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Keywords:

  • gender;
  • social support;
  • co-worker support;
  • tokenism;
  • professions

Abstract

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

Women's growing numerical representation in the professions has not necessarily translated into women being truly integrated in these occupations. Questionnaire data are used to examine whether female physicians are socially integrated in the male-dominated profession of medicine in terms of the support they receive from their medical colleagues compared to male physicians. The literature on tokenism and homophily suggests that women in male-dominated professions receive less support than their male colleagues, whereas the social support literature predicts that women typically receive more emotional support than men but less informational and instrumental support. The results of this study shed light on the complex and multi-layered ways in which gender is relevant to our understanding of the extent to which co-workers provide empathy, information and assistance to one another.


Introduction

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

The professions literature clearly documents the steady numerical growth of women's representation in male-dominated professions, such as law and medicine, over the last 50 years in Canada and other Western countries. A large body of literature has examined the effect of numerical proportions for gender inequality; however, findings indicate that women's growing numerical representation has not necessarily translated into women being truly integrated in the male-dominated professions on the same footing as their male counterparts (Yoder, 1991). Because professional occupations grant prestige, social influence and economic rewards, women's successful representation and integration in these fields may be particularly important to our understanding of gender inequality (Lincoln, 2010; Percheski, 2008).

It has been suggested that external (occupational) mechanisms that regulate access to the professions have been formalized and redefined along more meritocratic lines, thereby opening the doors for women. That is, women possess the necessary levels of expertise via formal qualifications to enter male-dominated professions. However, the internal (organizational) mechanisms that determine career success and access to certain prestigious segments of the professions remain dominated by informal and gendered criteria that exclude female professionals (Bolton and Muzio, 2007). This means that even though more women are entering the professions, barriers continue to persist that block their full and equal participation in the professions (Acker, 1990). Consequently, researchers have shifted their attention to the barriers women face once they enter the professions that result in their relatively lower earnings or prestige, slower career progress, concentrations in less prestigious areas of specialization, and higher rates of departure compared to men (Boulis and Jacobs, 2008; Reskin, 1988; Riska, 2001; Wallace, 2004).

One of the barriers that has been identified is the informal social ties that exclude women and reinforce the male-dominated structures of authority (Blair-Loy, 2001). The literature suggests that these informal ties and relationships are critical to career advancement and success, earnings and promotions and other forms of recognition (Ibarra, 1997). In addition, supportive interpersonal relationships at work have been clearly documented as significant predictors of many important work-related outcomes, such as job satisfaction and earnings (Kay and Wallace, 2010), as well as broader outcomes such as mental and physical health (Ducharme and Martin, 2000).

These same patterns described in the general professions literature have been documented in the medical profession in Canada and elsewhere, where many barriers that historically deterred women's entry into medical schools and the profession have been eliminated over recent decades (Boulis and Jacobs, 2008). In many Western countries (e.g., Australia, Canada, the United Kingdom, and the United States), even though about half of all medical students are women, women remain an occupational minority in medicine (Taylor, 2010). For example, current Canadian statistics show that women represent 57 per cent of first-year medical students but only 36 per cent of practising physicians (Canadian Medical Association, 2012). Moreover, despite more women entering and practising medicine, many women work in specialties (e.g., cardiology, general surgery) or settings that continue to be primarily male-dominated, where in some cases they are the only female physician or they represent less than 10 per cent of the physicians working there (Boulis and Jacobs, 2008; Ku, 2011; McMurray et al., 2002; Tsourourfli et al., 2011). Canadian statistics show, for example, that less than 10 per cent of practising physicians are women in certain surgical specialties, such as neurosurgery, orthopaedic surgery and urology (Canadian Medical Association, 2012). As Longo and Straehley (2008) recently noted, based on their research on women surgeons in the United States: ‘The entrance of women into medicine in critical mass is a necessary but not sufficient condition for gender equality’ (p. 95). Studies indicate that women in medicine follow different career paths, are under-represented in leadership positions, advance more slowly in their careers and are paid less compared to their male counterparts (Boulis and Jacobs, 2008; Riska, 2001). Thus, it appears that women's entry, participation and success in medicine reflect women's broader accomplishments in the labour force and professions in general.

The purpose of this paper is to examine the extent to which female physicians practising medicine in a province in Western Canada are socially integrated in the male-dominated profession of medicine in terms of how much support they receive from their medical colleagues compared to male physicians. Specifically, I set out to answer the research question: Are there differences in the amounts of social support that male and female physicians receive from their colleagues? In examining the support that men and women receive from their colleagues, three different types are considered: emotional, informational and instrumental support. Emotional support involves receiving empathy, sympathy or caring from another person (Olson and Shultz, 1994). Informational support refers to receiving work-related information, advice or guidance from another person (House et al., 1988). Finally, instrumental support is tangible aid that is rendered by providing actual assistance, such as helping a colleague to do their work or accomplish a task (Ducharme and Martin, 2000).

Two competing arguments are posed in the literature regarding gender differences in the amount of support received from one's colleagues. The literature on tokenism and homophily suggests that women in male-dominated professions will receive less support than their male colleagues. In contrast, the social support literature suggests that, as a result of gender socialization, women typically receive more emotional support than men, but less informational and instrumental support. These arguments are presented in greater detail below.

Tokenism, homophily and co-worker relations for women

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

Kanter's (1977) concept of tokenism is often used to explain the effects of being a numerical minority in a relatively homogeneous environment. The common experiences that Kanter noted in regard to female tokens in male-dominated jobs is that they are isolated, excluded from important informal social and professional networks and offered little support by their co-workers (Taylor, 2010). Kanter described ‘homosocial reproduction’ as the process where those in power fill positions they oversee with ascriptively similar others, which serves to reproduce their advantage over successive generations of workers (Elliott and Smith, 2004).

It is important to note, however, that tokens' experiences are not necessarily gender neutral as Kanter tends to suggest. That is, men who are tokens in female-dominated occupations and work settings do not always experience the same negative consequences of numeric imbalance reported by women (Yoder, 1991). In some cases, the opposite occurs, where the greater visibility that token men experience is advantageous to their career and upward mobility as they are likely to share the same sex status as their male supervisors and be viewed as more competent and better suited for leadership positions (Taylor, 2010). That is, studies report that token men may benefit from the ‘male advantage’ of working in female-dominated occupations (Pierce, 1995; Taylor 2010; Williams, 1992).

Others have suggested that the token effects observed by Kanter may result from homophily processes that define in-group and out-group membership (Roth, 2004b). Homophily preferences reflect a tendency for people to feel more attracted to others who are similar in salient respects and an inclination to associate with others and develop stronger ties with those who are like themselves (Erickson et al., 2000; McPherson et al., 2001). It is argued that people tend to be attracted to those who are similar because they often share common interests and tend to be able to communicate more easily (Reskin, 2003). Gender similarity, as an easily observed and salient ascribed characteristic of interpersonal similarity, likely leads to greater social integration and more supportive and cooperative relationships (Cook and Minnotte, 2008; Roth, 2004b). Tokens who differ from the majority may experience more isolation, restricted access to mentors, less information and fewer professional networks and sponsorship, and less collegial support (Wallace and Kay, 2012). Exclusion from these social networks represents structural barriers that may severely hinder career opportunities and career success (Blair-Loy, 2001; Ibarra, 1997; Kay and Wallace, 2010; Riska, 2001; Roth, 2004a, 2004b).

Social networks made up of job-related contacts may provide a wide array of valuable resources such as information, advice, referrals and support (Ibarra, 1997; Kay and Wallace, 2010). According to Acker (2009), male professionals may devalue and exclude women from important informal social networks ‘by not listening to them in meetings, by not inviting them to join a group going out for a drink after work, by not seeking their opinions on workplace problems’ (p. 210). These patterns have been observed in a recent study of surgeons, where female surgeons reported that they feel lack of support in terms of mentoring, collaborative research opportunities and informal networking (Sonnad and Colletti, 2002). Similarly, male physicians appear to have greater access to professional networks and can rely on their colleagues to help them out when things get tough at work (Novelskaitė and Riska, 2006). These small but significant exclusionary practices maintain current institutional arrangements and the gendered organizational hierarchy of male-dominated occupations (Longo and Straehley, 2008). As a result, based on the tokenism and homophily literatures, it is hypothesized that women will report receiving less support from their colleagues than men.

Gender, social support and co-worker relations

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

Two different bodies of social support literature are relevant in examining gender differences in supportive relations at work. In the work literature, social support has been shown to be critical in coping with work-related stress, as well as important in contributing to the enjoyment of one's work and commitment to one's employing organization and occupation (Ng and Sorensen, 2008; Thoits, 1995). A supportive work environment may provide a valuable resource by making one feel appreciated and cared about by one's co-workers, facilitating success in one's work, and positively affecting one's work attitudes (Viswesvaran et al., 1999). In the health literature, social support and integration reflect the positive consequences of being involved in relationships, where there is a plethora of studies that demonstrate benefits for a variety of mental health outcomes (House et al., 1988; Lincoln et al., 2003; Thoits, 2011; Wellman and Wortley, 1990).

In general, both social support literatures suggest that women experience more supportive co-worker relations than men (Bellman et al., 2003; Greenglass, 2002; Schieman, 2006; Wallace and Kay, 2012). Research shows that women tend to report providing and receiving more support from others, and having more close ties to non-family members than men (Liebler and Sandefur, 2002; Wellman and Wortley, 1990). Some researchers have examined different types of co-worker support and found that women tend to receive more emotional support from colleagues, particularly from other women, whereas men tend to receive more informational and instrumental support from their colleagues that are key for upward mobility in organizations (Ibarra, 1992; Olson and Shultz, 1994). These patterns have also been found among physicians, where female physicians are more likely to report friendly relationships among their colleagues who are willing to listen to their work-related problems, whereas male physicians are more likely to have colleagues who help them out in times of need (Novelskaitė and Riska, 2006).

Several different explanations for the gendered patterns of support have been posed in these literatures. One explanation refers to how men tend to be socialized to be self-reliant and independent, whereas women are socialized to seek support, take advantage of that support and be a source of support when necessary (Ng and Sorensen, 2008). Thus, when support is required, men and women have been socialized to provide it and seek it out in different ways, and men generally have fewer supportive relationships than women (Bellman et al., 2003). Another explanation is that women's relationships tend to depend on emotional closeness, whereas men's tend to focus on shared activities, which may explain why women typically exchange emotional support and men usually exchange instrumental support that involves shared activities (Liebler and Sandefur, 2002). Lastly, it has been suggested that because women generally feel they have less control in interpersonal contexts than men, women usually rely on more emotional or expressive coping styles (Schieman, 2006). In contrast, men's relatively high perceptions of control preclude the need for emotional or expressive responses and instead they can turn to more instrumental or control-directed strategies (Krajewski and Goffin, 2005; Lazarus and Folkman, 1984). A recent study on physicians illustrates how male and female physicians network differently, where women often seek supportive and empathic relationships rather than ties with senior professionals who have made a major influence in the medical field (Buddeberg-Fischer et al., 2010). In sum, the social support literature suggests that women will report receiving more emotional support from their colleagues than men, but less informational and instrumental forms of support than men.

Gender, work and family involvement

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

Despite the prominent role of social support in the work, stress and health literatures, several researchers have noted that little attention has been devoted to the potential antecedents of co-worker support (Ducharme and Martin, 2000; House et al., 1988; Thoits, 1995, 2011). As well, the factors that may affect the distribution of support and whether these factors vary for women and men in affecting the amount of support they receive has not been examined extensively (Schieman, 2006). An important contribution of this paper is the introduction of two sets of factors that may help explain gender differences in supportive collegial networks and that may vary in importance in shaping the supportiveness of social relationships at work. These include indicators of women's and men's work and family involvement.

There is considerable evidence in the literature that shows how men and women differ in their work and family obligations and commitments (Becker and Moen, 1999; Bianchi et al., 2000; Sayer, 2005). Moreover, there are contradictory schemas reflected in the cultural norms of the ‘good mother’ that requires ‘intensive mothering’ in contrast to the ‘ideal worker’ who is unencumbered by competing demands and always available for work at a moment's notice (Correll et al., 2007). Similarly, the ‘ideal doctor’ is available to work all hours of the day and even beyond their contracted hours, which has been referred to as the ‘all hours’ temporal norm in the medical profession (Özbilgin et al., 2011; Tsourourfli et al., 2011).

Women are generally viewed as less committed to their careers than men, and studies show that women in medicine are more likely to leave the profession and do so sooner than men, and are less inclined to join professional organizations (Burton and Wong, 2004; Wallace, 2008). Because large numbers of women have entered the professions more recently, women in the professions average less experience than their male counterparts (Reskin, 2003; Wallace and Kay, 2012). Men and women also tend to end up in different specialties and work settings (Bird, 1996). Even amongst high-status professionals, the traditional patterns persist, where men typically devote more time and energy to their work responsibilities than women, and women devote more time to their family responsibilities than men. Studies of physicians show men are more likely to miss a family activity because of work and women are more likely to miss a work activity, particularly those outside of regular work hours, because of family (Sonnad and Colletti, 2002). Additionally, female physicians typically work fewer hours than their male colleagues, and are more likely to work part time, even though this often incurs criticism from their colleagues (Boulis and Jacobs, 2008; Martin, 2003; Özbilgin et al., 2011; Tsourourfli et al., 2011). Keizer (1997) notes, the more hours physicians work, the more of a physician they are viewed to be and the more dedicated and esteemed they are in the eyes of their colleagues. Moreover, it would seem that those who are more involved in their work and spend more time at work will have more opportunities to develop supportive and social ties with their co-workers (Wallace and Kay, 2012). Thus, it is expected that physicians who are more involved in their work will likely report more supportive collegial ties.

In regard to family involvement, women are more likely than men to be responsible for household and childcare tasks, even when women work in prestigious, male-dominated occupations (Blair-Loy, 2001; Suitor et al., 2001; Young and Wallace, 2009). The literature suggests that family responsibilities reduce the amount of time that individuals have available to socialize with others at or after work, thereby reducing their opportunities to develop and maintain social networks in general and work ties in particular (McGuire, 2002). The situation is no different for physicians, where studies report that female physicians are responsible for two to three times more of the childcare and household responsibilities (Carr et al., 1998) and significantly more female physicians report conflict between their career and family than men (Gross, 1997). For example, a recent national Canadian survey found that female physicians spend an average of 42 hours a week with the primary responsibility for their children, which is almost triple the amount of time reported by male physicians, which averages about 15 hours a week (Martin, 2003). It is expected that physicians who are more involved with their family responsibilities will receive less support and assistance from their colleagues.

Based on this literature, I explore whether involvement in the work and family domains affects the amount of support physicians receive from their colleagues, and whether the effects of their involvement on collegial support differ by gender. Specifically, I address the following two questions: (1) If gender differences exist in the amounts of social support physicians receive from their colleagues, is it attributable to differences in the work and/or family involvement between male and female physicians?; and (2) Do the factors that affect social support received from colleagues, such as work and/or family involvement, have differential effects on social support for male and female physicians?

Data and methods

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

Sample

In March 2008, questionnaires were sent to all physicians registered in a single health region encompassing a major urban centre and surrounding rural areas in Western Canada. A total of 1178 questionnaires were received from an eligible 2957, yielding a 40 per cent response rate. A chi-squared test was computed to determine whether the percentages of the sample represented by each of the 12 major medical specialties (e.g., anaesthesiology, emergency, family, psychiatry) differ significantly from those reported in the health region. The chi-squared value equals 3.984 (11 df, p = 0.970), indicating that the sample distribution does not differ significantly from the percentage of physicians in each specialty in the region. The sample appears representative of the population of physicians in this regard.

The sample includes 383 (40 per cent) women and 576 (60 per cent) men. All physicians included in the analyses are married in order to be able to examine their degree of family involvement. On average, they are 48 years of age and have practised medicine for about 17.5 years. However, some have just recently begun their careers and others have been practising medicine for more than 50 years. On average, participants work just over 40 hours a week on site at a clinic or hospital (excluding call) when their work consists of mainly patient care activities (mean = 42.6 hours) and almost another 8 hours a week at home (mean = 7.8 hours).

Measures

Unless otherwise indicated, the response sets for the Likert items include: strongly disagree (coded 1), disagree (coded 2), neutral (coded 3), agree (coded 4), strongly agree (coded 5). An (R) indicates the item is reverse coded. Multiple item measures were summed and divided by the number of items to calculate a mean score where a higher score indicates a greater value of that variable. Cronbach's alpha (α) is also reported for the multiple items measures below.

Dependent variables

Collegial support: The items measuring collegial support are from scales developed in two prior studies (House, 1981; King et al., 1995). For each type of support, respondents were asked to report the extent to which their medical colleagues do the following when they have a stressful day at work. Emotional support was measured by four items tapping the extent to which their colleagues: try to cheer them up; try to understand when they get frustrated at work; do not seem interested in hearing about their work stresses (R); and do not really listen when they talk to them about the stresses of their work (R) (α = 0.76). Informational support was measured by three items reflecting the extent to which their medical colleagues: offer suggestions or solutions to deal with their difficulties at work; help them to figure out how to solve a work-related problem; and share ideas or advice in dealing with their difficulties at work (α = 0.84). Instrumental support was measured by two items regarding the extent to which medical colleagues: work together with them to get things done; and take on extra work responsibilities (α = 0.65).

Work involvement: Work involvement was assessed by the following variables: career commitment, weekly work hours at the office and at home, extra work activities, work effort, years practising medicine and medical specialty. Career commitment was measured by two Likert items from Konrad et al.'s (1999) Physician Worklife Survey: ‘If I were to choose over again, I would still become a physician’; and ‘I am seriously thinking about leaving the medical profession’ (R) (α = 0.69). Work hours (office) was measured by a single item asking how many hours a week on average they work on site (e.g., hospital, clinic) excluding on call hours; and work hours (home) was measured by asking them to report how many hours they work at home. Extra work activities was measured by a single Likert item: ‘I frequently attend work-related activities (e.g., meetings, conferences) outside of regular work hours’. Work effort was measured by five Likert items (Caplan et al., 1975; Marks and MacDermid, 1996). Respondents were asked about their day-to-day work experiences and to indicate the extent to which they feel they: do not have enough time to get everything done; are rushed; have too many demands placed on them; need more time to do all of the things that are expected of them; and are overextended in order to finish everything (α = 0.87). Years practising medicine is the number of years respondents have been practising medicine after their postgraduate training. Medical specialty was coded 1 for respondents who identified their area of practice as primarily in family medicine, obstetrics/gynaecology or paediatrics and was coded 0 for all other areas of practice (McMurray et al., 2002).

Family involvement: Family involvement was measured by four indicators: scaling back work hours for one's children, household responsibilities, the time respondents spend alone with their spouse and parental status. Scaling back for children refers to the degree to which the respondent has reduced the number of hours they work for the benefit of their children with responses ranging from not at all (coded 1) to very much (coded 4). Those without children were coded 1. Responsible for housework was measured by a single item that asked respondents who usually does most of the household tasks (e.g., meals, laundry, cleans the house) around their home. If they indicated ‘me usually’ or ‘me almost always’ they were coded 1, and all other responses (e.g., partner usually, partner always, both of us equally) were coded 0. Time alone with spouse refers to how often the respondent and their spouse spend time alone together talking or sharing an activity. The possible responses ranged from never (coded 1) to every day (coded 5). Parental status was coded 1 if the respondent had any children currently living with them at the time of the study, and 0 if not.

Control variables

In addition, three control variables were included in the analyses. Spouse's work status was coded 1 if they work full-time or 0 if they do not. Perfectionism was measured by three Likert items from Purdon et al. (1999) that tap the extent to which the respondent has extremely high goals, expects higher performance than most people, and is very good at focusing their efforts on attaining a goal (α = 0.65). Earnings reflects the respondent's self-reported 2007 gross annual earnings from the practice of medicine in Canadian dollars (CAD).

Data analysis

Three analytic strategies were used in this paper: mean difference tests, ordinary least squares (OLS) regression and tests for gender interactions. Mean difference tests were conducted to determine how men and women differ in their work and family involvement. OLS regression was used to test the main effects of gender on physicians' collegial support. In addition, OLS regression was used to test the relationships between work involvement and family involvement and physicians' collegial support. Lastly, in order to explore whether the factors that affect social support received from colleagues, such as work and/or family involvement, have different effects on collegial support for male and female physicians, 14 multiplicative gender interaction terms (e.g., medical experience × gender, earnings × gender) were computed. The regression models for each type of support were re-estimated with the addition of these interaction terms added in four blocks; one block each for professional involvement, work involvement, family involvement, and the control variables. Of the 42 potential gender interactions for the three different types of support, only four were statistically significant at the 0.05 level. Given the small number of gender interactions, the regression results for women and men are pooled in Table 2. The four significant gender interactions are identified and discussed where relevant in the results section below.

It should be noted that the zero-order correlations and variance inflation factors (VIFs) that were estimated for all of the variables included in the analysis do not suggest any collinearity problems (available from author).

Mean difference results

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

Table 1 shows the extent to which women and men differ in their collegial support and work and family involvement. The results suggest that women receive significantly more emotional (mean = 3.53) and informational (mean = 3.56) support from their colleagues than do men (mean = 3.34 and mean = 3.31, respectively). Both genders report receiving somewhat less instrumental support from their colleagues in contrast to the other two types of support, but no gender difference is observed in the amounts of instrumental support received.

Table 1. Mean difference tests for women (N = 383) and men (N = 576) in medicine
VariableWomen Mean (SD)Men Mean (SD)
  1. * p < 0.05; ** p < 0.01; *** p < 0.001.

Emotional support3.53 (0.64)3.34 (0.61)***
Informational support3.56 (0.68)3.31 (0.74)***
Instrumental support3.06 (0.79)3.06 (0.77)
Work involvement  
Career commitment3.97 (0.87)4.05 (0.89)
Work hours (office)38.75 (16.98)44.28 (15.29)***
Work hours (home)7.50 (8.67)8.03 (8.07)
Extra work activities3.46 (1.00)3.54 (0.99)
Work effort3.84 (0.78)3.75 (0.75)*
Years practising medicine13.67 (9.05)20.08 (12.29)***
Medical specialty (1 = Female dominated)0.61 (0.49)0.29 (0.45)***
Family involvement  
Scaling back for children2.31 (1.15)1.65 (0.82)***
Responsible for housework0.49 (0.50)0.04 (0.21)***
Time alone with spouse3.50 (0.88)3.60 (0.83)*
Parental status (Parent = 1)0.64 (0.48)0.54 (0.50)***
Control variables  
Spouse works full time0.73 (0.45)0.25 (0.43)***
Perfectionism3.92 (0.58)3.87 (0.57)
Earnings212,156 (113,583)321,199 (144,376)***

Turning next to work involvement, three of the seven indicators suggest that men are more involved in their work than women. Men (mean = 44.28) report working significantly more hours at the office on a weekly basis than women (mean = 38.75), but women (mean = 3.84) report exerting slightly more work effort than men (mean = 3.75). Men report significantly more experience practising medicine, where they average 20 years of experience compared to women's 13.5 years. More than half of the women (61 per cent) work in a female-dominated specialty in contrast to about one-third (29 per cent) of the men. Both women and men often feel rushed at work with too many demands and too little time. Both genders report working about 8 additional hours per week at home, are equally active in participating in extra work-related activities and meetings outside of regular work hours, and do not differ in their relatively high levels of career commitment (i.e., averaging about 4 on a 5-point scale).

Women appear more involved in the family domain, in terms of scaling back their work hours for their children as well as being primarily responsible for household tasks. A more detailed analysis of the frequency distribution of these variables reveals that 46 per cent of the women compared to 16 per cent of the men reported reducing their hours ‘a fair amount’ or ‘very much’ for the benefit of their children. Half of the women (49 per cent) are ‘usually’ or ‘almost always’ responsible for most of the household tasks around their home compared to 4 per cent of the men. The genders appear similar in the amount of time they spend alone with their spouse, although the mean difference is statistically significant, suggesting that men (mean = 3.60) spend more time alone with their spouse than do the women (mean = 3.50). A more detailed analysis of the frequency distributions indicate that about half of both men (49 per cent) and women (47 per cent) report spending time alone with their spouse talking or sharing an activity almost every day and about 10 per cent of both genders report spending such time with their spouse every day. Women are also more likely to have children living at home (64 per cent) compared to the men (54 per cent), which suggests the women may have more family commitments than the men.

Lastly, in terms of the control variables, male and female physicians do not differ significantly in the degree to which they are perfectionists. Women are far more likely than men to have a spouse who works full time — 73 per cent compared to 25 per cent, respectively. Women in medicine earn, on average, significantly less than male physicians. For example, they earn approximately 66 per cent of their male colleagues' earnings which translates into approximately $110,000 CAD less a year on average.

Regression results

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

Table 2 contains the regression results for all three forms of collegial support. After taking into account physicians' professional, work and family involvement, and the control variables, women report receiving significantly more emotional (b = −0.089) and informational (b = −0.181) support from their medical colleagues than men. Also consistent with the initial results in Table 1, women and men in medicine report receiving similar amounts of instrumental support from their colleagues.

Table 2. Regression results for emotional, informational and instrumental co-worker support (N = 959)
 Emotional supportInformational supportInstrumental support
b (SE) βb (SE) βb (SE) β
  1. * p < 0.05; ** p < 0.01; *** p < 0.001.

  2. a

    statistically significant gender interaction (* p < 0.05).

Gender (Men = 1)−0.089 (0.053)−0.069*−0.181 (0.062)−0.121**0.022 (0.069)0.014
Work involvement      
Career commitment0.122 (0.023)0.172***0.110 (0.027)0.133***0.087 (0.029)0.099**
Work hours (office)−0.002 (0.001)−0.0510.001 (0.002)0.0150.001 (0.002)0.030
Work hours (home)−0.007 (0.002)−0.089**−0.009 (0.003)−0.098***−0.009 (0.003)−0.097**
Extra work activities−0.028 (0.020)−0.045−0.004 (0.024)−0.0060.009 (0.026)0.011
Work effort−0.030 (0.029)−0.037−0.044 (0.035)−0.046−0.111 (0.038)−0.109**
Years practising medicine−0.020 (0.002)−0.186***−0.010 (0.002)−0.151***−0.006 (0.003)−0.085*
Medical specialty (1 = Female dominated)0.099 (0.043)0.078*0.070 (0.051)0.048−0.012 (0.056)−0.007a
Family involvement      
Scaling back for children0.031 (0.024)0.051a0.058 (0.028)0.082*0.064 (0.031)0.085*
Responsible for housework−0.026 (0.055)−0.017−0.054 (0.041)−0.021−0.039 (0.072)−0.021
Time alone with spouse0.100 (0.024)0.137***0.122 (0.028)0.144***0.026 (0.031)0.029
Parental status (Parent = 1)−0.051 (0.051)−0.041a−0.038 (0.060)−0.026a−0.052 (0.067)−0.034
Control variables      
Spouse works full time−0.062 (0.044)−0.049−0.062 (0.052)−0.043−0.022 (0.058)−0.014
Perfectionism−0.059 (0.035)−0.055*−0.026 (0.041)−0.0210.020 (0.045)0.015
Earnings−0.000 (0.000)−0.078*−0.000 (0.000)−0.065*−0.000 (0.000)−0.015
Constant3.433 (0.220)***3.146 (0.259)***2.980 (0.285)***
R20.1400.1150.049

It was expected that the more involved physicians are with their work, the more opportunities and greater likelihood of receiving support from their colleagues. This prediction is generally not supported by the results in Table 2. Only career commitment is consistently related to collegial support in the hypothesized direction — the more committed physicians are to their medical career, the more emotional (b = 0.122), informational (b = 0.110) and instrumental (b = 0.087) support they receive.

In regard to work hours, only the hours physicians work at home is significantly related to all three types of support, where it reduces their collegial support. The more time physicians spend working at home, where they are unlikely to be working with colleagues, the less emotional (b = −0.007), informational (b = −0.009) and instrumental (b = −0.009) support they receive. The only other work involvement variable significantly related to support is work effort, where the harder physicians work and the more overwhelmed they are by the demands of their job, the less their colleagues work together to get the job done or take on extra work responsibilities for one another (b = −0.111).

Another unexpected finding is that the longer physicians have been practising medicine, the less support they receive from their colleagues. Since male physicians have significantly more experience than female physicians, this may partly account for the gender gaps in emotional and informational support.

The pattern of findings for working in a female-dominated specialty shows intriguing variation across the three forms of support. Those working in a female-dominated specialty receive more emotional support (b = 0.099) than those working in other medical areas, which may be partly why women, who are more likely to be working in these areas, receive more support than men. In contrast, physicians' specialty is unrelated to the amount of informational support they receive. And lastly, the findings for instrumental support differ significantly for women and men. The equations were analysed separately for women and men (results not shown) in order to interpret the gender-specific effects. For male physicians, if they work in a female-dominated specialty they receive significantly less instrumental support from their colleagues (b = −0.130, SE = 0.075, β = −0.078, t = −1.731). That is, men receive more instrumental support if they are working in more gender-neutral or male-dominated areas of medicine where more of their colleagues are men. In contrast, the effect for women is positive (b = 0.124, SE = 0.086, β = 0.078, t = 1.433). That is, women working in specialties with mostly other women are more likely to receive instrumental support from their colleagues. This finding offers support for the tokenism and homophily arguments in regard to tokens receiving less support from their colleagues and those who are more ascriptively similar having stronger ties and experiencing more supportive and cooperative working relationships.

It was suggested above that the more involved physicians are with their family, the less support they will receive from their colleagues at work. Physicians who have scaled back their work hours for the benefit of their children, however, receive more informational (b = 0.058) and instrumental (b = 0.064) support from their colleagues. These coefficients do not differ significantly for women and men, whereas they do for emotional support. For emotional support, men receive more support if they have scaled back their hours for their children (b = 0.062, SE = 0.034, β = 0.084, t = 1.830). In contrast, the amount of scaling back that women do is unrelated to the amount of emotional collegial support they receive (b = 0.024, SE = 0.039, β = 0.044, t = 0.627). Table 1 showed that women are significantly more likely to scale back for their children than men and this does not appear to negatively affect women's support network, but it does not strengthen it either. Being primarily responsible for housework is unrelated to the support received at work. However, the more time spent alone with one's spouse is positively related to emotional (b = 0.100) and informational (b = 0.122) support, but unrelated to instrumental support. Lastly, parental status is related to both emotional and informational support. Statistically significant gender interactions were also found for this variable. For men, parental status was unrelated to the amount of emotional (b = 0.033, SE = 0.065, β = 0.028, t = 0.514) and informational support (b = 0.057, SE = 0.080, β = 0.039, t = 0.714) they receive. In contrast, for women, if they have children they received significantly less emotional (b = −0.190, SE = 0.088, β = −0.143, t = −2.158) and less informational (b = −0.240, SE = 0.960, β = 0.170, t = −2.482) support than if they do not have children, which offers some corroboration for the family involvement arguments.

Lastly, two of the control variables are relevant to understanding physicians' support systems at work. The personality trait perfectionism, was only related to emotional support, where physicians who are more perfectionist receive less emotional support (b = −0.059) from their colleagues. Earnings was related to both emotional and informational support, where the more physicians earn the less support they receive from their colleagues.

Discussion

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

The primary objective of this paper was to examine the extent to which female physicians are socially integrated into the male-dominated profession of medicine by comparing the amount of support women and men feel they receive from their colleagues at work. Two competing arguments were posed regarding hypothesized gender differences in collegial support. The literature on tokenism and homophily suggests that women in male-dominated professions will receive less support than their male colleagues, whereas the social support literature suggests that women will typically receive more emotional support than men but less informational and instrumental support. Both arguments were supported by the findings of this study that illustrate the complex and multi-layered ways that gender is relevant to our understanding of the extent to which female physicians are socially integrated in the medical profession.

Tokenism, homophily and co-worker relations for women

In respect to the tokenism and homophily arguments, an interesting pattern of results was found regarding the links between working in gendered medical specialties and the amount of instrumental support men and women receive from their colleagues. Women appear to benefit from working in more female-dominated specialties, whereas men benefit from working in fields with more men. As indicated above, homophily preferences reflect a tendency for people to associate with others who are more similar to them and develop stronger ties with those who are like themselves (Erickson et al., 2000; McPherson et al., 2001). It appears that the homophily argument holds for both women and men working in gender segregated specialties. As well, it appears that men do not enjoy the ‘male advantage’ of working in female-dominated specialties as some literature has suggested (e.g., Pierce, 1995; Williams, 1992). Rather men, like their female colleagues, receive more instrumental assistance and support when they work with co-workers who are similar in their gender status.

The literature shows that there has been substantial temporal continuity in the gendered representation of medical specialties as well as persistent cultural and reputational differences across medical specialties (Boulis and Jacobs, 2008; Ku, 2011). It has been suggested that women tend to choose specialties where women physicians are already practising, and this may be because their critical mass seems to promote a comfort level for women entering these fields. In fields where there are more women, there are more female role models and this in turn helps to recruit more women. Moreover, women in medicine continue to report being excluded from interpersonal interactions as well as experiencing harassment, belittlement or humiliation, particularly in more male-dominated specialties, such as surgery, that have reputations of being ‘macho fields’ and ‘old boys' clubs’ into which women are still not openly welcomed (Gargiulo et al., 2006). Future research should explore the gendered ways in which encouragement, mentoring and other micro-inequities in physicians' day-to-day interactions have subtle but significant effects on the social interactions women and men experience across different medical specialties.

It should be noted, however, physicians working in sex-segregated medical specialties do not necessarily work in settings that reflect the same sex composition (Taylor, 2010). That is, occupational sex compositions are not always mirrored at the hospital, clinic, department or team level (Roos and Reskin, 1992). For example, if a female physician works in a male-dominated specialty, such as surgery, she likely works in a male-dominated surgery department or clinic and she may turn to her female non-medical co-workers for support (e.g., nurses, office staff). In contrast, if a female surgeon spends most of her day working with a team of other female surgeons, she may turn directly to them for support. The female surgeons in these two different scenarios likely differ in their opportunities and experiences to seek and receive assistance from their colleagues that is not captured by measuring the sex composition of their medical specialty. Future research might explore the sex composition in the immediate workplace in terms of work groups or support networks in order to better understand the impact of different system levels of sex segregation, tokenism and homophily.

Gender, social support and co-worker relations

The results of this study also offer corroboration for the social support hypothesis. The results show that women receive greater empathy and caring and work-related advice and information from their colleagues than men. It is unclear, however, whether women receive more support from their colleagues because they are actively seeking more support than men, as the literature suggests, or because as women they are more receptive to receiving it or perceived as needing it more (Wallace and Kay, 2012). Future research should examine in greater detail the processes through which women receive support from their colleagues and the extent to which it depends on their gender alone or perhaps gender differences in support-seeking behaviours.

It also should be noted how emotional and informational support differ from instrumental support. The former involve receiving understanding, empathy or information that are not necessarily immediately helpful, but may prompt the individual to help him or herself (Olson and Shultz, 1994). Through talking and listening, the individual may feel better from receiving emotional support, or appraise the situation and their coping response differently after receiving feedback, guidance or informational support. In contrast, instrumental support typically tackles the source of the problem more directly, where co-workers step in to help complete a task or actively relieve the individual of their work duties in some way. Thus, instrumental support may reflect a greater sacrifice on the part of co-workers in terms of the time and energy they dedicate to helping their colleagues — interventions that likely take co-workers away from their own work responsibilities. It appears that this more demanding and sacrificial form of support occurs more frequently among co-workers who are similar in their gender status.

Gender, work and family involvement

In addition, I set out to examine whether gender differences in the amount of social support that physicians receive from their colleagues is attributable to gender differences in work and family involvement. In examining this question, several unexpected results were found that deserve further discussion. Starting first with work involvement, the most significant way that men appear more involved in their work is in spending longer work hours at the office, clinic or hospital than women. For both men and women, however, it is not their visible work hours or participation in extra work activities that are relevant to colleagues' supportiveness. Rather, the time physicians spend working at home is consistently related to all three types of support, where the more time they spend completing work tasks at home, the less emotional, informational and instrumental support they receive. This may reflect the different types of work tasks that physicians are able to perform at home (e.g., finishing charts or dictations, completing patient-related paperwork, financial record keeping). Such take-home tasks may be more routine or predictable and may not typically require support or assistance, regardless of where they are completed. In contrast, the more unpredictable, novel or difficult tasks encountered at work may be the ones that lead physicians to seek help and support from their colleagues. In addition, the negative relationship between working at home and support may reflect the practical difficulties of seeking and accessing support from one's co-workers after leaving the workplace, even though more time spent at work does not appear to increase support where it might be easier to access.

Lee (2002) suggests that the logistical costs of time and effort required to identify, locate and seek suitable helpers may be an obstacle for physicians in their busy work settings, where everyone is working under tight time constraints, rushing and over-extending themselves to meet their work demands. In addition to these logistical costs, she also argues that seeking or accepting help from others involves ‘social costs’, since the person seeking help may appear incompetent, dependent or inferior to others (Lee, 2002; Ng and Sorensen, 2008). This may be particularly the case for men and those working in a male-oriented occupational role, such as medicine, where being competent, independent and even superior are consistent with notions of masculinity. While this paper has focused on gender differences in the amount of support received by women and men, future research might examine the extent to which men and women differ in their help-seeking behaviours, and particularly in the obstacles they face in seeking support from colleagues.

Another unexpected finding is that greater work effort reduces rather than increases the amount of instrumental assistance provided by colleagues. Further, the receipt of emotional and informational support are unaffected by how hard individuals work. The negative relationship with instrumental support may reflect a situation where one's co-workers are also working hard and have little to offer one another in terms of assistance and help. As mentioned above, instrumental support can be potentially costly for colleagues to give each other in terms of time and energy, as it likely involves taking the supporter away from their own work tasks. Future research might explore the extent to which colleagues in one's work environment are overly busy or over-extended, and whether this affects their ability to provide one another with this particular type of support.

Turning next to family involvement, as predicted, women in medicine are clearly more involved in their family roles, as seen by the extent to which they scale back their work hours for their children and are primarily responsible for household chores. The unanticipated findings are that the more time physicians spend with their spouse and the more they have scaled back for their children, the more support they receive from their colleagues. It is possible that physicians who are more involved with their family seek more support and/or their colleagues understand and empathize with the challenges of balancing a demanding career and family responsibilities and offer more assistance to them (Ng and Sorensen, 2008). This interpretation is challenged, however, by the finding that mothers receive less emotional and informational support than women without children, which is consistent with the family involvement hypothesis. The literature suggests that contemporary cultural beliefs assume that women with family responsibilities bring less effort to their work, and are less motivated and productive because they are either saving their energy for their home time or they have no energy left for work after meeting their home responsibilities, despite empirical evidence that has shown otherwise (Bielby and Bielby, 1988; Voydanoff, 2004; Wallace, 2008; Young and Wallace, 2009). As well, Correll et al.'s (2007) experimental study examining status-based discrimination mechanisms found that mothers are rated as less competent and committed to paid work than non-mothers and they are consequently discriminated against in terms of hiring and salary decisions. The motherhood penalty reported in this study, that mothers receive less emotional and informational support than non-mothers, deserves more attention in terms of exploring mothers' support-seeking behaviours as well as co-workers' assumptions and beliefs regarding the relevance of motherhood in providing support.

Conclusions

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

The literature suggests that one of the barriers that may prevent women in male-dominated professions from being truly integrated is that they may be excluded from informal and social relationships that are often critical to career advancement and success. And while many studies have examined the benefits or outcomes of receiving social support, very few have examined the factors that influence the amount of support received from one's colleagues. The results of this paper shed light on the complex and multi-layered ways in which gender is relevant to our understanding of the extent to which co-workers provide empathy, information and assistance to one another. It appears that many women in medicine feel supported by their colleagues, particularly in terms of the amount of emotional and informational support they receive. In addition, homophily preferences appear relevant in regard to instrumental support, where women receive more instrumental support when they work in more female-dominated specialties. However, gender differences in work and family involvement do not appear to account for the support gender gaps in ways that were predicted. Nor does physicians' involvement in these different domains account for much variation in the support men and women receive from colleagues. It is clear we still know little about the factors affecting the supportiveness of co-worker relationships.

In terms of the broader implications of this study, we must ask whether these supported women working in a male-dominated profession benefit to the same extent as their male colleagues in terms of their well-being, productivity, job satisfaction and career rewards? As well, from the perspective of the tokenism and homophily arguments, do women truly feel they are integrated in their profession and accepted as members on an equal footing to their male colleagues and does this vary across different specialties that may be more or less gender segregated? And from the social support literature, we should ask whether women are more active in seeking support from their colleagues and/or more receptive to receiving or acknowledging it than their male counterparts? In answering these questions, we should be able to better understand the ways in which women come to be accepted, supported and rewarded in male-dominated occupations.

In closing, several limitations of this study should be noted. One limitation is the cross-sectional design, which does not allow determination of the causal ordering of linkages among the variables in the model. Second, the data are subjective, self-reports based on the perceptions of individual physicians. Such data are susceptible to distortions if respondents answer so as to maintain a series of consistent answers or to present themselves in a favourable light or from other effects of common method variance (Podsakoff and Organ, 1986). For example, future research might consider more objective measures of work and family involvement, or alternatively reports from respondents' co-workers and supervisors or spouses, respectively. Third, it should be noted that physician surveys are particularly prone to low response rates (Cummings et al., 2001) and this sample of physicians is no exception. Recent evidence on physician surveys, however, suggests that response rates are poor indicators of response bias and when analysis of differences between responders and non-responders are conducted, there are often few significant differences in relevant characteristics between the two groups (Cummings et al., 2001; James et al., 2011). Lastly, this paper focused on a single, high-status, professional occupation, namely Canadian physicians. Some of the findings presented in this paper may be limited to this particular occupation, or specifically Canadian physicians, or high status professionals more broadly.

Acknowledgements

  1. Top of page
  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References

Support for this research was provided by a Research Grant from the Alberta Heritage Foundation for Medical Research's (AHFMR) Health Research Fund and financial and in-kind support from Alberta Health Services (AHS) (former Calgary Health Region). The opinions contained in this paper are those of the author and do not necessarily reflect the position or policy of AHFMR or AHS. The author wishes to acknowledge the invaluable comments provided my Fiona M. Kay, Jane Lemaire and Marisa C. Young on an earlier draft of this paper. This paper was presented at the 2011 Annual Meeting of the American Sociological Association in Las Vegas, Nevada.

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  2. Abstract
  3. Introduction
  4. Tokenism, homophily and co-worker relations for women
  5. Gender, social support and co-worker relations
  6. Gender, work and family involvement
  7. Data and methods
  8. Mean difference results
  9. Regression results
  10. Discussion
  11. Conclusions
  12. Acknowledgements
  13. References
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