Power, diversity and medical regulation

My recent tweets (@davearlingtontx) in September 2017 featured historical snippets focusing on women in medical regulation. In one I focused on a regulatory trailblazer: Adele Hutchinson, MD. This graduate of Boston University appears to have been the first woman to serve on a state medical board anywhere in the U.S. This occurred surprisingly early–in Minnesota in the 1890s. The fact that two other women (Margaret Koch; Hannah Hurd) succeeded her on the Minnesota medical board seems all the more remarkable considering the male domination of medical boards individually and collectively throughout the majority of their history.

Admittedly, this gender landscape has changed over time. One rough calculation I made in 2011 using records from the Federation of State Medical Boards (www.fsmb.org) indicated that women comprised 40% nationally of all members serving on state medical boards. Similarly, women served as the executive director (i.e., chief staff member) on half of the boards in 2011; a figure that holds true currently.

I can’t help but think about these otherwise random facts when I reflect on a picture like the one below featuring the board of directors of the Federation of State Medical Boards (FSMB) in 1960. Established in 1912, the FSMB served the individual state medical boards of this country both then and now. I have been proud to work for twenty years with this organization.

FSMB leadership 1960

There is nothing particularly remarkable about the photograph. In fact, I could show many more photos just like it of FSMB leadership. Whether plucked from 1930 or 1950 or 1980, the photos would all look very similar in one regard: leadership involved no one of color and no women. This is what power looked like in this country for many years, indeed the vast majority of this country’s history. Pick virtually any area you wish to analyze: business, government, law, medicine. A picture like this is reflective of where power rested in the United States for a long time. A picture of those holding power in any of these areas (in this example, medical regulation) would look a lot like this.

I think this is part of the reason many people look at the Confederate monuments that harken back to this kind of world and power structure and feel they are no longer appropriate today on multiple levels.

I am proud to say that leadership of the organization I work for no longer resembles a photo like this. Still, it gives pauses to consider just how late it was when change finally arrived in these power dynamics. The first woman (Dorothy Bernstein) did not serve on the FSMB board of directors until the 1970s. Dr. Bernstein, coincidentally, came from the Minnesota medical board. Yet, her brief appointment to serve out a vacancy on the board didn’t translate into a woman being directly elected to FSMB governance until the 1980s. Dr. Susan Behrens (pictured) gained this honor and later was elected to serve as the organization’s board chair, 1989-90. Behrens_Susan_1Another woman, Dr. Barbara Schneidman (1991-92), soon followed. For those interested, Dr. Behren’s shared her personal story in moving amongst governance circles. See vol. 98, no. 2 of the Journal of Medical Regulation http://jmr.fsmb.org/archives/

(The opinions expressed here reflect the views of the author and do not represent those of the FSMB.)

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