American women's health care. A patchwork quilt with gaps

DURING the women's health movement of the 1960s, women began to express their discontent with the traditional hierarchical model of physician-patient interaction.1In recent years, several developments reflect an increasing appreciation of women's health needs by the US medical profession. The recognition of systematic biases in biomedical research excluding women from clinical trials led to the establishment of the Office of Research on Women's Health at the National Institutes of Health.2 Health services researchers have reported significant disparities in the use of major diagnostic and therapeutic interventions for women compared with men.3-7 Certain women's health problems (eg, menopause, osteoporosis, breast cancer) have received increased attention and resources. Women's health care centers that offer many services at a single site have evolved as a new model for comprehensive health care.8 The number of female physicians has increased.9Two studies have found that, compared with male physicians, female physicians spend more