The Reproduction of Patriarchy and the Politics of Gender in Medical Practice: A Critical Discourse Analysis Across Training, Career and Life

Women physicians and women physician-researchers (WP/WPR), in Canada and in the United States, do not experience the same professional success, inclusion, and work-related health outcomes as their male colleagues despite current medical school acceptance parity. They work harder than the latter to meet clinical benchmarks, comply with professional imperatives, and live up to societal standards. These benchmarks, imperatives and standards are designed and reproduced by male physicians, when not reproduced by female physicians themselves. The hardships that contribute to the distress and burnout experienced by women physicians and physician researchers – including yet not limited to multiple-role demands impinging on women’s physical and emotional well-being – are acknowledged, yet not critiqued, by the medical community. Indeed, the dominant narrative within the profession frames these hardships as caused by gender-specific lifestyle and behavioural choices, using them as examples of how individual choices by women physicians and physician-researchers lead to career successes or failures, while neglecting to identify, much less challenge, the male-dominated construction of medical practice. Patriarchal structures, tendencies and biases embedded in the profession of medicine normalize and reinforce gendered institutional policies, professional practice, and societal values that favour male success in medicine and reproduce the distress and disadvantages experienced by women physicians and physician-researchers. Using a discourse analysis approach that illuminates how the discourse of medicine tends to reproduce the social order by excluding its critical appraisal, this paper examines the medical and healthcare policy literature to reconstruct the boundaries of the debate around gendered inequities in medical practice. I discuss these inequities and their impact on the health and well-being of women in medicine, and propose policies with the potential to both address these inequities and contribute to the integration of women in medicine. In so doing, these policy courses may also have significant, positive implications for health care delivery, in Canada, the United States and elsewhere.