Gender factors

By MARALINE KUBIK
VINDICATOR STAFF WRITER
When Susan Kelly gave birth to each of her two sons, a man delivered them. He was a competent physician, but she didn't feel comfortable talking with him.
When she reached midlife, and began experiencing the symptoms of menopause, the Poland woman switched doctors.
"I wanted to be able to talk to a woman who might have had similar experiences -- someone who would understand experientially, not just from a medical perspective," Kelly said. "I wanted to know what was going on with the emotional changes I was experiencing as well as the physical changes, and I didn't think a man could understand because he'd never experienced it."
She's been with her new doctor, Joni S. Canby, a female obstetrician/gynecologist, at least 12 years and has no desire to switch.
The atmosphere in Dr. Canby's office is more comfortable, Kelly said. "All of her employees are women, and they are more sensitive. If it's going to be a few more minutes, they'll come out and tell you."
General doctor: When Kelly moved to a new neighborhood in Poland, she continued seeing her female gynecologist but opted to find a new general practitioner.
For primary medical care, Kelly didn't care if the doctor was a woman or a man. What mattered most, she said, is how convenient the doctor's office was to her home.
Her primary care physician's office is a mile and half from home, she said.
National trend: Kelly is typical, part of a national trend that puts female doctors specializing in obstetrics, gynecology and pediatrics in especially strong demand, said Dr. Sheila Steer, director of the office of women and medicine at Northeastern Ohio Universities College of Medicine in Rootstown.
Many women, especially young women, prefer female obstetricians and gynecologists, Steer said. Patients' preferences for female physicians in those areas are so strong, she added, that general practitioners who are men often employ female nurse practitioners to perform their patients' gynecological exams.
Students studying to be physicians have also responded to the trend. Nearly 50 percent of students admitted to medical school are women, up from 30 percent just 15 years ago, Steer reported. While men once dominated all areas of medicine, fewer men are applying to medical schools and of those who are, a smaller percentage is choosing to pursue careers in specialties where patients increasingly exhibit preferences for women.
Percentages: For the 2001-2002 school year, 18,142 men applied to medical schools, an 8.4 percent decline from the year before when 19,816 men applied, according to the Association of American Medical Colleges. The number of female applicants also declined, but not as dramatically: 16,717 vs. 17,273, a 3.2 percent drop.
Female residents dominate a handful of medical specialties including obstetrics/gynecology and pediatrics. In 2000, 69.9 percent of residents specializing in obstetrics/gynecology were women, according to the AAMC, up from 44.2 percent in 1989. Similarly, 65.2 percent of residents specializing in pediatrics in 2000 were women, up from 50.3 percent in 1989. Female residents also outnumbered men in medical genetics with 53.1 percent of the resident positions in 2000, and dermatology with 55.8 percent of the resident positions.
Despite the influx of women in medicine, not all patients are lining up to be treated by female physicians.
No preference: Most people who call the Trumbull County Medical Society for physician referrals don't care whether they are referred to a man or woman, said Marla Fraelich, executive secretary.
"Obstetrics-gynecology is the only area where they are asking specifically for a woman," Fraelich noted. Then, those who have had a female physician definitely want to be referred to another female doctor, she said. Women who've had a male obstetrician/gynecologist don't specify, she added.
What seems to matter most to callers, especially older callers, Fraelich said, is the location of the physicians' offices.
Valley residents: Half of the callers seeking referrals from the Mahoning County Medical Society are concerned about where physicians' offices are located, said Eleanor Pershing, executive director. A few ask for physicians of a specific gender -- mostly women looking for a gynecologist -- but, she said, they are in the minority. A few callers also ask about physicians' ages and board certifications, Pershing said.
At UPMC Horizon, in Mercer County, Pa., callers to the physician referral line "are concerned first and foremost with specialty, geographic area, then insurance, hospital affiliation and gender," said Kathy Lima, vice president of community development.
Callers presume they will be referred to a male physician, she said, "so they only tell us if they prefer a woman."
Requests for female doctors come mainly from women looking for gynecologists, but there have also been "requests for female primary care physicians and some female specialists -- cardiologists," Lima said.
Most requests for female physicians come from women, she added, but a few men have also requested the names of female doctors.
kubik@vindy.com