Last week, I saw this brochure laying around the common workspace. It is allegedly used to help with the mental status orientation of our elderly patients at the hospital.

What stands out to you in this image? Tell me in the comments section (preferably before you read the rest of this post).

The first thing that stood out to me was the fact that the doctor was depicted only as a male figure. Right after seeing this, the thought about the origins of subconscious bias and unrecognized influences as it pertains to gender roles in medicine began to simmer in my brain.

I equally respect all those, like myself, with the XX chromosome whom I work with. Some are RN’s, LPNs, techs, doctors, phlebotomists, social workers, case managers, clerks, janitorial staff, chefs, administrators etc. I believe we each play a uniquely vital role in facilitating the lives of those we serve.

That being said, I am a woman and a Hospitalist and for one reason or the next, I often get mistaken for a member of staff that is NOT the physician. On one occasion I had to be from the hospital kitchen and was at the patient’s bedside to pick up the empty dishes, on another day I was the biomedical company representative and was at the bedside to check my device’s functionality etc. Of course, these assumptions always came up prior the proper introductions I make once I enter the hospital room. It often amuses me and I never take offense because I know my true identity.

If you haven’t noticed, I have a subtle interest in sociology and psychology. So when I saw this image I couldn’t help but wonder if unintentional imagery to assess cognitive function could create or facilitate pre-existing unconscious thought processes. Or thought patterns such as —the doctor has to be male.

Before you get sensitive about this post; I must declare that my current coworkers are male. We work well as a team, there is mutual respect and so this is NOT a  “male doctor bashing post”. What I want on the other hand is to shed light on the individuality of gender and the power each carries within. I also want to bring forth the argument of traditional bias in medicine.

Anyways, later that afternoon I was loitering the floors, checking on patients. An adult male was stalling there too. He had on him; the usual white and blue gown that our patients wore so I figured he must be someone waiting on his discharge papers from the hospital.

I happened to stop at the pod adjacent to his room, probably in an attempt to follow up on blood test results on the computer that stood there, unoccupied. I tucked my stethoscope in my long white coat pocket and simultaneously pulled out a piece of paper from my pocket, which always happens to be the list of the persons under my care on a particular day.

The gentleman stopped what he was doing and gave me a long stare and asked: “ So, are you a student or a nurse?”.

I have been a student and can be a nurse. I admire the nurses I work with; they multitask well, show extreme tenderheartedness to patients and are exceptional at caregiving activities.  So nothing wrong there, but why couldn’t the guess be the doctor, at first? #subconsciousbias #tradtionalbias.

But, I gently responded : “Neither Sir, but do you need anything?”

He proceeded to disclose his concern with needing to be home on time. Our conversation was interrupted as his discharging doctor arrived to discharge him.

I smiled to myself and walked away, thinking about the booklet (above) that I took a photo of earlier.

img_8306Photo of myself from 2014, midway through residency training

— — — — — — — — — — — — —

Two days later, I was rounding on that same floor. This time I had two gentlemen behind me, they followed me everywhere I went. One was a third-year osteopathic medical student learning during his first Internal Medicine clerkship on my service and the other is a “Foreign Medical Graduate” mentee who was shadowing to gain U.S. clinical experience.

We walked into the next person’s room as part of our routine, after I lectured extensively about her condition outside her door. We were discharging her home. I began to offer appropriate discharge instructions and came to the point where I had to instruct her to follow up with her Family Doctor in one week from the time she left the hospital.

I said: “Ma’am I will like for you to go back to see Dr. X and HE will need to check —.”

She quickly interrupted me. “ You mean SHE, Dr. X is a woman …”.

Her facial expression gave away her disappointment in the fact that I did not know that. It was almost as if she assumed all the female doctors within a 10-mile radius would know each other and stick/work together. Maybe we should?

I felt ashamed. The image of that photo chart came to mind. Just like that, I had become victim of the unconscious bias that her primary doctor was supposed to be male.

At that point; I had a flashback to my conversation with the gentleman in the hallway and my internal reaction to the poster I saw on the ward.

So, who is to blame?

Maybe our subconscious biases exist because of the prevalence of what has been and so no one is at fault. But it’s 2017 and there are many more female physicians today than ever before so is that still an excuse?

Could it be that one way to shift the current cultural perspective on the women in medicine will occur when there are many more women boldly choosing medicine? For those of us who have already made the choice, maybe we can make our impact felt and not only our voices heard.

Above all, the change we expect to see in others starts from inside of us. I choose to be boldly feminine in my daily encounters with patients to encourage the idea that there are many of us out here who will activate a new wave of thinking about the XX chromosome carriers and their role in the healthcare delivery. Irrespective of how young or old we look, how sweet or kind we are, how big or small, we can equally do great things! We can lead, coach, protect, nurture, heal, be parents, children, siblings and still be professionals and even doctors!

Maybe you have a bright idea to share on how WE can overcome this gender and other traditional bias?

Tell me your experiences or thoughts below.


  1. Beatrice
    10/26/2017 / 3:11 am

    I related so much to this piece because I’m quick to spot gender (or racial) biases in so many aspects of daily life but sometimes I catch myself unconsciously making assumptions like you described, or stereotyping people. Just goes to show how deeply ingrained certain biases are, that even when we are aware of them, we still have to make a conscious continuous effort to change our thinking.

    • ninotswalk
      10/26/2017 / 3:13 am

      Agree! It’s has to become a conscious daily effort. We have to keep our eyes open to see and understand the influences around us so we can place them appropriately.

  2. Whitney
    10/26/2017 / 12:38 pm

    The doctor is automatically male and the nurse is assumed to be a female

    • Whitney
      10/26/2017 / 12:47 pm

      Hey Ninots,
      Great write up. We as a society have be conditioned to think of men as providers and get all the important jobs and.MOst doctors are men,so these biases will continue to happen.,However, on other to start changing these , we have to make a conciuos effort to be biased with our tho king and asked open ended questions without coming to a conclusion before we get the answer. It is not easy but we have to choose to do it everyday and things can gradually change.
      P.S your blog is everything,so proud of you.

    • ninotswalk
      10/26/2017 / 7:02 pm

      Thank you for your perspective

  3. SG
    10/26/2017 / 12:48 pm

    Yes, I did think all nurses were female. When a male friend of mine told me he was a nurse. I had to probe him about it. I didn’t believe him at first.

    • ninotswalk
      10/26/2017 / 6:57 pm

      Thank you for your comment. We all are inclined to preconceived notions. Good thing is we are enlightening our minds to possibilities of what’s traditionally unfamiliar to us. Me and you both.

  4. David Ashworth
    10/26/2017 / 2:05 pm

    Initial thought: Probably something that was printed in the 1970s. In every example, however, there is a 50% chance that the sex of the character would be female. There are also different races depicted, is the brochure also trying to say that all nurses appear Asian? Or are we living in a world where we feel the need to show two pictures of all the characters to show that they could be either male or female?

    • David Ashworth
      10/26/2017 / 5:56 pm

      Thank you for sharing. One thing about being a white man is that I never wake up and look at myself in the mirror and consciously think, “Hey, I’m a white man.” Therefore, I don’t consider some realities of society such as biases based on the individual’s sex or race. Whether I like or not, I am limited in understanding for some others, and their understanding of me if we simply don’t go through the same experiences. I can’t say I know what it’s like to be a woman. Or a doctor for that matter. Or a Californian. Or fill in the blank with whatever. But we all, however, can comment and steer our society to one that is improved and further embracing humans despite differences or similarities.

      Also, I wonder if the patient simply thought you were too young to be a doctor. If so, a student (doctoral or not) or nurse would be a more appropriate guess.

      • ninotswalk
        10/26/2017 / 7:00 pm

        Thanks for sharing. This was just a perspective post. One opinion therefore highly skewed. Accolades, gender, age shouldn’t matter in the service of a patient. The quality of service should remain optimal and subject to criticism.

    • ninotswalk
      10/26/2017 / 7:01 pm

      Probably. Interesting perspective – didn’t see it that way. But that explains how differently we think and see life.

  5. Pavithra Kesavan
    10/26/2017 / 3:57 pm

    Very nice post Dr.Lum, it’s not only gender bias that female doctors face, if you look young and petite it’s yet another level to overcome 😖 But in a way our profession also teaches us to learn to be patient and not get offended so we do explain our roles to patients who rests their health in our hands and hope for the best.
    Thank you for sharing your experience, touching

    • ninotswalk
      10/26/2017 / 6:58 pm

      Yes. The patient is our priority and their lives are important. We should never forget to prioritize that.

    • ninotswalk
      10/26/2017 / 6:58 pm

      Thanks for sharing

  6. 10/26/2017 / 5:08 pm

    Love! Yet, another great piece Nina! I do think society ingrains these ideologies at a young age. Thank you for exploring this topic!

    • ninotswalk
      10/26/2017 / 6:59 pm

      We can all change in one way or the other. Thanks for your comment.

  7. Maurane
    07/20/2018 / 9:24 am

    When the picture gradually opening i though a doctor on a medical paper common thing, i said the same thing when i saw the nurse; but when saw the priest what passed in my mind this paper is showing different important persons in our life. Curiously when i saw that family’s picture i though but where is the son?

    • Maurane
      07/20/2018 / 10:00 am

      To be sincere , when i saw that the therapist is a woman, that gender equality problem didn’t bothered me. But you are right when you say we must all work in other to be equal with each other and also try to be true to ourself.

Tell me what you think.