The scientific study of the sexual dynamics that come into play during residency training seems to both fascinate and repel trainees and their supervisors. One of the more provocative and shameful dimensions of this area of inquiry, the abuse of residents, causes a good deal of distress. How do we respond to findings of significant psychological abuse, discrimination on the basis of sex or sexual orientation and sexual harassment in medical settings? How can we ignore over a decade of research? How can we not heed the experience of so many young physicians? Given the uncertain times in Canadian medicine and the insecurity in our professional and personal lives, we must work together to improve the culture of our teaching institutions and implement measures nationally and locally to close this dark chapter.
BACKGROUND: The most heavily discussed subject on Eyr, the Norwegian mailing list for general practitioners, has been the introduction of a general practice list system (GPLS). MATERIAL AND METHODS: All messages in the GPLS debate were recorded from its start in August 1996 up until the GPLS was introduced nationwide in June 2001. RESULTS: During this period, 243 different persons posted 2,153 messages about the GPLS, 232 of the participants were physicians, 203 of them GPs. Mean age was 46 years; males were strongly overrepresented (87%). 80% of the participants posted ten or fewer messages, 10% posted 11-20 messages, and 10% posted more than 20 messages. GPs sent most of their messages in the evenings, academics and public health officers sent most of their messages during work hours. Mean length of the messages was 179 words, 72% were responses to earlier messages. Most of the messages were neutral regarding the GPLS, 207 (9.6%) were negative, and 181 (8.4%) positive. Academics, public health officers, and participants in a GPLS trial were heavily overrepresented with positive messages. INTERPRETATION: It is concluded that this debate has been fairly balanced. Participation greatly exceeded what would have been possible in traditional media.
In 1992, the Norwegian Medical Association started a comprehensive research programme on doctors' health and welfare. More than 30 studies are planned, based on a variety of data sets and methodologies. The core of the programme is the 1993 questionnaire survey. 9,266 active doctors received comprehensive questionnaires about their health, level of living and working conditions. The response rate was 72%. The response rate was higher for females than for males, 80% as against 69%. Of the categories of doctors, specialists in private practice showed the lowest response, 50%. In the main study a "question overlap" was applied, where each doctor received four out of 16 thematically different questionnaires. One questionnaire was common to all, the three others were randomly distributed among the recipients. The purpose of this design was to increase the potential for multivariate models in the analysis. We find the 72% response rate among the active doctors satisfactory, and feel confident that we have a reliable data base for further analyses.
In recent years, Danish society has focused on the service and the information available for patients in health care. A test sample out of 1,000 members of the Danish Medical Association selected at random revealed that the majority had positive attitudes to service and information in health care. The study also indicated that doctors do not consider that any particular dress code is particularly appropriate but consider that personal appearance and the way patients are addressed are individual matters. This individualistic attitude which is consistent with Mintzberg's sociological structural theory does not invariably seem appropriate.
Consumer charges in connection with visits to a doctor are common in a number of countries often used for comparison but are not employed in Denmark. The Danish Medical Association is opposed to consumer charges in health care and a test sample out of 1,000 of the Medical Association chosen at random showed a definite majority opposed to consumer charges. A minority of the profession was in favour of a nominal fee of less than 70 Danish crowns (approximately 7 pounds) for visits to a doctor while scarcely 4% considered that the fee should be more than 100 Danish crowns (approximately 10 pounds). 40% of the participants considered that the consumer charge would have to exceed 100 Danish crowns before it was of any consequences for the health of the patient. In addition, this study revealed that female doctors were more opposed to consumer charges than their male colleagues. At present, more women than men commence the medical curriculum in Denmark and it must therefore be anticipated that the percentage of women in the Danish Medical Association will soon exceed the present 30%. The resistance os the Danish Medical Association to consumer charges in health care will, therefore, probably be retained.
PURPOSE: To describe the attitudes of female nurses and female resident physicians toward each other in surgery, internal medicine, obstetrics-gynecology, and emergency medicine in one Midwest teaching hospital in the United States. METHOD: Using a qualitative methodology, 51 women were interviewed in 2002: 28 nurses and 23 residents. Questions were asked to determine if and how female nurses and female residents believed gender was a factor in their interprofessional relationships, how each described their relationship with the other, the kind of assistance female nurses provide to female residents, the kind of assistance sought by female residents, and the strengths and challenges of the female nurse-female resident relationship. Data were analyzed using NUD*IST software. RESULTS: Consistent with similar studies conducted in Norway and Australia, the results include the following: For female nurses, occupation is secondary to gender, which is to say that gender is the most important link between female nurses and female residents. For female residents, gender is secondary to occupation/occupational status. CONCLUSIONS: With the number of female residents increasing each year in hospitals, this relationship should be further examined so that dysfunctional communication patterns between the two groups can be challenged.
In order to investigate the attitudes towards the prescription of hormone replacement therapy in menopausal and postmenopausal women, a questionnaire was mailed to two random samples of Norwegian general practitioners. The first sample (n = 340) was investigated in 1990, just before a national consensus conference on the use of oestrogens, the second (n = 240) one year after the conference. Nine short case stories were presented and the doctors indicated their attitudes to oestrogen prescribing in each case. Four items were systematically investigated: climacteric symptoms, smoking, risk of cardiovascular disease and osteoporosis. In general, a restrained attitude towards the prescribing of oestrogen was found. Smoking and a family history of cardiovascular disease reduced the willingness to prescribe. The doctors had more patients on oestrogen treatment in 1992 than in 1990. In general, the answers indicate a more liberal attitude to replacement therapy in 1992, but the pattern of willingness to prescribe remained unchanged. Female physicians showed greater willingness to prescribe oestrogen than their male colleagues did, and were more updated on contraindications.