). 

While I was on rotations in other hospitals, I would carry a small bag with my "pocket" stuff. Pens, a Drug Pocket, my phone. Most "professional" women's clothing prohibits actually using pockets if they do exist. This teeny satchel was usually the scape goat in my mis-identification. 

This is one of those issues that makes me a bit cranky. Have I told you yet about the preceptor who told me that it was perfectly reasonable to be mistaken for the social worker since "doctors don't have long curly hair, you can't expect to be taken seriously"? It makes me see red. 

If, in real life, I'm mistaken for another profession or not a professional at all, based on my hair and my satchel, what must the medical world think of me based on my online profile? 

Some argue that our online presence allows others to see our "true selves" (it's the basis for many relationships that start online). Social media (SoMe), plays a big part in my life. I'm in a tiny rural town, most of my friends are in different provinces. Without my online presence, I would be entirely isolated. My professional online presence is split between The Imposter and Dr. SoandSo. Maintaining my anonymity on this blog is important to my being able to use it as a sandbox for trying out ideas and ways of dealing with patients in a safe environment. As Dr. SoandSo, I have opinions on family medicine and its role among the specialties. As just me, I am on Facebook with my friends and family so I can watch my family grow up from a distance. 

I'm seeing guidelines and suggestions about how docs (and everyone else) should behave online. It's true, many docs are illiterate in the ways of SoMe, but I think that they are aware of how to behave in a crowded mall. The same rules we learned in kindergarten apply. 

1. Share everything. Post your references so others can also be as smart as you.
2. Play fair. Don't overload your online profile so that your friends aren't also visible. 
3. Don't hit people. Don't call them names. Maybe they have had a really bad day.
4. Clean up your own mess.  Untag any photos that you wouldn't want your mother to put into the family Christmas card. 
5. Don't take things that aren't yours. Credit any source that you use. You wouldn't want someone else prancing around in the sweater you took 3 years to make claiming they knitted it themselves. Our intellectual property is just as important. 
6. Say you're sorry when you hurt somebody. Apologise when you make a mistake and correct those mistakes.
7. Wash your hands before you eat. MRSA y'all. 
8. Live a balanced life - learn some and think some and draw and paint and sing and dance and play and work every day some. Your online friends are interested in the new bottle of wine you found just as much as they are the new journal article that you found so fascinating. Share. But please don't overshare. 

Truthfully, first impressions are just that. The patients who mistook me for a social worker trusted my ability to care for their medical needs. First impressions don't matter nearly as much as who we as health professionals truly are. How many times have you heard from your patients the story about the surgeon in his million dollar suit with no bedside manner? Could you possibly sleep well at night knowing that you had treated your patients in a way that would have put you in the corner during kindergarten? My online presence is as close as it comes to knowing the real Imposter and how she speaks with her patients. 

Dress respectfully for your patients but act respectfully (online and face to face) for yourself as much as them. 

Prejudice is a four letter word. No really, count again.

Prejudice is live and well in the medical community
:: waits for the shocked gasp ::

One of my tutors firmly believes that everyone has equal access to health care and that Americans are well off with respect to wait times and ability to get care. I get so angry. Then I blather on and on about other things because I know if I don't change the subject I'm going to punch her in the mouth. She goes on and on about the 350lb man with a donut in hand who comes in complaining of >insert whatever illness we're discussing that week<

She also assumes that people who work blue collar jobs are a) idiots that aren't capable of understanding a treatment plan and b) don't care about their health.

If Canadians, rich and poor, have equal access to health providing opportunities, then why are babies born to teen aged moms significantly smaller? If it's not the reduced counselling about prenatal nutrition received compared to women in their 20s and 30s, and the lack of medical support for this demographic, then I just don't know what it would be.

I recently came across this blog called "First, Do No Harm"
It's terrific, horrifying and well written. Fat people who have been treated like garbage talk about their experience accessing health care in the US. I know it's the same here just listening to my tutor.