The Changing Face of Medicine: Women Doctors and the Evolution of Health Care in America

[Excerpt] This book is a case study of one profession that plays a key role in the health care sector, which now represents about one seventh of the U.S. economy. It examines the most dramatic demographic change in this sector in the last century. But the issues we raise are likely to be of interest more broadly for what they say about the changing roles of women in contemporary society. Women\u27s entry into medicine is taken as dramatic evidence that the barriers to opportunity for women are rapidly falling in America. Does the experience of female physicians to date bear out this optimistic view? An alternative view is that gender roles remain deeply entrenched in our institutions and culture. Specifically, the gender division of household labor continues to constrain the choices of all women. The trade-offs between work and family may be clearest in the most demanding professions, such as law and medicine, which require a high degree of professional devotion. Our study builds on the fine histories of women in medicine written by Walsh, Morantz-Sanchez, and More. The analysis presented here focuses on the period since 1970, thus complementing the important studies of Bowman and colleagues and Bickel. Lorber examined the experiences of the generation of women who pioneered the transformation of the profession. With the benefit of additional decades of perspective, we are in a position to examine whether the role of gender in medicine is changing

Mammography screening for low income women

The existence of a significant fraction of women who fail to comply with mammography guidelines has led to a substantial body of literature on women\u27s decisions about mammography. Although relatively large in quantity, this literature is relatively limited in theoretical depth. Much of this work is atheoretical or based on value expectancy theory. The focus on value-expectancy theory has led many researchers to neglect the relationship between social networks/social supports and adherence to mammography guidelines. The relative oversight is a critical shortfall because there is reason to believe that social context is a determinant of health behaviors. In addition to being limited theoretically, much of the research on the correlates of mammography has been conducted on white, middle class women who are enrolled in health maintenance organizations. The behavior of uninsured and low-income women remains understudied. This dissertation seeks to address these gaps in the literature. Using data from a series of focus groups, a large scale questionnaire administered to two distinct populations, and a series of in-depth follow-up interviews, I examine the relationship between social influences and mammography guidelines for a population of middle-aged, low-income women. Analysis of the focus groups and in-depth interviews suggests that women\u27s conversations about mammography serve multiple purposes. They allow for the maintenance of a pro-mammography social norm, but also enable women to express concerns about mammography and anxiety over seeking care given financial constraints. Finally, conversation may influence the type of concerns women experience by influencing feelings of belonging and/or depression. Analysis of survey data suggest that social influences have a significant influence on plans to get a mammogram. Specifically, perceived social norms directly predict women\u27s intentions to get a mammogram. Further, emotional support and behavioral social norms influence intent to get a mammogram indirectly via positive and negative beliefs about the procedure

Mammography screening for low income women

The existence of a significant fraction of women who fail to comply with mammography guidelines has led to a substantial body of literature on women\u27s decisions about mammography. Although relatively large in quantity, this literature is relatively limited in theoretical depth. Much of this work is atheoretical or based on value expectancy theory. The focus on value-expectancy theory has led many researchers to neglect the relationship between social networks/social supports and adherence to mammography guidelines. The relative oversight is a critical shortfall because there is reason to believe that social context is a determinant of health behaviors. In addition to being limited theoretically, much of the research on the correlates of mammography has been conducted on white, middle class women who are enrolled in health maintenance organizations. The behavior of uninsured and low-income women remains understudied. This dissertation seeks to address these gaps in the literature. Using data from a series of focus groups, a large scale questionnaire administered to two distinct populations, and a series of in-depth follow-up interviews, I examine the relationship between social influences and mammography guidelines for a population of middle-aged, low-income women. Analysis of the focus groups and in-depth interviews suggests that women\u27s conversations about mammography serve multiple purposes. They allow for the maintenance of a pro-mammography social norm, but also enable women to express concerns about mammography and anxiety over seeking care given financial constraints. Finally, conversation may influence the type of concerns women experience by influencing feelings of belonging and/or depression. Analysis of survey data suggest that social influences have a significant influence on plans to get a mammogram. Specifically, perceived social norms directly predict women\u27s intentions to get a mammogram. Further, emotional support and behavioral social norms influence intent to get a mammogram indirectly via positive and negative beliefs about the procedure

Professional Role Confidence and Gendered Persistence in Engineering

Social psychological research on gendered persistence in science, technology, engineering, and mathematics (STEM) professions is dominated by two explanations: women leave because they perceive their family plans to be at odds with demands of STEM careers, and women leave due to low self-assessment of their skills in STEM’s intellectual tasks, net of their performance. This study uses original panel data to examine behavioral and intentional persistence among students who enter an engineering major in college. Surprisingly, family plans do not contribute to women’s attrition during college but are negatively associated with men’s intentions to pursue an engineering career. Additionally, math self-assessment does not predict behavioral or intentional persistence once students enroll in a STEM major. This study introduces professional role confidence—individuals’ confidence in their ability to successfully fulfill the roles, competencies, and identity features of a profession—and argues that women’s lack of this confidence, compared to men, reduces their likelihood of remaining in engineering majors and careers. We find that professional role confidence predicts behavioral and intentional persistence, and that women’s relative lack of this confidence contributes to their attrition.National Science Foundation (U.S.) (Grant # 0240817 & 0503351