American Scientist

Vol. 66, No. 4 (July–August 1978)

DOCTORS WANTED: NO WOMEN NEED APPLY: Sexual Barriers in the Medical Profession, 1835–1975 . Mary Roth Walsh. 303 pp. Yale University Press, 1977. $15.

THE HIDDEN MALPRACTICE: How American Medicine Treats Women as Patients and Professionals. Gena Corea. 309 pp. William Morrow, 1977. $10.

In October 1970 the Women’s Equity Action League (WEAL) filed a class action complaint against every medical school in the country, alleging abuses in admissions. This suit and some individual cases connected with affirmative action requirements of the federal government resulted almost immediately in an increase in female enrollment in American medical schools, a trend that is still moving upward. Within five years of the filing, the number of women medical students in the U.S. had tripled, and the 1976 entering class showed a 700 percent gain over the 1959–60 level; rises so dramatic were possible because so few women had previously been enrolled. Yet, women currently make up less than 25 percent of the total of medical students, up from 9 percent in 1969–70. The effects of these new admission policies on internships, residencies, and all of American medical practice remain to be seen. One can reasonably predict, however, that the U.S. by the end of this century will have moved from its present low position (8 percent women physicians) among industrialized nations to one more in accord with that of the U.K. (25 percent) and the U.S.S.R. (74 percent), and one can hope that sexual barriers will continue to crumble and good sense more and more to prevail.

Past history suggests that this outcome is not inevitable. In 1950 there were fewer women doctors in Boston—long “the stage for most of the crucial battles that have marked women’s efforts to enter medicine”—than there were in 1890. The “golden age” of women physicians in the U.S. was during the second half of the nineteenth century. In 1900 there were around 2,500 graduate women physicians in this country, 10 times the number then found in England and 25 times the number in Paris. A precipitate decline set in, followed by 50 years of stagnation. Walsh’s thorough and penetrating study of sexual barriers in the American medical profession over the past 140 years demonstrates and elucidates this pattern by systematically analyzing sex differentiation and discrimination in this “high status” occupation.

Drawing on primary sources hitherto largely unstudied by sociologists and historians of medicine and science, she has amassed an impressive amount of statistical data which she handles expertly and felicitously. Her focus is on women who aligned themselves with standardized, rather than irregular, medical practices. Her conclusions are balanced and instructive, illuminating not only her particular subject but American medical and social history in this period. She supports her argument that “feminism was a crucial variable” in women’s progress in Boston medicine between 1850 and 1900 and successfully challenges two notions later widely held: the first, that extended educational requirements and licensing laws kept women out of medicine and, the second, that women themselves voluntarily rejected medical careers. Rather, she maintains that in the twentieth century “the medical establishment made a conscious effort to minimize the number of women physicians...[and] succeeded...[because] women physicians were never able to exert any real power in medical institutions.”

Well-organized and well-written, Walsh’s book is a model of historical analysis. She avoids unsupported hypotheses and emotional bias and provides valuable data and useful conclusions. This important and readable work is handsomely printed and bound.

Gena Corea’s The Hidden Malpractice is a journalistic account, written from the feminist viewpoint, of how the American medical profession, since early in the nineteenth century, has treated women—as patients, medical workers, and medical professionals. Its brief first part, “How Women Have Been Barred from Healing,” considers female physicians, divisions among them, and female health workers. The much longer second part, “How the Male Domination of Medicine Affects the Health Care Women Receive,” investigates aspects of the patient-doctor relationship, social control of medicine, venereal disease, birth control, male contraception, abortion and sterilization, childbirth, midwives, and treatment of common female health problems. Any prolonged indictment is apt to become tedious, but the book is valuable in alerting both men and women to unwarranted assumptions about “normalcy” in health standards and medical practices and in pointing out many procedures and attitudes that have no place in a profession dedicated to healing and comforting. In an epilogue Corea describes the women’s health movement; there are also source notes and a list of resources for change that are useful. Both patients and physicians will find the book a salutary read. —Elizabeth C. Patterson, Physical Science, Albertus Magnus College