Lyrics from Sly and the Family Stone:
Sometimes I'm right but I can be wrong
My own beliefs are in my song
The butcher, the banker, the drummer and then
Makes no difference what group I'm in
'Cause I am everyday people, yeah, yeahThere is a blue one who can't accept the green one
For living with a fat one, trying to be a skinny one
And different strokes for different folks
And so on and so on and Scooby dooby doo-bee
Oh, sha sha, we got to live together
A provocative opinion appears in the NY Times - Don’t Quit This Day Job – in which the author, a woman physician writes these harsh words:
It isn’t fashionable (and certainly isn’t politically correct) to criticize “work-life balance” or part-time employment options. How can anyone deny people the right to change their minds about a career path and choose to spend more time with their families? I have great respect for stay-at-home parents, and I think it’s fine if journalists or chefs or lawyers choose to work part time or quit their jobs altogether. But it’s different for doctors. Someone needs to take care of the patients.
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But the productivity of the doctors currently practicing is also an important factor. About 30 percent of doctors in the United States are female, and women received 48 percent of the medical degrees awarded in 2010. But their productivity doesn’t match that of men. In a 2006 survey by the American Medical Association and the Association of American Medical Colleges, even full-time female doctors reported working on average 4.5 fewer hours each week and seeing fewer patients than their male colleagues. The American Academy of Pediatrics estimates that 71 percent of female pediatricians take extended leave at some point — five times higher than the percentage for male pediatricians.
So this hard working female anesthesiologist opines that women who work part-time or quit medicine are failing society. She has harsh words and seeks to cause much guilt.
And she writes a very judgmental piece. And I disagree with her sanctimony.
I recently spoke with a college student who asked me if anesthesiology is a good field for women. She didn’t want to hear that my days are unpredictable because serious operations can take a long time and emergency surgery often needs to be done at night. What she really wanted to know was if my working life was consistent with her rosy vision of limited work hours and raising children. I doubt that she welcomed my parting advice: If you want to be a doctor, be a doctor.
I would rather see a committed part-time physician than a burned out full-time physician. Over the years in my administrative position I worked with many women. Some worked full-time; some worked part-time. Each woman made a decision about work hours that fit her situation.
I've known many women who always thought they would work full-time, until life intervened. Having them work hard part-time and remain satisfied with both their personal and work lives seemed to me then, and seems to me now as an appropriate use of their talent.
What does full-time really mean? How arbitrary is that term? Does devoting our lives solely to medicine make us better physicians?
Dr. Sibert, who wrote the piece, has made the decision that works best for her. However, her opinions on what others do appears arrogant and presumptuous. So, I respect her right to write, but I am must disagree with the vigor of her screed.
{ 8 comments… read them below or add one }
We think this also applies to other women professionals too and why they are not as many of them – CEO's of companies, lawyers, pilots, military especially during wartime, etc. (especially those with children trying to have it all) We would agree a happy well adjusted part time physician is better than a burn-out more than full time one.
Oh, the Sibert piece in the NYT left me fuming over my coffee this morning! I'm glad to see someone provide a reasoned response.
To my ears, she's basically rehashing one of the arguments that kept medical school (and law school, grad school and college) completely closed to women for so long: 'Why would we let you in, when you'll just run off and have babies anyway? Much better to only educate men.'
I really appreciated the part where she completely blows off one of the main reasons why women (ahem–AND MEN–although she doesn't seem to realize this) must reduce their hours at work, "And in a perfect world, hospitals and clinics could keep more female doctors working full time by setting up child care centers — with long operating hours — on site. "
All of this hits very close to home: I'm about to start residency, I'm in a committed relationship and my partner and we would like to have children some day.
With friends like these, who needs enemies?
I cant help but agree with the Sibert article. I have been in practice for over 20 years and have seen so many women either retire, work reduced schedules or leave medical practice to work for industry. There may be less than an dozen women who practice full time who are over 55 in the community in which I practice in Los Angeles.
Medicine is a dear commodity and thus we may be doing society a disservice by granting medical positions to those that will not provide full duty. Since there are numerous physician shortages in various specialties and locations it seems we are wasting a resource. There are numerous qualified individuals rejected for medical positions who may be more likely to provide greater public service.
Public and private grants fund medical education and could be considered wasted if the product does not return on the investment.. Coveted residency positions are also wasted if graduates fail to utilize the benefits of there training for our society who invested in them in the first place.
To me, medical education as it is in the US is a sort of public trust. If Medical Schools and residency programs have the demographic ability to determine which of there applicants will best serve the public needs, then they should be employed. Gender should not overshadow the overall public interest and well being.
Kudos to Dr. Sibert for speaking the truth. Many will disagree because it is not politically correct. But, I saw time and time again during my residency and fellowship that women simply did not put in same time, on average, during residency and fellowship compared to their male counter-parts. Also, more women tend to take salaried positions in large health care organizations instead of pursuing private practice further exacerbating the situation. I commend her for her honesty.
I'd like to know how part-time these part-time doctors actually are.
I'm in IT when my kids were little I worked part-time – 38 hours a week. I would have worked 40 but 38 was the cap. It's not the regular hours that are hard for a Mom to put in, it's the un-predictable hours that play havoc with family life and the arrangements that working parents cobble together.
Kids don't stay little forever. Unless a woman is married to Bill Gates she's going to be likely to switch back to full-time work to generate cash to educate and launch her children, as well as provide for her own retirement.
If this channels women into the lower paid areas of medicine, the ones where they actually deal with people and their problems as opposed to manipulating robots and working in dark rooms and labs then maybe this is a positive thing.
A few years ago the British Medical Journal had an editorial about this, the gist of it being that more women were going into medicine, they tended to work fewer hours than their male counterparts, and society needed to take this into consideration when calculating the number of physicians coming out of medical school. There was no moralizing in the article, just a statement of facts.
There's both good and bad in it, as in all things. The most important duty of parents is to raise their children well, and this requires time. Having a dad or mom work 80 hour weeks is hard on the rest of the family, and "quality family time" is probably impossible when an individual is exhausted from work. Having the ability to work part time is good for these issues. However, there will inevitable be conflicts between the needs of a patient on a particular day and a planned family event. Having a percentage of physicians working part-time and taking extended leave for childbirth will inevitably shift more responsibility and work onto those who work full-time. I think this problem is especially acute in residencies. I doubt that too many residents, male or female, are keen on increasing their workload to cover for a colleague who takes several weeks or months off for a delivery. I also suspect that working part time decreases the sense of "ownership" that a physician has for the patient's problems. These are downsides to part time doctors. Nonetheless, this is the world we live in, and as the BMJ suggested, for better and worse society in general and the profession in particular will have to find ways to cope.
As a female, non-traditional medical student who is 40 and starting her third year in August I see both sides of this argument. I ended up leaving undergrad when my 2 year old was diagnosed with diabetes, I understand that life has a way of intervening and changing our priorities. I am grateful that at my advanced age I was given a place that could have gone to a younger student that might be able to work 15 years longer than I will likely work. I appreciate the resources that society is using to educate me, even if I am paying a larger share than my colleagues in foreign countries who better subsidize medical education. I think, however, that this problem is not limited to only female physicians. I have several classmates, male and female, who are very interested in the life-style specialties and I think they view being a physician as a job. I believe some of this is just the immaturity of youth and hopefully most students will outgrow it during the clinic years and residency. Outside of medicine, I have had problems contacting our male private banker because his children were sick and his wife, also a professional, could not take additional time off work. I'm not sure how this problem can be solved without returning to the earlier days of not letting women into professional schools, as mentioned by an earlier writer. While I agree that medicine requires a greater dedication than other fields, I am not ready to demand female physicians meet some perceived societal contract or be judged as wasteful. We have several male physicians in my small town (with many elderly patients) that no longer take call or cover hospitalized patients. Are they judged as failing their patients when the patient calls the office after hours and just gets a recorded message telling them to call 911 if its an emergency?
This is the subject of many discussions I have with my daughter who is starting in an accelerated pre-med program.
I have worked for a number of OB/GYN groups in private practice as a nurse and see the frustrations experienced by all(physicians,staff and patients) when a female MD takes time off for maternity leave and/or, "tries" to go part-time.
What advice should I give her?
Eventually I encouraged my daughter to read this year's Barnard college speaker, Sheryl Sandberg. She is COO of FB. Here is an excerpt, though I highly recommend you read the entire transcript!
"We can’t wait for the term “work/life balance” to be something that’s not just discussed at women’s conferences."
In reference to making choices- family/career she says
"until that day, do everything you can to make sure that when that day comes, you even have a choice to make. Because what I have seen most clearly in my 20 years in the workforce is this: Women almost never make one decision to leave the workforce. It doesn’t happen that way. They make small little decisions along the way that eventually lead them there. Maybe it’s the last year of med school when they say, I’ll take a slightly less interesting specialty because I’m going to want more balance one day. Maybe it’s the fifth year in a law firm when they say, I’m not even sure I should go for partner, because I know I’m going to want kids eventually."
"These women don’t even have relationships, and already they’re finding balance, balance for responsibilities they don’t yet have. And from that moment, they start quietly leaning back. The problem is, often they don’t even realize it. Everyone I know who has voluntarily left a child at home
and come back to the workforce—and let’s face it, it’s not an option for most people. But for people in this audience, many of you are going to have this choice. Everyone who makes that choice will tell you the exact same thing: You’re only going to do it if your job is compelling."
"So, my heartfelt message to all of you is, and start thinking
about this now, do not leave before you leave. Do not lean back; lean in. Put your foot on that gas pedal and keep it there until the day you have to make a decision, and then make a decision. That’s the only way, when that day comes, you’ll even have a decision to make."
As for me, I'd rather see us all discussing how to make the healthcare system better for patients and healthcare workers with less focus on faulting women doctors.
If we listen to Dr Sibert's simplistic article, perhaps we should start screening all candidates for genetic risk factors and pre-existing health issues because they may not provide us a return on investment either if they, god forbid, need care themselves. And then, should we ask all med school candidates if they are going to go into public health and seek careers outside the USA, WHO or provide care to the less unfortunate in Africa or Haiti…. where's the return on our "investment"?
Why don't we start recruiting in kindergarten, like the Soviets did for their gymnasts!
In our OB/GYN practice there are many patients that only want to see a female physician. Why is that Dr Sibert?
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