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

Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995.By Ellen S. More. Cambridge: Harvard Univ. Press, 2001. Pp. 340. $22.95 (paper).

Reading Ellen More's scholarly overview of the journey of American women in medicine from 1850 to the present, Restoring the Balance, was a little like feeling the ache in an old wound on a rainy day. Any female physician who has worked at building a serious career (particularly in academic medicine) will find eerily similar echoes of her own experiences in More's fascinating and well-researched study of the difficult journey American women doctors have made over the past century and a half.

More takes the title--and the theme--of her book from sociologist Rosabeth Kanter's view of the distribution of power within a heterogeneous group. If the minority members of a group are no more than 15 percent of the total membership, they are only "tokens," and the group culture is shaped entirely by the majority members. But as the size of the smaller group increases (to about one-third of the total), the minority members have an opportunity to form partnerships and alliances with the dominant group, and the dynamics of control and power are then defined as "tilted." Only when there is an even membership is the balance of power "restored." I found the paradigm confusing: how can power which has never been "balanced" between the group members--but has been held stubbornly, tenaciously, and effectively by another group (in this case, male physicians)--be "restored"? It seems to be that "winning a fair share" would be more accurate. And whether or not we will ever do so remains to be seen.

More's story is well told and comprehensive. She apparently had intended to tell the tale of only one woman, Sarah Dolley, who in 1851 became the third female to graduate from a chartered medical school in the United States. An extensive body of correspondence that extended over 40 years between Dolley and her son made her a particularly interesting subject: she wrote to him not only detailed accounts of her efforts to build her practice, but of all of the reservations, problems, and difficulties she faced over the course of her professional and personal life.This part of the book makes a fascinating point: many of the issues Dolley faced are precisely the same ones with which women in medicine wrestle in 2001: how to balance the demands of family (for which most women are expected--and choose--to bear primary responsibility), a medical career, and the needs of the communities in which she lives. At the urging of Leah Dickstein, however, More agreed to expand her work to trace the development of the American MedicalWomen's Association.The result is a detailed, meticulously documented, and particularly rich study of the personalities and accomplishments of the most important women in American medicine over the last century and a half. It is a fascinating tale, told without polemic or sentimentality, and replete with historical facts that make the book an important resource for any scholar interested in how individuals gain--and keep--power to shape the world around them.

World War II heralded a unique time for all American women, including those interested in medicine. It gave females an unprecedented opportunity to enter medical schools and to pursue training programs after graduation--and opportunity of which they could never have dreamed before this time. I remember women at the Columbia University College of Physicians and Surgeons who told me stories of being admitted to orthopedic and surgical training programs during the war, only to be ordered to leave as soon as the war ended, so they could pursue "more appropriate" disciplines (usually pediatrics, obstetrics and gynecology--and in rare instances for those who appeared particularly gifted, internal medicine). Interestingly, many of...