"What's in a name?"

Gender equity is an incredibly important issue in health care (and in society at large, of course) today.  For example, there is evidence that (1) female physicians are paid less than male physicians (see "Do we need a National Women Physician's Day?"), (2) female physicians are more likely to be introduced by their first name rather than by "Doctor" and their last name (see "A Life of Privilege - part III", and (3) female physicians are less likely to serve in academic leadership (see a recently published study by my colleagues here).  In addition, one scientific study went so far as to suggest that women don't lead resuscitation teams as effectively as men (see "Do we need a National Women Physician's Day - one year later") because they are "inferior leaders" (a subsequently published study suggested otherwise, see "Word choice matters"). 

Women in health care today are subject to obvious forms of discrimination and prejudice.  For example, the New England Journal of Medicine published a study in the last two weeks that showed that nearly 2/3 of surgical residents in the United States reported discrimination based upon their self-identified gender and almost 20% reported being subjected to sexual harassment.  The women who reported being victims discrimination, abuse, and harassment were much more likely to report symptoms of burnout, depression, and thoughts of suicide.  Clearly we need to do a better job at addressing outright discrimination, prejudice, and harassment in our workplace.  Unfortunately, women are also victim to a less obvious form of gender discrimination known as implicit bias, and addressing this form of bias in the workplace will be more difficult, but undoubtedly equally as important.

If you don't understand what implicit bias is, perhaps I can help.  The aforementioned study looking at gender differences in resuscitation team leadership is a great example.  In this study, the authors suggested that women were more timid, reserved, and less direct compared to men, and as a result, the men made better leaders during the crisis situation of a resuscitation.  There is a widespread misperception that women are more timid and less aggressive than men. 

Just look at hurricanes.  Between 1950 and 2012, there were 94 Atlantic hurricanes that made landfall in the United States.  According to one study, hurricanes with a female name were far more deadlier than those that had a male name.  Consider that the selection of hurricane names are determined in advance before the start of the hurricane season.  If hurricanes with female names are deadlier than those with male names, this has occurred completely by chance (even when you factor in that US hurricanes were only given female names up until the 1970's), even after removing two of the most deadly hurricanes in American history, Hurricane Katrina (1,833 deaths in 2005) and Hurricane Audrey (416 deaths in 1957), which were both female names! 

Why are female hurricanes deadlier than male hurricanes (notably, the statistical analysis used in the study was somewhat controversial)?  The study investigators suggested that the reason has to do with the fact that men and women have different stereotypes.  Men are expected to be strong, competent, and aggressive, whereas women are expected to be timid, passive, and nice.  Multiple experiments conducted by the study investigators suggested that feminine- versus masculine-named hurricanes are perceived as less risky.  In other words, the general public associates male hurricanes with being more violent and dangerous than female hurricanes, so they are more likely to seek shelter or evacuate.  However, when a female hurricane comes along, the general public is less likely to take shelter or evacuate.  The risk of death is therefore increased due to greater exposure to the hurricane itself.

I hope you get my point.  I suspect that if you asked most of the individuals participating in the series of experiments in the hurricane study, they probably wouldn't think that they were biased in any way towards feminine-sounding hurricanes.  The fact remains, we likely are all subject to this kind of implicit bias.  How can we combat this form of bias?  It starts with the simple recognition that it exists.  "What's in a name" turns out to be more important than we think.