Is some healthcare 'macho' and other healthcare 'feminine'

i know. that's why i thought plastic surgery - it sems to be the definitive (not in terms of perception, that'd be rocky, but in terms of (private) funding etc)

the division of medical care along 'macho' (and therefore valued/ funded) lines is interesting, but has more to do with whatever is ground-breaking/ research worthy i think. pushing the barriers to save lives (and enhance the reputation of the pct/ get better kpi results/ improve statistics) is always going to get more funding than those things that aren't taken as a measure of success in business terms (ie longer term therapies/ provision of portage to children with developmental delays etc) - they aren't concrete enough to be valued in business terms.

it's the same thing that the adult with cp on the 23 week programme was hinting at i think (from what i've read on here - can't watch it as i'm o'seas) - the innovations to be able to resuscitate 23 weekers are what is valued for their potential, not just to save the lives of premature babies, but for the increases in knowledge that might be transferable to other areas of medicine. with the best will in the world, (and the general perception of people with disabilities in the uk) no-one is going to put that sort of money into ongoing support to improve gait. it's a travesty, i agree.

so i think we are agreeing, but on different terms. loosely it is to do with what is valued in a patriarchal society, but in reality it's more to do with slashed budgets and proof of scientific value and potential. (science being another topic i could waffle on about in loosely patriarchal/ sociological terms until i lose the will to live)

the problem with medicine is that it isn't terribly scientific at all, unless you are working in those areas that are pushing boundaries and attracting research funding... and the problem with science...

i'm not a huge fan of either tbh.

but it's interesting to ponder nhs funding. the disabled and the elderly are pretty much written off (they aren't much use to society anyway in gdp terms) so it's more what we do value as a society - youth, hard workers, strength, (all those things that men are and women aspire to ) apparently. so it's by default a societal issue, but not specifically a patriarchal one in the first instance.

i'm not making any sense at all, am i?

I think the US birth mortality rates probably have more to do with very poor antenatal care (or rather poor care for poor people). It's a system very heavily biased towards diagnostic and elective care and away from preventative treatment. But that's what happens when you have a highly monetarised healthcare system.

I've worked with many clinicians including doctors from many disciplines (I used to manage quality assurance). Surgeons have traditionally had the highest status and I'm fairly sure it's still quite a male dominated field, but I'm not sure that orthopedic surgeons are any different to any other group. The influx of women in medical school is likely to change that over time, although whether they will be attracted to the long hours and on call nature of surgery without a supportive 'wife' at home is I guess another matter.

ah. found a tenuous link.

most plastic surgeons are men. that i can find a feminist argument with.

joni - the doc who saved dd2's life and looked after her in scbu was female. her orthotists have all been male. i can't find a feminist argument in there at all.

we have a choice of two paeds at the mo, both male. (although there is a female paed working in town whose books are full ) it probably says more about society than it does about the docs themselves...

dunno. we've never had to fight for funding tbh (and our orthopods have always been a circumspect bunch - not a whisper of surgery in sight). will have to sleep on it.

I was really shocked on that thread when one mother said they wouldn't let her decide whether or not to let her baby die. They just want to play God these men. IN other cases, where the woman wants her baby to stay alive, they take her to court to fight her decision.

ON a slightly related topic:
IN Japan parents are starting to sue doctors for problems with their babies , especially if they die. As a result the rules imposed upon pregnant women are even stricter than ever before.
I avoided all the strictures by going for 2 midwife homebirths, but what I'm getting at here is that the doctors make out as though it is they who deliver the healthy babies. They actually believe the normal healthy babies come about thanks to them . They refuse to give information to the mothers about the options available; they're information hoarders, in fact, and women are then supposed to simply "trust" . So when something does go wrong, the logical step to take, from the POV of the parents, is to blame the life-creators i.e the doctors.
Now, if these doctors would just relinquish their control, return it to its rightful place i.e the mothers, then if something happened to the baby there is no-one to blame. It's understood that everyone involved did their best but that sometimes, death is part of life.
I'M not so sure that modern medicine has really done much for birth at all when you think that the U.S has astronomically high maternal and infant death rates, possibly because of their astronomically high C-section rate.
If people want to be involved in the system, that's fine, but there is obviously an drive for life and death to become as medicalized as possible . I think other options should be explored, other more peaceful options.

Going back to the topic, I think nooka's right to say the distinction is between 'heroic' healthcare - the dramatic battle for life and death - and the other, less exciting but just as important stuff, such as pain management or chronic disease management.

Macho stuff I'd define as including emergency medicine and orthopaedics (has anyone ever met an orthopod who wasn't a rugger bugger?). Probably most surgery, tbh. Stuff that is regarded not exactly as softer but less macho would be paediatrics or anaesthetics. My guess would be there are far more female consultant paeds or anaesthetists than orthopods.

That doesn't mean, of course, that the way orthopaedics or surgery is run is deliberately sexist in an overt way. But it is striking that some specialties have far fewer senior women than others.

Oh Joni . This is clearly, and understandably, a really bit, really emotional issue for you. I hope you manage to find the answers you want soon.

I do agree that im22 was very abrupt and pretty unpleasant, but no one else reacted like that but you said lots of people attacked you when we didn't. It doesn't feel very nice to be accused of attacking someone you simply disagreed with...but I'm guessing that you're coming from a pretty dark place right now. I can't imagine what you're going through, and your partner too.

im22, a request.
In this section we manage to discuss a lot of quite contentious and sometimes very sensitive topics without, for the most part, being rude. Sometimes tempers are lost and voices get raised but people don't generally fly off the handle at a single exploratory post where the poster is clearly thinking through ideas and raising questions. If the topic is to be a safe space for discussion it is nice if it can remain this way.

joni, I feel for you, but the fact is you haven't posted this in a medical/social studies etc. forum, you have posted it in a feminist forum claiming that your DP doesn't get the care he deserves (although you didn't mention him in your original post and if you had, I fully admit I would have toned down my initial criticism) because of some patriarchal dominance in who decides what gets funded and what doesn't in healthcare.

My posts were an attack on this assumption, not on you or your circumstances, and although I am sympathetic to your position, please don't assume that this means your original post/question has any merits. Your DP doesn't get the care he deserves (and I fully believe you that he probably doesn't) because of some of the issues raised by other responders, as well as many more, but please don't blame my entire gender for something that isn't it's fault.

I wish you and your DP all the best and that he can get the help he deserves

I've just said that I agree that it happens! I disagree that it is a feminist issue, though! But, like I say, I disagree at the moment. I'm sensible enough to know that there may well be arguments that persuade me to think otherwise.

And it's not a subjective matter. You feel attacked but you weren't by anyone except the first respondent, whose response probably put you on the defensive and made you see all the other disagreements as attacks when they weren't.

If someone knocked into you by mistake, but you felt it was an attack, that doesn't make it one. It's not fair to post a message, and then tell the people who disagree with you that they are attacking you.

Well you are totally right that long term care is underfunded. I think that's mostly because it is hidden. It's not a very attractive area to go into for many (for doctors there are few private practice opportunities, and probably not much research funding either) and the costs are often split across health and social care, so too many opportunities for passing the buck when money is short.

I think only one person has 'attacked' you, Joni. The others have just disagreed with you. I agree with you that long term care is difficult to find support for from the powers that be, but I don't, at the moment, think it's a feminist issue.

Joni, I'm a nurse. I'm also a feminist. I'm afraid, though, that I don't have a clue what you're talking about! It's certainly not an attitude I have ever come across.

I think the OP has bought into all sorts of stereotypes and doesn't really perhaps know very much about neo-natal care (which generally involves months of care, with often many crisis along the way).

Personally I think that there are issues about heroic healthcare, whether that is saving very premature babies or campaigning for some of the more advanced (often very expensive, with nasty side effects and fairly small benefit) chemotherapy treatments for cancer. Or indeed the lack of palliative care options for the very frail elderly or terminally ill.

But I think that this is more to do with the prevalence of the 'where there is life there is hope' viewpoint; a growing distance from and therefore fear of death; the dominance within the healthcare system of hospitals; and the Cinderella status of many community based services and very little to do with gender.