Sicker Shock

Vascular surgeon examining a patient’s foot at MUSC

In medicine, young women continue to pay a higher price for family

by Helen Adams

Forty percent of female doctors in a recent study stopped working or moved to working part time within a few years of finishing their medical training. In contrast, all of the male doctors kept working full time.

The researchers, including senior author and MUSC psychiatrist Constance Guille, M.D., say this is important for a few reasons. First, there’s a growing shortage of doctors in the U.S. Losing doctors early in their careers is making it worse. And losing female doctors may be particularly problematic.

“We know that patients of female physicians have lower hospital readmission rates and lower mortality in comparison to patients of male physicians. Further, when we lose women in medicine, we lose the potential for them as leaders in health care. This is really important given that gender diversity in leadership is highly associated with better profits and decision-making.”

Elena Frank, director of the Intern Health Study at the University of Michigan and lead author on this study, said she and Guille wanted to know why there was such a clear difference when it came to male and female doctors’ schedules.

The difference was evident from their participants’ responses. “For men, the big words that jump out are financial — need money, loans. I don’t think you could even find the word ‘child’ on the male ones,” said Frank.

Guille said for women the major factor was childcare responsibilities — balancing work and family.

The researchers said women and men should be free to choose how much they work or whether they stay home for family reasons. But it should be a genuine choice, not something forced on them by circumstances.

“It’s very common for people to see this and say some women are just choosing to put family first,” said Frank. “Which is wonderful and a great choice for anyone who wants to make that. But in reality, what we’re seeing is that often there isn’t choice.”

Guille said that if the differences weren’t so striking, they wouldn’t be speaking out so strongly. “But the major gap between these two groups is suggesting that we don’t have systems in place to support physicians as parents.”

Frank agreed. She said the U.S. lags behind much of the world when it comes to supporting work/family balance. Having programs in place to support people juggling work with childcare and other family responsibilities could change things.

“Resources like on-site day care, flexibility in work hours and paid maternity leave would be helpful,” said Guille.

Federal law guarantees 12 weeks of unpaid leave, but not everyone is able to actually take the time. Frank would like to see change not just in policies but also in the culture surrounding them. “Men often have access to leave, but the institutional culture pushes against them actually taking it,” she said.

The study reported here included 344 doctors. About half are women, half are men. They work in a range of specialties.

Frank said it’s important to see the gender difference in medical work hours as something that can stack the deck against women and that labeling it as a disparity will help people see that it has to do with power and underlying structures and history.

“We’re not going to see the kind of changes we need without first acknowledging that,” she said.

Forty percent of female doctors in a recent study stopped working or moved to working part time within a few years of finishing their medical training. In contrast, all of the male doctors kept working full time.

The researchers, including senior author and MUSC psychiatrist Constance Guille, M.D., say this is important for a few reasons. First, there’s a growing shortage of doctors in the U.S. Losing doctors early in their careers is making it worse. And losing female doctors may be particularly problematic.

“We know that patients of female physicians have lower hospital readmission rates and lower mortality in comparison to patients of male physicians. Further, when we lose women in medicine, we lose the potential for them as leaders in health care. This is really important given that gender diversity in leadership is highly associated with better profits and decision-making.”

Elena Frank, director of the Intern Health Study at the University of Michigan and lead author on this study, said she and Guille wanted to know why there was such a clear difference when it came to male and female doctors’ schedules.

The difference was evident from their participants’ responses. “For men, the big words that jump out are financial — need money, loans. I don’t think you could even find the word ‘child’ on the male ones,” said Frank.

Guille said for women the major factor was childcare responsibilities — balancing work and family.

The researchers said women and men should be free to choose how much they work or whether they stay home for family reasons. But it should be a genuine choice, not something forced on them by circumstances.

“It’s very common for people to see this and say some women are just choosing to put family first,” said Frank. “Which is wonderful and a great choice for anyone who wants to make that. But in reality, what we’re seeing is that often there isn’t choice.”

Guille said that if the differences weren’t so striking, they wouldn’t be speaking out so strongly. “But the major gap between these two groups is suggesting that we don’t have systems in place to support physicians as parents.”

Frank agreed. She said the U.S. lags behind much of the world when it comes to supporting work/family balance. Having programs in place to support people juggling work with childcare and other family responsibilities could change things.

“Resources like on-site day care, flexibility in work hours and paid maternity leave would be helpful,” said Guille.

Federal law guarantees 12 weeks of unpaid leave, but not everyone is able to actually take the time. Frank would like to see change not just in policies but also in the culture surrounding them. “Men often have access to leave, but the institutional culture pushes against them actually taking it,” she said.

The study reported here included 344 doctors. About half are women, half are men. They work in a range of specialties.

Frank said it’s important to see the gender difference in medical work hours as something that can stack the deck against women and that labeling it as a disparity will help people see that it has to do with power and underlying structures and history.

“We’re not going to see the kind of changes we need without first acknowledging that,” she said.