KevinMD: Defending the physician, even when they are wrong

Recently I read a post on KevinMD titled: The blonde minority: Sexism is alive in medicine. on August 18, 2014, by Elizabeth Horn, a resident physician.

I look at the world very differently, I see patterns and connections that others don't see. Think Sherlock Holmes or House M.D. (Here is a little known fact: David Shore, the creator of House, based the character of House M.D. on Sherlock Holmes.)

As i read this article, I saw the proof of the theory (sexism is alive in medicine) presented supporting the opposite conclusion. What put me over the edge was Dr. Horn admonishing someone who was acting in a very respectful manner, in dealing with a confusing situation that healthcare created and refuses to address: the position of a person wearing scrubs.

I commented on how her story did not support the title and how she disrespected patients and their families. My comment was deleted. That pissed me off. So now I am going to hit back harder.

Here is my original comment that was deleted on Kevin MD:

There is a glaringly simple answer to the problem that you present and it is not sexism. (I hope you don't diagnose patients like you diagnose social issues).  

First I will address the "marry a plastic surgeon" thing. Plastic surgery is MOSTLY elective. They are usually not covered by insurances so they don't have to jump through hoops to get paid. They are happier with their profession, patients, etc.  

I don't know what your speciality is (you conveniently left that out) , but unless you are going into something where the pay scale is comparable with that of a plastic surgeon, then that person spoke the truth. I will acknowledge that it may have been inappropriate, but still the truth.  

Just as a physician says "we are professional and have seen it all" when a patient expresses apprehension about exposure of their body, thus making it about the physician's feelings and totally ignoring the patient's feelings: you are doing the same with this issue.
Perhaps the real issue is how you present yourself:  

"A natural blonde... my diminutive frame...my blonde mane...rather than a skirt suit... heels to a respectable 1.5” or less. I avoid using the word “like” too often...become disproportionately focused on the thoughts and opinions of male physicians and residents... Not that I mind a youthful complexion...a young, reasonably attractive blonde doctor... trust-fund boyfriend I had... the tortoise shell glasses, changed into my skinny jeans, a favorite sweater, suede heeled boots, put down my hair and applied a little mascara and blush." (Your words.) 

LIKE, oh my God, it's Elle-izabeth Woods of "Medically Blonde."   

Don't take not being called "doctor personally." In the 1970's you saw 3 people in hospitals: doctors, nurses, and orderlies. Each wore a specific uniform and were easily identifiable.  

As you stated, today there are "physician... ...nurse, physical or occupational therapist, student or housekeeper" and everybody wears scrubs. Let's not forget visiting surgical company reps (demonstrating equipment in the OR), janitors (sometimes), phlebotomists, lab techs, quality control specialists, EMT, and a host of others subject to the facility's infection control plan.  

Is it NOT just as disrespectful to you for someone to call a CNA doctor???? 

Calling you "miss" was sign of respect, respect that you are obviously LACKING for the person who called you that! Obviously they did not know your title, and used a respectful address for any unknown woman. 

Obviously with that paternalistic, arrogant, everything-about-you attitude, you are fitting quite well in the medical profession quite well.

While my comment may have been slightly inflammatory, the way she disrespected patients  and their families was more inflammatory. Everybody wears scrubs, there is no color coding to tell what position a person holds. People have been complaining of this for years. Calling her "miss" was polite and respectful!

Here is how she describes herself:

A natural blonde... my diminutive frame...my blonde mane...rather than a skirt suit... heels to a respectable 1.5” or less. I avoid using the word “like” too often...become disproportionately focused on the thoughts and opinions of male physicians and residents... Not that I mind a youthful complexion...a young, reasonably attractive blonde doctor... trust-fund boyfriend I had... the tortoise shell glasses, changed into my skinny jeans, a favorite sweater, suede heeled boots, put down my hair and applied a little mascara and blush.

If she is using sarcasm here, then I apologize for not catching that. I don't think that is the case though. I think that she presents herself (perhaps unconsciously) in such a manner then call it sexist when people don't take her seriously. I am not saying that this is right, and there may be some sexism involved.

There is nothing here about paying for college and med school, the burden of student loans, the years at a resident's salary trying to survive. If indeed she did have a trust-fund boyfriend then the only way you meet someone like that is if you are in those circles. Mentioning "residency at an ivy-league institution" is another giveaway, usually implying influence of the family she comes from. I suspect that she comes from a very wealthy family.

LIKE, OMG, it's Elle-izabeth Woods of "Medically Blonde." 

The frightening thing is how she deals with this issue and (more importantly) it would affect her interactions with patients  and their families:

 I have learned to speak up, to maintain eye contact and to assert myself if needed when rounds become disproportionately focused on the thoughts and opinions of male physicians and residents.

This is PATERNALISM! What if a patient doesn't agree with her decision of treatment?

It is troubling issue is that she aims this at ALL men. Has no man ever taken her seriously? This is stereotyping and REVERSE SEXISM. Then she makes the following comment where the man that she chose to marry is the only "good man" in the whole post, And the gender of the "trusted adviser" is conveniently undisclosed due to lack of pronouns:

During my internship, I went on a date with a good man and a couple of years later, he proposed. As I made plans for my career after residency, I met with a trusted adviser who after discussion of the several options I was considering, fellowship, research, physician positions, assured me not to worry too much. I was, after all, marrying a plastic surgeon.

I also comment on lack of disclosure of what her choice of speciality will be. All physicians are hurting financially, but general practitioners are hurting the most. The physicians that are thriving are the ones free of the bonds of medicare, medicaid, and insurance. Concierge physicians and plastic surgeons are two of these, and they are prospering. Dr. Horn fails mentioning her choice of speciality.

On July 28, 2014 KevinMD titled "Doctors today: Young, broke and human" by Aunna Pourang M.D. Indeed financial security is a major concern, even when both spouses are physicians. One being a plastic surgeon, alleviates much of the financial burden of that household.

Either I am missing sarcasm in this article, it is poorly written, or she is learning to be paternalistic. Looking at how the healthcare system operates, I go with the latter.

As a man I am offended by this post. As a patient, this post invokes fear in me of how Dr. Horn as a physician would respect my choices and my dignity.

I welcome a response from Dr. Elizabeth Horn or KevinMD.

--A. Banterings