April 23, 2001 -- Christine Litwin-Sanguinetti, MD, says you don't need to be a brain surgeon to see why female patients are flocking to practices like hers.
"I've had women say to me, 'I can talk to you about things I would never say to my male gynecologist,' especially if he was young and handsome," says Litwin-Sanguinetti, founder of the Women Physicians OB/GYN Medical Group in Mountain View, Calif. "If a women is 59 years old and having sexual difficulties, it's hard to say that to a 30-year-old man."
Her all-female practice in California's Silicon Valley, which started with just her and another physician 19 years ago, was once something of a novelty.
Not today. With many women patients preferring to talk about issues like pregnancy and sex with another woman, the demand for female obstetrician-gynecologists is at an all-time high -- so much so that some male doctors believe they're being discriminated against in hiring.
While most ob-gyns are men -- some 64% -- but that's mainly because a generation ago, most physicians were men. This year, over 70% of ob-gyn residents are women, and medical schools are reporting that as many as 80-90% of students planning to enter the specialty are women.
Some doctors say that male medical students who express interest in becoming ob-gyns are frequently talked out of it by their advisors.
John Musich, MD, chairman of the Council on Resident Education in Obstetrics and Gynecology, says he's recently heard of some medical practices in Florida that were openly advertising for women doctors, a tactic some male doctors believe is discriminatory. And some medical journals have been carrying advertisements that state, "All-female practice seeks associate."
A colleague told Musich he could not recall a male ob-gyn hire in the San Francisco area in the past decade.
"I don't know if that's good for the marketplace," Musich says.
Erin Tracy, MD, who chairs the junior fellows advisory council of the American College of Obstetricians and Gynecologists, says she frequently urges male medical students to become ob-gyns, often to no avail.
"I hear a lot of anecdotal reports from male medical students that they've had teachers or advisors tell them this is not a good field for men," Tracy says. "The reality is that while sometimes a patient does prefer a female provider, many just want the best. My male partners are just as busy as I am."
Tracy also notes that while women patients may be looking for doctors who have shared common experiences, she's never had a baby herself.
"My father is a cardiologist, and he's an excellent cardiologist despite never having had cardiac [heart] disease," she says.
Still, the practice of medicine is a business, and many patients who are in the marketplace for ob-gyns are seeking women physicians.
Karen Lovett, of the Houston-based search firm Practice Dynamics, says she sees an increased demand to hire women ob-gyns, especially in urban areas where competition to lure away patients can be fierce. "If a practice is losing market share, they think a female can win it back," she says.
On the other hand, patients in rural areas can't be as choosy. In one widely publicized case, a New Jersey ob-gyn who said he was told he wasn't bringing in enough patients -- and was fired two months later -- sued the practice, charging breech of contract and sex discrimination.
David Garfinkel, MD, who ultimately opened up his own practice right next to his old one, said he also didn't get a $65,000-a-year raise he'd been promised, and that the stated reason was that he wasn't bringing in patients because he was male.
The practice has countered that Garfinkel was let go strictly for economic reasons. The case is pending before the New Jersey Supreme Court.
In two very similar cases, though, judges have determined that fired male ob-gyns were not discriminated against, that the preference by women for female ob-gyns was natural, and that some jobs --- washroom attendants, for example -- will have sex-based requirements.
The rise of all-female practices is evident on the Internet, where a number of practices bill themselves as "Women Caring for Women," accompanied by soft impressionistic art and text that emphasizes the caring nature of the physicians. Litwin-Sanguinetti's practice in California states that "we strive to create a practice environment that is comfortable for you," and that "we do not share calls with anybody else."
Consider this online testimonial for one longtime ob-gyn in central New Jersey: Holly Roberts, DO, recently retired, who headed up a four-woman practice.
"Dr. Roberts feels that, as a female physician, she is particularly sensitive to women's health needs," it states. "She has herself undergone ovarian surgery and has given birth to three children. She can, therefore, identify and empathize with the concerns and problems of her patients."
"I think that women are well-suited to medicine in the first place," says Litwin-Sanguinetti. "They tend to be caretakers, and there's a lot of caretaking that you do in ob-gyn."
Musich says there tends to be more demand for women ob-gyns in highly affluent areas like Silicon Valley, while it's somewhat less of an issue in more blue-collar areas.
Litwin-Sanguinetti, meanwhile, says her practice doesn't get many applications from young residents, but that only one was ever from a man.
He didn't get the job.