Is there a difference in the way men and women practice dentistry? Part II
In the Gender shift article we looked at the demographics of women in dentistry and in Part I we looked at the research on the differences between men and women. Now we have arrived at the original question: Is there a difference in the way men and women practice dentistry?
(This is a long article, printing it will make it 25% faster to read.)
I have been postponing answering this question because I don’t have enough answers. I am an old, white guy with no women in my dental school class, only one woman dental student in the whole school and one woman dentist on the faculty. I have had very little contact with women who are dentists. (I have had many non-dentist women as mentors who have helped me understand the masculine and feminine principles as the apply to the helping professions and health care.)
So why, I keep asking myself, am I asking and attempting to answer this question?
So why, I keep asking myself, am I asking and attempting to answer this question?
The reason I asked the question was that I was struck by the small number of women in the advanced relationship-based or health-centered workshops I facilitated or attended. It was far below the 30% number of women at the critical 35-45 years of age where men have traditionally become interested in Relationship-based or health-centered dentistry. And, the number of women who are members of ISOC reflects this trend. (Recent reports from advanced CE course sponsors indicate this discrepancy is lessening.)
In order for relationship based dentistry and ISOC to continue to thrive, they need to attract and include the 30% and soon to be 50% of women who are dentists.
I have also wondered if the feminine would balance the flawed masculine paradigm of dentistry.
I have always thought that relationship-based dentistry was a natural fit for women. Deborah Tannen’s and Louann Brizendine’s work on gender differences and neuro-biochemical differences validated that women have a social and biological predilection toward building relationships that men have had to learn.
Hence the “Is there a difference” question.
I have asked this question of the ISOC advisory board and teachers in advanced relationship-based dentistry continuing education. There have been no earth shattering answers. However, their responses to this question have influenced the following tentative answers.
Women have some social and biological relationship advantages (see Part I), but the selection and training process in dental schools tends to negate this advantage. Dental Schools still use the same selection process in choosing women for dental schools that they use to choose men. This selection and training process favors people with analytical, deductive aptitudes in science, engineering, tactics and techniques and a thing instead of people orientation.
There have been several studies done that show that the dental and medical education process reduces students caring, compassion and their ability to connect with patients. Add this dehumanizing education process of dental school and the relational advantage is further diminished.Per Tannen’s and Brizendine’s research, most women do not have the same ego need to be number one and do not seek advanced education to meet this need. (They may have other reasons for seeking advanced education. Their seeking of advanced education could manifest later than men’s.)Anecdotal reports suggest that there is very little difference between how men and women want to practice when they graduate from dental school. But, and it is a big but, when Brezendine’s “mommy brain” kicks in and women dentists have children, their focus shifts to wanting a more balanced life that does not detract from family and their profession of dentistry.
It is in seeking this balance, that extreme stress is created for women dentists. One of the stress mitigating scenarios for women is to leave their private practice and seek a 9 to 5 associateship, faculty appointment, welfare clinic, military service or a managed group practice where the demands are perceived as not as great as running a private practice.
They may also cut down on the number of hours they work or leave the practice of dentistry.
This stress will probably lead to very creative solutions by dentistry and women to create new ways of practicing that enable women dentists to balance work and family.Therefore, in my opinion, the biggest potential difference between the way men and women practice revolves around how the woman dentist deals with being a mother and dentist. All working women have had to deal with the challenge of working and being a mother. The issue for women dentists is that there is not much history in how women dentists have faced this challenge. This is especially challenging for a woman who has a solo private practice. If a woman dentist is single or does not have children, then there is much less of a difference in the way men and women practice dentistry. The prejudice the early women dentists faced because they were “a woman doctor” is receding and is replaced by people who seek out women dentists, because they are women.
I know this from personal experience (because of my first name of Lynn), that people (mostly women) often wanted to see me because they thought I was a woman dentist. These people perceived women as being more caring and gentle - this may or may not be true. The other reason was women wanting to support women.As to learning how to practice in the relationship-based way (and for other ways of practicing dentistry) for a woman, they will have to meet the same challenges and learn the same lessons that male dentists have learned.
There are developmental stages that all dentists need to go through to climb the ladder of excellence. To practice dentistry at its highest levels in a private practice, dentists have to pay an enormous price in time and money (equivalent to an Ivy league education) in a relentless pursuit of advanced courses in technique, human relations, marketing and business.
Traditionally, this journey has been started in the 35-45 year old range for men. This developmental period coincides with the biggest demands on women dentists by their family and children. As mentioned above, women with children may delay this pursuit of advanced education until their children are older.Women may prefer to learn from other women who are adept or masters. As more and more women become adept or masters at practicing dentistry, they will become mentors for the women that follow them.Women may not seek advanced education in relationship-based dentistry because then think they are naturals at relating. This is a mistake - it is like thinking a grade school education is good enough when you need a graduate education in helping relationships. In order to have a fully functioning relationship-based practice, women need to learn the higher, more sophisticated lessons of human relations, technique and business skills just as men do.
The current generation of women dentists will be a bridge generation that deals with the many challenges of being pioneers in the way women practice dentistry.
I can not leave this series without expressing my concern that this generation of women dentists has not balanced the masculine paradigm that has dominated health care from the early 1900's to the present with the feminine. As yet, they have not made their practice of dentistry their own by integrating the feminine with the masculine. They have adopted the masculine paradigm of dentistry.
This concern shows up in my disappointment that more women dentists have not been attracted to relationship-based dentistry. I see no evidence that women dentists are reclaiming the rich heritage of women as healers.
For a more complete look at the healing activities of women from prehistoric times to the present read Jeanne Achterberg's "Woman as Healer". Achterberg examines how women have impacted the healing professions historically and how their role was subjugated to males at the start of the 20th Century. She discusses how the "feminine" can balance what has been a male dominated health care system. She believes that "When the balance is finally achieved, and the feminine voice is heard, much of what is now practiced in the name of health care will be deemed clearly unethical."
Here is an excerpt from her book:
"Changes most likely to result from women exercising their conscious responsibility include:
Differences in the nature of medical education and in the practice of medicine itself.
A shift from the hierarchy of a power-based health system to one of more egalitarian proportions.
The elevation of women's professions to higher levels of competency, respect, and responsibility.
More attention to larger systems of health, including the ecology of the earth.
The inclusion of therapeutics that treat the mental and spiritual aspects of health with the mainstream of health care.
A more human-centered healing system, which will be assured if the feminine nurturing voice is included."
Achterberg's book was written in 1990. I wrote about the need for many of these changes in dentistry and health care in my book "In A Spirit of Caring", published in 1994. While some dentists, physicians and hospitals (relationship- based dentistry, integrative medicine and the Planetree hospitals) have made these changes, I see no evidence of the above changes happening in mainstream health care - dentistry and medicine - with either male or female doctors. If anything, there has been regression.
Where does all of this leave us?
This is a very incomplete, biased and flawed look at the “Is there a difference” question. Hopefully, it will be a start and catalyst for women to examine how they want to practice dentistry. Will they integrate the rich tradition of women as healers? Will they be the ultimate experts on how women practice dentistry by this integration? Will they share their experiences and help each other thrive in the practice of dentistry? Or will they continue to adapt to the masculine paradigm?
The experience, knowledge, wisdom and perennial philosophy of men like Bob Barkley, L.D. Pankey, Avrom King, Bob Frazer, Rich Green, Doug Young, Mike Schuster, Bud Ham, and Wilson Southam is still of immense value. They have paved the way for all of dentistry over the last half century. This mentor’s work still helps both men and women learn the necessary lessons both need to learn to be the best dentists they can be.
Hopefully, the current bridge generation of women in dentistry will integrate the feminine and masculine into a more humane, holistic, caring, relationship-based dental profession. Hopefully they will add to the rich tradition of women as healers and men as healers.
We will have to wait and see.
If you have questions or comments, please go to the discussion forum to comment: Discussion Forum
To read the first two articles in this series go to: The Gender Shift, the demographics of women in dentistry. What impact will it have? first and then: Is there a difference in the way men and women practice dentistry? Part I second.