Why is medicine so slow to change?

Last weekend, I crashed the ACOG convention in Austin, armed with flyers about the need for better vulvar anatomy and training standards for vulvar surgeries. As anticipated, I encountered some resistance, largely due to the fact that doctors don’t really like getting accosted by a layperson with flyers. But surprisingly, I encountered a lot of support and agreement as well.

I used to read the content of OB/GYN textbooks and journal articles and conclude that the world must be against me. I could maybe see how older, male-dominated OB/GYN leadership could perpetuate systemic negligence concerning vulvar anatomy and female sexual function, but I couldn’t understand why young OB/GYNs weren’t speaking up when most of them were female. Back in 2012, a physician ex of mine called me to let me know the OB/GYN residents he talked to about this problem agreed with me — they too were mad when he pointed out that the nerves of the clitoris were omitted from their textbooks. Instead of feeling encouraged, I got upset. Why weren’t they fighting to change it?

I think the answer is that most doctors, especially younger doctors, don’t feel like they have the power or seniority to change much. Shouldn’t their professional societies enable more influence from all their members rather than only those in leadership positions, far along in their practice? Insofar as culture dictates medical literatature content, the effect of elderly medical leadership is that medicine is not caught up with mainstream culture. While the public recognizes women…