Physicians introduced differently if they are women

Julia Files and Anita Mayer, physicians at the Mayo Clinic, started seeing a pattern: When their male colleagues were introduced at conferences, they were usually called “Doctor.” But the men introduced them and other female doctors by their first names.

The pair quickly realized they weren’t alone. Sharonne Hayes, another Mayo doctor, had noticed the same thing. While a male colleague would be introduced as “Dr. Joe Smith,” for example, the women were often simply called “Julia,” “Anita” and “Sharonne.”

So the three decided to study speaker introductions at “grand rounds” — events where doctors, researchers, residents and medical students present medical problems and treatments for discussion. Their research showed that unequal introductions were real — that women were less likely than men to be introduced by professional title when men did the introducing.

“It gets down to perception of expertise, perception of competence,” said Files, an associate professor of medicine at Mayo and the lead author of the study. “We know that in other settings, choices of words really impact women’s progress in careers.”

The study, published in the Journal of Women’s Health, looked at videos of 321 speaker introductions at 124 internal medicine grand rounds from 2012-14 at Mayo Clinic campuses in Arizona and Minnesota.

The results showed that male introducers used professional titles for female doctors only 49 percent of the time on first reference, but introduced male doctors by their titles 72 percent of the time.

Female introducers used titles in introductions of both male and female doctors more often than male introducers (96 percent of the time vs. 66 percent of the time).

Hayes, a professor of medicine and cardiovascular diseases, said the form of address wouldn’t matter if it were the same for both genders.

“It’s the inequity and the context,” Hayes said. “I don’t mind being called ‘Sharonne’ — it’s my name! — but if all the men are being called ‘Doctor Jones’ and all the women by only their first names, that’s offensive.”

“While I have to assume it’s inadvertent, the effect is to put me in my place as ‘less than,’ ” she said.

The unequal introductions can affect a woman’s performance, noted Hayes, who directs the Office of Diversity and Inclusion and the Women’s Heart Clinic at Mayo’s headquarters in Rochester, Minn.

“The other thing is, grand rounds is kind of a high-stakes event that is the premier educational venue at academic medical centers,” Hayes said. “As the speaker, you’ve spent hours preparing for it, may be a little nervous in front of the podium, ready as an expert, and then somebody says, “Here’s ‘Sharonne.’ You’re immediately put off a bit and may not be at your best performance.”

Kim Williams, a professor and the chief of the Division of Cardiology at Rush University Medical Center in Chicago, said male introducers might be using first names for women because they felt more familiarity with them. But he added, “That’s not acceptable.”

While Williams said first-name introductions didn’t happen at Rush, female doctors at other institutions said they were all too common. “My question would be ‘Are there any women doctors who have never been introduced by their first names?’ ” said Esther Choo, an associate professor of emergency medicine at Oregon Health & Science University in Portland. “There are a lot of built-in presumptions about your level of commitment and capability.”

Choo, who lectures on gender bias in medicine, said she thought the firstname introductions could reflect unconscious bias but might also be because of familiarity or the introducer’s seniority, which the study brings up.

Kim Templeton, a professor of orthopedic surgery at the University of Kansas in Kansas City, said she cringed every time she heard female doctors introduced by their first names and had experienced it plenty of times herself.

“Women don’t tend to be thought of as leaders. They’re thought of as worker bees and the people who work well together,” said Templeton, immediate past president of the American Medical Women’s Association. “Talking to us is no different than talking to their wives or daughters at home.”