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, Massachusetts, Harvard University Press, 1999. xi, 339 pp. illus., $49.95 (cloth).

Despite their relatively small numbers throughout most of the past 150 years, women physicians have long been a “remarkably visible force” in American medicine (p. 249). Women physicians have supported manydifferent goals, perhaps most notably a broad vision of health care as well as improved treatment of women in particular. In this well-written and important book, Ellen More relates many of the roles taken by women physicians by using the central theme of “balance.” More takes this to mean balance in (at least) three ways: balance between work and family, balance between equality and difference, and balance between therapeutic and empathetic attention to the various dimensions (psychological, social, and physiological) of patients’ lives.

More’s view encompasses both individuals and organizations. She contrasts all-female medical societies with all-male ones to great effect. She describes how Progressive-era “maternalist” health initiatives advanced both general benevolent ideals and specific women’s careers. Women saw these initiatives as both consistent with universal medical ideals and congruent with their underlying professional and scientific values. They sought to accomplish their goals through public health movements and settlement houses. Women physicians’ relative success in this area was not matched with success in gaining access to the newly invented temples of medical power, hospitals. More describes how women were systematically excluded from training at most American hospitals, but during the First World War found a home, albeit a somewhat uneasy one, as part of the voluntary overseas service known as the American Women’s Hospitals (AWH). Following the war, 1921 passage of the Sheppard-Towner Act seemed to presage the increasing importance of many of the ideals for which women physicians had worked over the past decade or so. But the act was not renewed in 1927, and women physicians had to seek other ways of influencing American health care.

More traces the obstacles faced by women during the second half of the twentieth century as they attempted to acquire advanced training or participate in national movements, as well as some of the strategies women used to overcome these obstacles. More explains some women’s career paths by applying the theory of “cumulative career advantages or disadvantages,” the hypothesis that advantages and disadvantages from the early years of someone’s professional life, although seemingly slight, may acquire much greater importance over the course of that person’s career. While this theory could apply to people of any gender, women appear to be more likely to experience deleterious effects. (This theory gained credence by a recent report on the status of women faculty in science at the Massachusetts Institute of Technology, published too late to be included in this volume, which comes to a similar conclusion.) More sees some commonalties in the world of women of all backgrounds, but is particularly sensitive to the additional difficulties faced by women of color.

One of the strongest parts of this book is More’s analysis of emblematic women’s careers, starting in the mid-nineteenth century and extending almost to the twenty-first. She unpacks the ways in which each career was a result of both necessity and choice. These biographical vignettes frame the book and give it at times a very personal feel. The many pictures of the women being discussed enhance that approach. These images are a central part of the book. Black and white, old and young, the women in these pictures remind the reader of the heterogeneity of female physicians and simultaneously stand in sharp contrast to the prototypical (and often nearly indistinguishable) pictures of older white men that pepper too many medical history texts (or talks).

This book adds much to our...