Never before have women meant so much to so many. Recognized as
the health care system's biggest customers, they are being treated
such: researched and marketed to, tracked and talked about.
Consider: Premarin, an estrogen replacement, is the most widely
used prescription drug in the United States. From 1991 to 1992, the
number of hospitals with a women's health center rose 19 percent,
according to a survey by the American Hospital Association.
In many cities, Atlanta and Dallas among them, hospitals are
competing for pregnant Medicaid patients; among the lures are free
Disney movies for the older children, infant car seats, baby
insulated beverage flasks and monogrammed blankets.
Even the women who coalesced 30 years ago into something loosely
called the women's health movement are struck by the mix of
responsive medicine and commercial grasping that the 1990s have
delivered. It is both more and less than these mothers of
intervention bargained for.
"As a lasting legacy of the women's movement, health care is one
of our shining moments," said Dr. Susan Reverby, a professor of
women's studies at Wellesley College, who recently served on an
obstetrics and gynecology advisory panel for the federal Food and
While acknowledging that "the health care system is relentless in
its ability to figure out where the next buck is coming from,"
Reverby said the medical profession had become more aware of women's
concerns, especially those beyond the gynecologic. "There's much
more consciousness about what women's issues are," she said. "We can
now talk about heart disease and about AIDS."
But not all women applaud the results of that new consciousness.
Rachel Fruchter, an associate professor of obstetrics and
gynecology at the State University of New York Health Science Center
in Brooklyn, said she was appalled that women were pursued so avidly
as consumers, particularly by pharmaceutical companies whose
advertisements picture radiant middle-aged women and counsel, "Ask
"The pretense that that's what the women's health movement wanted
is a bad joke," Fruchter said.
In the beginning, the women's health movement talked mostly about
abortion and contraceptives. But as its baby boomer leaders have
reached the age of influence -- and the age of menopause -- the
health concerns of older generations have taken on new urgency.
That urgency is also fueled by the fact that women are living
longer -- on average, more than seven years longer than men -- and
are thus suffering from the crippling diseases of old age, like
arthritis and osteoporosis.
At the same time, women have not just been complaining about
doctors but have been becoming doctors. The influx has made female
patients happier and helped bring new emphasis to the doctor's role
as interviewer, said Dr. Charlea Massion, a family doctor at the
Santa Cruz Medical Center in California and a clinical faculty
at Stanford University.
"Women physicians do have, and linguistic studies show this, a
different way of communicating," Massion said.
"I don't think women physicians are necessarily interested in
women's health just by being women, and I don't think women
physicians are more open-minded or have a more comprehensive
just because they are women. …