Medical Careers and Feminist Agendas: American, Scandinavian, and Russian Women Physicians (Social Institutions and Social Change)

180 Pages·2001·16.44 MB·English

by  Elianne Riska

Medical Careers
and
Feminist Agendas
SOCIAL INSTITUTIONS AND SOCIAL CHANGE
An Aldine de Gruyter Series of Texts and Monographs
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Medical Careers
and
Feminist Agendas
AMERICAN, SCANDINAVIAN,
AND RUSSIANW OMENP HYSICIANS
Elianne Riska
ALDINE DE GRUYTER
New York
About the Author
Elianne Riska is Academy Professor of tht Academy of Finland, and von Wille-
brand-Fahlbeck Professor of Sociology at Abo Academi University, Finland. She
received her Ph.D. in Sociology at the State University of New York at Stony Brook
in 1974, and has served as an assistant professor and an associate professor of soci-
ology in the Department of Sociology and College of Human Medicine at Michi-
gan State University. She was a senior researcher at the$ocial Insurance Institution
of Finland from 1981 to 1984 and began teaching at Abo Akademi University in
1985. Her published works include Gcizdel; Woyk, mid Medicine and Geudcred Moods.
Copyright 0 2001 Walter de Gruyter, Inc., New York
All rights reserved. No part of this publication may be reproduced or
transmitted in any form or by any means, electronic or mechanical,
including photocopy, recording, or any information storage or
retrieval system, without permission in writing from the publisher.
ALDINE DE GRUYTER
A division of Walter de Gruyter, Inc.
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Hawthorne, New York 10532
This publication is printed on acid free paper @
Library of Congress Cataloging-in-Publication Data
Riska, Elianne
Medical careers and feminist agendas : American, Scandinavian,
and Russian women physicians / Elianne Riska
p. cm. - (Social institutions and social change)
Includes bibliography, references and index.
ISBN 0-202-30667-4 (cloth : alk. paper) - ISBN 0-202-30668-2 (pbk.
: alk. paper)
1. Women physicians-Cross cultural studies. 2. Women
physicians-United States. 3. Women physicians-Russia (Federation)
4. Women physicians-Scandinavia. 5. Women in medicine-Cross
cultural studies. 6. Sexism in medicine-Cross cultural studies. 7.
Social mediciiie-Cross-cultural studies. I. Title. 11. Series.
R692 .R57 2001
61 0 ’.8 2-dc2 1 2001022600
Manufactured in the United States of America
10 9 8 7 6 5 4 3 2 1
Contents
Preface vii
Introduction 1
Social Theories about Medical Work and Gender 9
Women’s Entry into Medicine and Medical Practice
in the United States 33
Conditions Influencing Women Physicians’ Careers
in Scandinavia 57
Women Physicians in Russia and the Soviet Union 73
Does Gender Matter?
Women as Medical Practitioners 87
New Pioneers: Women in Pathology 103
Women’s Challenge of Medicine:
A Revolution From Within or Outside Medicine? 117
Conclusions 137
References 149
Index 167
V
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Preface
This monograph is the result of a research effort that was originally gen-
erated while I was teaching medical students at the College of Human
Medicine at Michigan State University in the 1970s. I was intrigued by the
character of the socialization process that the medical students had to
undergo during their training, a process quite different from that typical in
other disciplines. Ever since, I have studied and followed the changes in
the status and power of the U.S. and Scandinavian medical profession.
Theory and research in the sociology of professions and health sociology
have shown me how knowledge is generated and organized in the mod-
ern world. In most of my work I have been interested in the sociology-of-
knowledge aspect of the development of modern medicine.
My adoption of a gender perspective on the medical profession can be
traced to reading Judith Lorber 's pioneering book on women physicians
in 1984. While I was doing the research reported in this book, Judith Lor-
ber offered invaluable advice, comments, and encouragement.
Some of the early ideas for this book derive from a plenary talk I gave at
an international conference on the changing status of the physicians, a con-
ference organized in Oslo in May 1997 by Olaf Gjerl~wA asland of the
Research Institute of the Norwegian Medical Association. That presenta-
tion was published later in Socinl Science nndMedicim (Riska 2001) and some
sections of this book have been adapted from that article. In the fall of 1998,
I ran a research seminar on health professions in the Department of Sociol-
ogy at Abo Akademi University in Finland. The core participants in this
research seminar-Cecilia Benoit, Elina Oinas, Sirpa Wrede-served as a
litmus test for the draft versions of the chapters included in this book. From
the beginning of the writing, their constructive comments set me on the
right track.
A number of other persons have had an important part in enabling me
to complete this project. AM Yrjala assisted me in conducting interviews
with women pathologists. Solveig Bystedt, with her usual patience and
kindness, assisted me in preparing the final version of the manuscript.
Julia McMurray, Bente Rosenbeck, and Liisa Husu have provided infor-
mation that has documented some of my main arguments. As a profes-
vii
viii Preface
sional editor and longtime friend, Katherine McCracken has provided
much-appreciated assistance in detecting the Swedish influence in my
English writing. My colleagues and graduate students at my professional
base since 1985, the Department of Sociology at Abo Akademi University,
Finland, have offered a most inspiring environment for doing research.
Finally, I am indebted to Richard Koffler, the executive director at Aldine
de Gruyter, for his interest in my early ideas for this book and for promot-
ing them into publication. I would like to thank Sissy Girard, Mike Soh,
and Jan Goldsworthy, who have helped in the production of this book.
A research position as an academy professor granted by the Academy
of Finland from 1997 to 2002 offered me an opportunity to embark on the
larger comparative research project on women physicians reported in this
volume. A subsequent grant (Academy of Finland nos. 53343 and 59221)
enabled me to collect data at U.S. university libraries.
Elianne Riska
Introduction
Doctor Discontent
Many American doctors are unhappy with the quality of their professional
lives. Abundant anecdotal evidence and several surveys identify some of the
factors that underlie their discontent. The actions doctors are taking confirm
that there is substantial dismay. What are they complaining about, and what
are they doing about it? Can a health care system function effectively if a
sizeable fraction of its physicians are disgruntled? Are patients well served
by unhappy physicians?
Kassirer, ”Editorial,” Neiu Efzglu~idJo ziriinl of Medicine
Recent changes in the character of medical work have made the medical
profession in many societies concerned about the lack of control over its
work. Some of the reactions have been collective and have resulted in
strikes or threats of such measures (Burke 1996).O ther reactions have taken
more individualized expression and are appearing as a growing prevalence
of health problems, stress, alcoholism, and suicides among physicians
(Stimson 1985; Lindeman, Laara, Hakko, and Lonnqvist 1996; Arnetz 2001;
Firth-Cozens 2001). During the same period that the profession is experi-
encing a loss of control over the conditions of its work, women have entered
the profession in increasing numbers. As new members and with new
capacities, will women physicians be able to ”humanize” the profession?
The increasing proportion of women in the medical profession has been
followed keenly both by conservative and feminist observers during the
past three decades. The conservative observers have been mollified by the
statistics that show that women physicians remain active members of
the profession even after forming a family. But the feminist voices continue
to be heard, and for various reasons. One of the early arguments for an
increase of women in the medical profession was the quest for equality
between the sexes. Liberal feminists demanded that women should have
the same educational opportunities as men. Many formal barriers to
women’s entry into medical schools have been eliminated over recent
1