How do we keep women physicians in medicine?

Undoubtedly, my favorite part of my non-clinical work is hearing from fellow physicians about their lives in medicine. Every once in a while, I receive an email that puts beautifully into words some of my own struggles.

A few weeks ago, I received an email from a colleague outlining her personal journey through her career, which she was hoping other physicians would benefit from as well. I know it spoke to me, and wanted to share it (with permission) after anonymizing some of the details.

Hi Nisha,

I did my residency and fellowship in (…). During my residency, I decided to have a baby without realizing how hard it would be to take care of a newborn. My husband is a physician, and I got through it, but I realized then that one of us has to cut down on the work hours.

Jobs market was tight after I finished my fellowship with almost no part positions. I decided to take up a telemedicine position as we were also planning to have another baby. I work for a great company, but my dream job is an academic position.

When I did this, my professors in my program started to question my decision. They even started suggesting that I do something else. Kids will go … get a good job … one of our relatives said I would lose my skills and needed to look for another job. One of the medical staff asked, “When are you going to get a real job?” One of my peers said that he was feeling sorry for me.

In the meantime, I could sense that my daughter wanted me to spend more time with her. I knew this job would give me the time I needed to be with my daughter, but I was in fear of what would happen. I would have felt better with my decision if I had received positive feedback about my decision.

I also wanted to do something academic after a few years, and everyone said that it might not be easy.

Finally, I decided to do a locums at an academic center. I was doing two jobs with one job with full-time night work. All because I let myself get affected by people’s perceptions. One day I got palpitations from the amount of work I saw on my list of things to do.

Then I came across a video of Indra Nooyi, the CEO of PepsiCo, saying that women still can’t have it all. With that, I quit my locums job and have not looked back.

I have finally settled into my job and found people who value work-life balance. I enjoy my kids more and enjoy my work. I have a great bond with my daughter. Let me be honest — my daughter did not like me before because I was too busy.

My question is why does it have to be so hard? Why are there not enough part-time academic and private jobs for women? If I had the choice, I would have done a part-time academic job while my kids are young and then gone full time after a few years. Women could be more productive if given a chance and if there was more understanding of their needs.

I hope to see more part-time jobs in the coming years with more women having happy, balanced lives without them having to choose between family and what they want to do.

Hope your work in the field helps change the workaholic culture in medicine to some degree. Let me know what I can do to contribute.

Thank you.

To me, this email summarizes so many of the dilemmas that women physicians face: the constant weighing of our professional desires against our goals for our families, and the frustration with lack of flexible job options. I don’t think I need to summarize these in this post, since the email does such a wonderful job of demonstrating it.

One point I’d like to make though — on a larger level, I worry about this regularly from a societal perspective. This year, a little over 50 percent of physicians matriculating in medical school are female. Statistically, a significant majority (up to 85 percent in some polls) of female physicians are married to other professionals, and therefore may not be as financially dependent on their physician incomes. I hear this so frequently from my female physician colleagues and friends. We love what we do and want to be able to do it, but can’t find options that work within the context of the rest of our lives, and ultimately, many decide to exit clinical practice or cut back more than they would like since there aren’t many intermediate options.

At what point do we make it just too hard to stay in medicine? As we consider the rising physician burnout rate as well as the rising physician shortage, are we doing enough to keep our physicians (male and female) in medicine? Increasingly, I hear from male physicians who are struggling with the same dilemmas in regards to wanting to cut down. To me, this is one of the most compelling arguments for increased flexibility in job options from a societal and institutional standpoint. I understand that it would entail significant restructuring of clinic and call schedules, and perhaps the way that we deliver care globally, but ultimately, I believe that principals of supply and demand will lead to these options. What I hope is that we don’t lose too many qualified and caring physicians as we resist these changes in physician demographics.

Nisha Mehta is a radiologist and founder, Physician Side Gigs and the Physician Side Gigs Facebook group. She can be reached at her self-titled site, Nisha Mehta, MD, and on Twitter @nishamehtamd.

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