By Linda Brodsky, M.D.
Tuesday, August 25, 2009
This week, U.S. women celebrate our 89th anniversary of gaining the right to vote and Dr. Linda Brodsky uses the moment to review the lingering effects of women's inequities on the burning national debate over health care reform.
Editor's Note: The following is a commentary. The opinions expressed are those of the author and not necessarily the views of Women's eNews.
(WOMENSENEWS)--On August 26, we celebrate Women's Equality Day, commemorating the 89th anniversary of the 19th amendment to the U.S. Constitution that gave women the vote in 1920.
Though officially organized in 1848 in Seneca Falls, N.Y., the U.S. women's rights movement endured 72 years before realizing this first critical goal.
Another 51 years passed before New York Congresswoman Bella Abzug in 1971 sponsored a bill so that each successive U.S. president would be able to proclaim August 26 as Women's Equality Day.
Now, 38 years later, where are we?
As a group, U.S. women are among the most educated and privileged in the world. But our gender gap in national political representation remains wider than 26 other countries.
That leaves us at a disadvantage in the most heated domestic policy debate of these days: healthcare reform.
As we monitor and participate in this debate, women should push for changes in national health policy that rectify women's inequalities as medical professionals and patients.
Gender profiling for health insurance purposes continues to be legal in most states.
Women pay more for individual health insurance if we are even able to obtain coverage.
A study by National Women's Law Center finds that a 30 year-old non-smoking women often pays significantly more than a 30 year-old male smoker.
Thus, many women, particularly those with lower incomes, go without health insurance and have less access to both preventative and necessary healthcare.
Many policies have no maternity benefits and many exclude those with previous C-sections or who have been victims of domestic violence.
And after we recover from birthing our children (and our country's future) and return to work, we often are denied job advancement at best, or face demotion or dismissal at worst. Protections are inadequate and nearly impossible to enforce given the enormous financial and emotional costs of litigation.
As we mature, women are more likely to be misdiagnosed and undertreated if we have heart disease.
We are less likely to get joint replacements for orthopedic problems and will suffer from back pain longer before receiving relief.
We are more often initially told "it's all in your head," suffering through mental health diagnoses where none exists.
Mothers of my patients have arrived in my office desperate because their own emotional integrity has been questioned when their 9-month old child still wakes 10-15 times each night crying or their rambunctious pre-teen is out of their control. When obstructive sleep apnea or severe extra-esophageal reflux are diagnosed and treated, how rapidly these mothers recover from their so-called "over-concern!"
Gender inequality for female physicians takes the form of fewer opportunities for advancement. This minimizes our impact in the arenas of research, particularly in women's health issues, public health policies and medical education of the future physicians.
Female physicians occupy only 17 percent of the positions on medical journal editorial boards, where the decisions about what research is worthy of publication are made.
Our numbers in medical academia--where we educate our future physicians and most research is performed-- are not representative.
Women are also in short supply in medical organizations that advise our elected leaders, such as the American Medical Association or the American College of Surgeons.
Female physicians earn only 61 cents for each dollar a male physician earns. We face a greater than 80 percent chance of experiencing discrimination and-or sexual harassment some time during our career. Higher rates of burnout are common. How can this physician work force be as effective as our rising needs require?
This situation translates into a dangerous misuse of our most important medical resources.
Misuse and underuse of physician talent is more than unhealthy as world-wide physician shortages are anticipated. In the long run, failure to equally value women as healthcare providers will ultimately damage our nation's health and healthcare needs.
It's time we took a bold approach to fixing gender equity as part of fixing our health care system. We can start this reform process by linking accreditation and federal and state health care dollars to metrics that include closure of the gender gap.
Finally we must not only recognize but also vigorously root out the pervasive negative effects of this gender gap in all aspects of our society. In healthcare, the stakes categorically mean the difference between life and death.
We may have the vote, but 161 years later, hundreds of proclamations, quasi-awareness holidays, or even scores of legislative initiatives have been insufficient to change the status quo. Gender stereotyping, gender discrimination, and other forms of violence against women, must be aggressively rooted out.
Dr. Linda Brodsky is a pediatric otolaryngologist and "accidental crusader" for equal rights. She is accepting submissions for her multi-author book project that will examine the effects of gender discrimination in healthcare. Stories can be submitted here. http://www.lindabrodskymd.com/book-project.html
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