“I hope it’s a boy doctor.”
It was the spring of 2014, and I was walking with my then-10-year-old son from our car to our family health team’s office. Our doctor is part of the Queen’s Family Health team, so we often see residents rather than our assigned physician. For this reason (and because I don’t ask about the schedule when I book appointments), we don’t always know the gender of the person who’ll be providing care on a specific day. (We can always ask to see our doctor, however, I’ve never done this. I’ve always bought into this model of medical education – even before I started working as an educational developer in the undergraduate medical program).
It had never mattered to my son. Until that day in April.
We were heading to an appointment about recurring rectal bleeding. He had first presented with this on New Year’s Day. The digital rectal examination at the child out patient clinic the next day was an uncomfortable experience that he now refers to as “the butt thing”.
If they’re going to do “the butt thing” again today he wants a boy doctor, he said.
“You know,” I said, matter-of-factly (or at least I attempted to be matter-of-fact), “at the Med School where I work they teach boy doctors and girl doctors all the same things. They all learn how to look after everybody.”
“Yeah, I know,” he said. “But if they do the butt thing, I want a boy doctor.”
My son has autism. He’s seen multiple physicians, therapists and interventionists in his short life. Until this point, he had never commented on their genders. This was a new request. I had until his name was called to sort out for myself what I would do.
There was a flurry of news reports the previous fall, in October 2013, about whether patients should have the right to choose their physician based on race, religion or gender. (See here and here for some of this coverage). The news hook was a position statement by The Society of Obstetricians and Gynecologists that argued its members should resist such requests in emergency and other after-hours situations.
Perhaps because the articles were focused on obs/gyn, much of the commentary that followed focused on women, immigrants, and others with religious concerns. I can’t recall any discussion about children and their preferences in the gender of a treating physician. Until that day in 2014, I’d never given it any thought myself. My kids have been “stuck” with whichever family physician I’ve found for us.
Until my son’s request for a “boy doctor.”
Is this a reasonable request? Is my job as his mother to convince him that physicians of either gender will provide him with great care and that he should feel comfortable with either gender? Or is my job to talk with the clinic staff, explain his concerns, and ask to see a male doctor on duty that day?
The resident we were scheduled with that day was, indeed, the “boy doctor” so I was let off the hook of having to ask to have the attending (male) physician replace the other (female) resident. As a woman, as an educator, I’m uncomfortable with the idea of that conversation. As a mother and my son’s advocate, I think it’s something I would have had to do to support him in his request for a “boy doctor” for this invasive examination.
While I was happy to be off the hook that day, I have yet to resolve this conundrum. Is it reasonable for patients (or parents of patients) to make such requests? If gender requests are OK, are other requests OK, too — race, religion, age? Are children a special case?
In my role as an educational developer, I take these mental musings further: What does this mean for medical education? Do our students need special instruction on how to address these patient concerns? Would I have more or fewer reservations speaking up on this for my child if I weren’t involved in medical education? Are there other parents who feel they can’t bring things like this up for other reasons? Is this a problem? How can this be addressed?
These are questions I’ve continued to wrestle with and I suspect I will for a long time. What do you think?