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

Readable and intelligent, Ellen More’s Restoring the Balance is a valuable addition to the literature on the history of women in the American medical profession. More uses the organizing motif of “balance” to tell the story of women physicians in the last 150 years. By this she means that their primary challenge since the mid-19^th century has been reconciling equality and difference through their struggle to be both women and professionals. They have not had an easy task.

While the lives of many of the women she chooses to explore are already familiar, More brings to her narrative some fresh archival material. There is an informative and engaging chapter on Sarah Adamson Dolley, one of the earliest to earn a medical degree in the United States. The author skillfully explores Dolley’s motivations and her creation of a female professional lifestyle characteristic of most women physicians in the 19^th century. Though educated at an eclectic medical school, Dolley had quite a successful career as a private practitioner in Rochester, New York, where she helped build a thriving and ecumenical professional community of competent and self-aware women physicians. Indeed, much of More’s research in these early chapters is drawn from the Rochester women’s medical community, which provides a rich case study that supplements our growing knowledge of the many challenges women doctors faced as they carved out a place for themselves at the end of the 19^th and the first two decades of the 20^th century. This is a community of women worth knowing about.

More’s book makes some new contributions to scholarship. Wherever possible she includes material on black women physicians from the early decades of the 20^th century to the present. Though conversant with the difficulties white women physicians had getting hospital internships, for example, the author is especially poignant in describing the combined effects of gender and racial discrimination on the careers of these determined young women. She has researched and interviewed black women physicians’ lives with dedication, and the book’s vivid portraits of courage in the face of overwhelming obstacles and challenges are compelling.

Most of this book revisits and confirms familiar conceptual and narrative territory. In doing so, Restoring the Balance securely reinforces the analytical frameworks established by other scholars. Once again we learn about women physicians’ struggles to find their own version of professionalism, of the various ways they coped with overt and covert discrimination, of their dilemmas about mediating between marriage and career, of their attempts to organize professional societies and their ambivalence about separating themselves off too much from their male colleagues. More offers some new venues for exploring women physicians’ participation in social medicine (which she calls “maternalist medicine”) by looking at women-staffed dispensaries and health centers in Rochester. She retells the story of the founding of the Medical Women’s National Association by concentrating on this organization’s establishment of the American Women’s Hospitals, a voluntary overseas service devised during World War I to afford women physicians an opportunity to aid the war effort when the army rejected their participation. She embeds a discussion of the ill-fated Sheppard-Towner Act in an insightful analysis of the decline of maternalist medicine in the years after 1930, noting the turn away from older notions of physician responsibility even among new generations of women physicians who, along with their male colleagues, came to accept fee-for-service as the norm.

More carries the story of women physicians up to the present. She makes an important contribution to understanding the changes that have taken place in the last 30 years. We are introduced to several extraordinary women physicians whose medical careers blossomed in the 1950’s and 1960’s and whose contributions to the field were outstanding. In addition, the author measures the impact of feminism and other social changes on women...