I think that women doctors are currently a bit screwed. We tend to either get along with the staff well, meaning nurses and front desk and janitors and all, or get along with the other physicians and the administration.If we get along well with other doctors, then we don't do well with staff and vica versa. This is based on my observations of 4 years of medical school, 3 in residency and 13 in practice.

I'm a woman doctor specializing in family practice and still doing obstetrics after 13 years. I'm also an introverted thinker. This means I enjoy studying my fellow doctors. I'm in a small town so the hospital-employed primary care docs doing clinic and inpatient are a small number. There were 13 when I got here. I am now tied for 2nd senior of the original 13 and we still have 13 physicians. We also have some nurse practitioners and physicians assistants. I am senior female doctor doing both inpatient and outpatient primary care. I wrote a satire called Local Doctor Survivor designing a game a few years ago, but only showed it to one physician's assistent that I trust. I am trying, so far unsuccessfully, to offer gentle mentoring to some of the new women.

The women doctors tend to burn out faster than the male doctors over the last ten years. Of the 10 gone, 5 were female and 5 were male. Currently we have six male doctors and 7 females. I am noticing a trend, very unscientific based on my small sample size, but I don't care if it's scientific. It just interests me.

Out of the 5 women doctors who have left in the last 9 years and the six that are her now including me, only one has gotten along with both staff and other doctors. She was nice to everyone and did the quiet mourned burnout. I admit that I'm not terribly sure about 3 of the new ones. The administration has not allowed me extra time for these studies. I get along with the staff, but the administration and other doctors often treat me like the bit of sand in the oyster. My orginal clinic spit me out. The administration backed them and then had a bit of a tiger by the tail, because I wouldn't go away. There is a sensible female administrator who I think views me with a bit of trepidation but kind of likes me anyway and she told me that the desk staff and nurses at the Spitting Clinic wanted me to know that they had no problem with me. I was trying to get my own clinic but when I suggested using a space that two previous docs had left and calling it the Doghouse Clinic, I was placed "temporarily" in another clinic. The new clinic was a bit nervous but we've bonded. I told the sensible female administrator that I was a lot happier in the clinic Where They Kill Small Birds With Guns then in the Yuppie Clinic. She about choked trying not to laugh, and hasn't forgotten it three years later. The administration notified me that I had to up my hours after a year and I met with them and said sweetly, "but I'm temporary." The CEO had forgotten, but the sensible female said, "No, you're permanant." "Oh, I'll have to go celebrate! Why thank you! I didn't know!" You can see why I'm a bit of a hairball for them.

We have two new woman family practitioners who both did an extra year fellowship in obstetrics. This means that they can do cesearean sections. Family practioners are often treated a bit like poor dumb relations by specialists, that is, by dumb specialists, so I infer that they got quite a bit of that in the fellowship year. Also, it is traditional for surgeons to yell at each other, especially faculty yelling at the fellows, residents and interns. One has to be a bit tough to survive. In medical school on my surgery rotation we had a fifth year, that is senior, female surgical chief. She had an interaction with a third year resident and at some point said, "Suck my balls!" He responded, "Yours are bigger than mine." I thought about a surgical residency but wanted to have kids, so family practice is it. Also I am a born generalist.

So guess whether our two new female family practice with an obstetric fellowship doctors are getting along better with the staff or the other doctors? Other doctors, of course. They have to be "manly and tough" to get through that training. My observation is that if a woman doctor behaves more like a woman then the other doctors don't like them and if they behave more like a Marcus Welby/House cross, the staff hate them. The staff feel belittled and feel that their experience is ignored. I stayed out of it for quite a while, but now am trying to delicately offer mentoring, would they like to discuss my observations re women doctors? One of them is interested, the other went on a tirade about the other lazy doctors.

The delicious twist to all of this is the obstetrics. The Spitting Clinic had 5 doctors doing obstetrics of which I was one. We are the only ones delivering babies in the small hospital in our small town. When I was reinstated at a different clinic, the deal was that they would cover my obstetrics call nights when I was out of town but when I'm in town I'm on call 100% of the time and they didn't want me taking care of their patients. And they wanted to be "polite in the halls". I figured they'd eventually regret this, but I thought it would take ten years at least. I am devious and patient. It has only been three years. I have been scrupulously polite in the halls. The other female obstetrics family practice doc quit and then the two women arrived. They are on cesearean section call one week out of three and are rapidly burning out. Not knowing the history, they have asked me to join the call a couple of times. I did not rush to do this so they went to the administration. We had a meeting last week, me, the sensible female administrator and the more mentorable female fp/ob (family practice with obstetrics). The other doctor had a plan and didn't really want to listen to my proposals. She started to pressure and the administrator said, "Well, the guys are over it, but maybe you aren't." This pissed me off so I described the "polite in the halls" comment and said that rather than being over it, I thought the guys had buried it and were pretending it hadn't happened. They said, "Well, they are guys." I said they'd gone to the administration about me when I was 3000 miles away on vacation and did they think I wanted to take call with backstabbers again? I said that I was scared of taking call with them, my impression that they don't like me has remained unchanged for three years and I was only considering helping because I think the two women do need help. I needed to think about it, they'd better at least pretend to listen to my proposals and let's meet again in a week. The Spitting Clinic is going to have a retreat to discuss problems in about 2 weeks and, of course, had to ask me to cover their obstetrics call because there isn't anyone else. I was kind enough to agree. The real underlying issue with the call turns out to be that they want to do the obstetrics call but do not want to do the inpatient medicine call, so are trying to pawn half of it off on me. I'm game for the obstetrics call but seems to me that all 13 of us do the medicine call: why would I be the only one to pick it up for two of them?

I've been rereading the Woman Who Rides Like a Man and enjoying it. I guess I am very happy with being a Woman Who Doctors Like a Woman though it definately rocks the boat. I like the motion, mostly. Being spit from a clinic was annoying but also quite educational. And now humorous.

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