Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995 (review)

Ellen S. More, Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995. Cambridge: Harvard University Press, 1999. 340 pp. $49.95 cloth; $22.95 paper.

As the number of women in the medical profession has increased in the western countries, American academic women have become interested in the history and current prospects of women's impact on medicine in America. There is a strange paradox in American medicine: Internationally, American women physicians were pioneers--they provided forceful images and role models for European women--but today the proportion of women in medicine in America is much lower than the proportion in most European countries. This topic provides a rich source for researchers not only in the history of medicine but in women's studies and the sociology of science. Some previous books on pioneering American women physicians have tried to restore women physicians as actors instead of casting them as victims of an all-encompassing male dominance and structure of medicine: For example, Virginia G. Drachman's Hospital with a Heart: Women Doctors and the Paradox of Separatism at the New England Hospital, 1862-1969 (1984) and Regina Morantz-Sanchez's Sympathy and Science: Women Physicians and American Medicine (1985). Ellen S. More's book belongs to this genre.

The basic inquiry of the book is captured in its title or in the question, as More phrases it, "how to be a woman and a physician, how to be different from, yet equal to their male colleagues" (2). According to More, the "dilemma of difference" has meant constant balancing between the demands of work/career and home/family. For women physicians this dilemma has centered around three issues: They have fought for professional equality in medicine, they have resisted male medicine's one-dimensional conception of professionalism, and they have tried to practice "holistic" medicine by taking into account preventive, public health, and psychosocial aspects in medicine. More guides us through 150 years of the history of American medicine and provides an overview of women's feminist concerns and struggles to achieve professional equity and the strategies adopted for reaching these goals. She uses the community of Rochester, New York, as a case study to show how the foregoing three issues were handled in the local context. In health care, Rochester is by no means a typical city. It provided early central leadership in health care, and the Eastman Kodak Company set an example for other industrialists of how to locally organize health coverage and services for workers. The patriarchal tradition of medicine in Rochester serves as the tacit ideological background for More's focus on the way that individual women and groups of women organized to promote their professional goals and their own agenda in medicine. Here the story of a local female doctor, Sarah Dolley, and the Women's Medical Society of Rochester serve as heuristic devices to capture the larger social phenomenon: Late nineteenth-century America was characterized by gender segregation--there were men's and there were women's spheres. This thinking also affected so-called Victorian medicine: Women were assumed to take care of children and other women. This gave women a clear constituency and they rallied around the discourse of maternalism or what More calls "moral motherhood."

After the Flexner Report of 1910, American medicine was bifurcated into two paths: Medical schools that promoted the paradigm of allopathic/biomedicine and others that promoted a preventive approach taught in the nation's new schools of public health. This bifurcation left American women doctors much more vulnerable to the rise of hospital medicine than their European counterparts, especially since American hospitals belonged to the voluntary and private sector. More shows how, as a response, American women physicians organized and, in 1915, founded the Medical Women's National Association (its name to be changed...