Am Fam Physician. 2025;111(5):393
Author disclosure: No relevant financial relationships.
American Family Physician (AFP) documents the changing status of women as both patients and physicians over the past 75 years and illustrates how much progress has been made since it was first published under the title General Practitioner (GP). Wins for women include improving gender equity in medicine; respectful representation in pharmaceutical advertisements; and a stronger evidence-based understanding of their physical and mental well-being.
The world portrayed in GP was almost exclusively male, as evidenced by the names of award recipients, honorees, and speakers at various national events. In 1960, only about 6% of those entering medical school and of practicing physicians were women1,2; by the 1980s, the percentage of women among medical school graduates had quintupled to 30%2; and in 2023, 55% of medical school entrants and 38% of active physicians were women.3,4
More concerning than the absence of professional women in the pages of GP is the unflattering portrayal of women in pharmaceutical advertisements. One advertisement shows a harried housewife whose dishes are in disarray; but after a dose of Ritalin, she stands smiling next to a tower of neatly stacked plates. Another advertisement portrays a voluptuous young woman furtively scarfing a dessert. The accompanying text states, “Our deadweight playmate knows wrong from right, but she can’t tame her overweight appetite.” Such portrayals of women are vestiges of a different era that sexualized women while emphasizing their neuroticism.
Women began to fare somewhat better in the 1960s, although in clinical articles they are mostly portrayed as weak, uncertain, and anxious. In one article regarding “the depressed gynecologic patient,” emotional lability is regarded as fundamental to the development of gynecologic symptoms.5 Another article from this era suggests a need to exert control over working women. The author insists that a “pre-employment gynecologic examination is indicated for all women” because it will “help predict which women will have an extraordinary absentee record because of gynecologic disorders.” According to the author, the objective is to defer employment until such disorders are properly treated so that a woman can be “healthy and efficient in industry.”6
Fortunately, AFP now presents patients as individuals of equal standing, irrespective of gender or sex. Contributing factors include vast changes in the role of women in industrialized nations, particularly women’s entry into the workforce. The advent of evidence-based medicine has also accelerated scientific and technological progress in women’s health and has demonstrated improved outcomes in women treated by female clinicians.7 A combination of person-centered care and objective science has changed the landscape for women, both as patients and physicians—influences that are clearly evident in the evolution of AFP over the past 75 years.
In 2003, AFP commentary explored the implications of performing fewer Papanicolaou tests due to the American Cancer Society’s recommendation to extend the testing interval from 1 to 3 years.8 What clinical intervention, the feature asked, should the physician offer in its place when the annual pelvic exam is no longer indicated? The author suggested the following approach: “She [note the physician’s gender] could begin with the patient’s history by asking open-ended questions to discover who she is, what her behaviors are, and what she values, and then present and apply the ever-changing evidence.” This person-centered advice goes a long way in illustrating how a less-patriarchal approach toward all patients has benefited women by encouraging respectful treatment that considers their wants and needs.
Person-centered care remains the mainstay of many AFP articles involving sex-specific interventions, such as two 2023 articles on preconception counseling9 and infertility treatment,10 which explicitly recognize the profound implications of sensitive topics on women’s health without the pejorative undertones of earlier decades. AFP and other journals now avoid reductive gender distinctions, which shows how our language itself has evolved and reflects a broader cultural movement away from gendered stereotypes in medicine.
Finally, the changing professional status of women as physicians is equally evident. While the early decades of AFP show scant mention of women as physicians and only rare depictions of female clinicians in advertisements, women now represent a robust proportion of AFP’s authors and editors. With these advances in mind, we have ample reason to celebrate Women’s Health Month, as marked by this article’s publication, on behalf of progress for our patients as well as for our women physicians.
WHAT AFP MEANS TO ME
As a family physician and educator, AFP is central to my lifelong learning journey. I stay current on high-yield topics in my clinical practice by reading its concise articles and summaries of key society guidelines and the latest evidence. I also use it as a primary source to teach my students and residents and prepare them for board examinations.
More importantly, the journal provides Patient-Oriented Evidence That Matters and summarizes the American Academy of Family Physician’s stance on other society guidelines; this reminds readers that amidst today’s overwhelming influx of scientific information, patients—not diseases—should remain the center of our decision-making by doing what matters and what is best.
Sara Elsayed, MD
Editor’s Note: The authors are editors of AFP.
