MEN WHO CONTROL WOMEN'S HEALTH: The Education of Obstetricians and Gynecologists by Diana Scully
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MEN WHO CONTROL WOMEN'S HEALTH: The Education of Obstetricians and Gynecologists

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Scully, a medical sociologist, has taken a long hard look at the training of obstetrician/gynecologists and found it sorely wanting: it emphasizes aggressive intervention in childbirth and the reproductive organs, she charges, and creates an ideal climate for exploitation. Scully accompanied OB/GYN residents at their work for two years and describes, disturbingly, how the practice of obstetrics and gynecology and individual physician's goals (e.g., the need to practice technical skills such as hysterectomies) interact to influence the development of attitudes and skills that are at variance with patients' health needs; and, since Scully's research was done in two different teaching hospitals (one private, one public), differences in health care for different groups are clearly illustrated. Scully is not unsympathetic to the residents she studied; but the light she sheds as to their reasons for entering this speciality is not encouraging. Known as ""the happy speciality,"" OB/GYN emphasizes life and avoids death; it's also an ""ego trip""-especially in infertility treatment-because women are so anxious and grateful. On the interesting question of whether women are better obstetrician/gynecologists than men (and the vast majority are men), Scully found only that the female residents seemed to have a greater understanding of what patients were experiencing-but that the male residents didn't feel this to be important. The training itself was geared toward short-term intervention, though most patient relationships are long-term, and devoid of up-to-date education in sexuality (as late as 1970, gynecology texts still professed such attitudes as ""The frequency of intercourse [in marriage] depends entirely upon the male sex drive""). The importance of all this, Scully reminds us, is that it is the background against which medical decisions are made. She presents some strategies for change, explaining how lay surveillance, health maintenance organizations, and national health insurance might change the face of women's health care. On an individual level, she feels women must protect themselves, and that entails being informed-not just about health, but about the system. -She has helped materially-and raised some fundamental issues in health care as well.

Pub Date: May 21st, 1980
Publisher: Houghton Mifflin