From the 1940 to the 1970’s, medicine went from an almost exclusively male club to a profession in which women physicians were commonplace.

Our physician guest is Dr. Anne Walling, who has written a book about the experiences of 37 women who attended a Midwestern medical school, Women in Medicine: Stories from the Girls in White

This was a time when pornographic images appeared in lecture slides, and sexual harassment and discrimination in the job market were ubiquitous.

Despite the misogyny, the women interviewed nearly all expressed gratitude that they were able to have such meaningful, rewarding, and stimulating careers.

Our guest told us that her interviewees described reunions where male colleagues seemed burned out and cynical, while many of these women remained upbeat and excited about their medical work.

What can we learn from the story of women’s entry into mainstream medicine? How has the profession been changed (or not) by their presence?

Soon after Lisa Iezzoni MD was diagnosed with multiple sclerosis during her first year at Harvard Medical School, from which she graduated in 1984, faculty and administrators discouraged her from practicing medicine.

And in her final year they made it impossible for her when the dean’s office refused to write a recommendation letter (now called a Medical Student Performance Evaluation).

This week marks the 35th anniversary of the American Disabilities Act which was signed into law on July 26th, 1990. Much has changed since but -- as Dr. Iezzoni, who went on to become an eminent scholar and national policy leader on disability, has documented -- not nearly enough.

She and others have documented wide disparities in the quality of care patients with disabilities still receive, and in 2021 she published the findings of a national study of physician attitudes towards disability that document’s persistent stigma and misinformation. Disabled patients were described as a “disruption to clinic flow” and a majority of physicians believed that patients with significant disability inherently have a worse quality of life.

Practices are also ill-equipped to care for them, Dr. Iezzoni, who chaired the U.S. Access Board’s advisory committee on accessibility standards for medical equipment observed that “healthcare has been among the most backward environments, in terms of making itself accessible. Movie theaters are accessible, sports stadiums are accessible, transit is accessible. But healthcare facilities—no.”

In our conversation with her, we explore why. How is it that physicians have such difficulty appreciating that disability is simply a part of the human experience? We explore the link between the culture within medical education and training, and the kind of people physicians become.

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References:

Physicians' Perceptions of People with Disability and Their Health Care

US Access Board