A Look Through Time: Analysis of William’s Obstetrics and Te Linde’s Operative Gynecology [26G

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INTRODUCTION: In Obstetrics and Gynecology, few tomes are as well-respected as William’s Obstetrics and Te Linde’s Operative Gynecology. Tracing the changes in these texts provides a window to enlighten us on the history of our specialty. Our objective is to systematically analyze the Preface and Foreword of each edition of William’s and Te Linde’s to gain insight into historical changes in our field. METHODS: The Preface and Foreword from 24 editions of William’s Obstetrics and 11 editions of Te Linde’s Operative Gynecology were obtained. Documents were assessed for the inclusion of predefined keywords/topics including: gender-specific pronoun usage, insurance, sterilization/contraception, government regulation/laws, documentation burden, malpractice, race, medicine as art/science, and others. Data were extracted and analyzed using Excel. RESULTS: Changing pronoun usage was evident across both texts. From 1941-1950, physicians were referred to as male 19 times and only once as female. The ratio of male-to-female pronoun usage became 1:1 in the 1990s. From the 1970s onward, “Physician Woes” including malpractice, documentation burden, regulation and insurance were mentioned at increasing rates. Governmental regulation and evidence-based medicine were first mentioned in the 2000’s. Medicine was increasingly referred to as a “science” rather than an “art” within the last two decades. Race was not mentioned. “Change” and “Improvement” were noted almost universally. CONCLUSION: Female pronoun usage reflects the increasing role of women in medicine. Analysis shows the trend from a less regulated field to one of increasing outside influence. “Physician Woes” have increased and likely contribute to physician burnout, which is on the rise.