This Won't Hurt a Bit

Really interesting article by Dr. Sibert and subsequent post by Dr. Au. It reminded me of a recent article in the Delaware News Journal on the unique path that mother's must take though med school and their careers -"Stethoscopes & diaper bags" June 7, 2011

It's great to see two sides to this debate, and there certainly are even more. I was disappointed to see that Dr. Sibert believes the only answers are 1) Better commitment and 2) More doctors. What about people not strictly relying on doctors and specialists for their health issues? What about investing in health promotion and disease-injury prevention? There are times when the medical solution is the best solution, while with others not necessarily. However, the lobby to make doctors absolutely necessary, invaluable, and invincible has been so great that most of the population cannot fathom 'NOT' running to see a doctor as soon as they get a sniffle. Real collaboration between various health professionals, including doctors, and evidence-based practice should lead the way to finding solutions to critical healthcare issues in the US and Canada.

Michelle, I agree with your response to Dr. Sibert's article. While I am not in medicine, I am a business executive and face many unfortunate stereotypes as a working mother. I have to produce more and work longer hours just so my male counterparts don't think I am slacking off to spend time with my kids. I recently had my second child, and took 4 weeks of maternity leave. My male boss gave me incredible grief over this decision and even asked me to reconsider having so much "down time" (as if recovering from L&D and caring for a newborn is a vacation). My point is Dr. Sibert's article perpetuates these stereotypes and does significant harm to those of us who choose to work and have a family. I am disappointed that another working mother would produce such a reckless piece of journalism. As you stated, her synopsis is a gross oversimplification of the issue, and reads as a huge complaint with little solution.

Thank you, thank you, thank you! I'm a female currently in medical school - I take USMLE Step I tomorrow! - and I was really annoyed by the NYT article. I plan on going into primary care and so it was particularly irritating to read about how female primary care doctors (who outnumber the men in that field) are really hurting our health care system by going part-time. Is she serious? If she's so concerned about the primary care shortage then maybe SHE should have gone into primary care! Then she could see what they are faced with: juggling similar work demands as her but with a fraction of the pay and likely even more administrative frustration - especially if they work with the underserved.

In her specialty it is likely a little easier (not that it's ever easy) for a woman to be full-time doctor and mom but that is not the case in every specialty so she really has no right to judge - it might make more financial sense for those underpaid women to go part-time when their kids are really young but as Dr. Au points out, that was not a decision they would have made lightly. Don't blame them, they're just doing their best to provide care while the whole healthcare system is pushing against them. They are anything but selfish, as she seems to imply, and they are the last people that should be pressured into forgoing motherhood if that's what is in their hearts.

Thanks Michelle for standing up for us all. I think it is also our responsibility as Dr. to be honest and educate those interested in the career. I went into podiatry for its better work life balence, but if someone had told me just be a doctor or not i might not have even considered. Life is not all or nothing, thats what makes us all different.

I am also a female in a doctoral program, and I don't see why female MDs feel such a strong need to HAVE IT ALL. You wrote about the need to NOT BE PERFECT a few articles ago. That perfection problem is YOURS not mine. YOU made the decision to become a MD--a prestigious and overpaid occupation. YOU made the decision to have kids--a trendy thing for female professionals to do. YOU ARE THE ONE WITH THE PERFECTION PROBLEM. But female MDs like yourself make YOUR PERFECTION PROBLEM my problem when you take my tax dollars that subsidize state supported MD education and you decide to be ALL COOL AND TRENDY AND STUFF and cut your work week by 3 days. When I go to look for a female MD, there are none to be found. All of your perfectionists are off living your highly prestigiouus, overpaid lives that nevertheless allow you to be great mothers too. But you are POOR DOCTORS. I cannot get appointments with female MDs. Frankly, they don't care about me as a person. Female MDs don't put in the long hours to keep up with medical journals, to publish papers, to run studies, to get updated technological training. You use your free time to go to soccer matches, to garden, to get massages, to do anything but think about your patients. I prefer male MDs because they don't skimp on their patients, like me, even if they do skimp on their families. But I'm a patient and I want the best quality care for me. Male MDs care about their patients more than female MDs.

You're a trendy perfectionist with entitlement issues, and I'm not buying your services.

Female MDs like yourself think you are taking a step forward for all women, but it ends up hurting female patients like myself. I am in an area where many female MDs have part-time hours. I cannot get an appointment with those female MDs even when I wait for months. I have turned to male MDs, and I am glad that I have. I really appreciate an MD who works a full week, and who gives me the sense that he cares about his patients enough to work beyond 5pm if necessary. Female MDs with part-time hours make it clear to their patients that they have very strict limits and the patients' needs come second to their family. What if the patient's crisis conflicts with a soccer match or a birthday party? As a patient, I would prefer a male MD who tends to the patient rather than the soccer match. As a taxpayer I also feel cheated. For state educated MDs their education was supported by people like me, who now cannot get medical attention from the doctors we helped to subsidize. I feel ripped off. This is a trendy thing for women to do, but it reeks of entitlement at hte expense of high quality patient care.

As earlier readers pointed out, your article echoes a lot of the frustrations that working women feel. Many of my colleagues are nurses (I am a volunteer) who are single or married with children. Both "types" of working mothers have voiced their concern and frustration over taking time off for a) L&D or b) to care for a sick child. Their frustration stems from several reasons: they feel guilty for taking time off, they feel that the father (married or separated) should be but is never expected to take turns and share the load, and they also feel that they have to work extra hard before and after to justify getting time-off, as if having a sick child to care for wasn't enough of a reason. It is frustrating to have someone in health care take leave because someone else has to take on the work load, but women shouldn't be the only ones chastised for it.

And yes! I also felt like Dr. Sibert's advice, to put it crudely, SUCKED. I wouldn't even call it advice and I am so fortunate never to have met a doctor that was so condescending and arrogant when asked for advice. A good mentor should share knowledge however unsavory that is based on their own experiences in medicine. Instead, she sat on her high horse and compressed a life-altering issue into an oversimplified "do or die" statement that doesn't give the student any tools or real knowledge with which to make a more informed decision.

If the government fully subsidized medical school, then I could see that people would have to commit to say, 10 years of practice. This is the case for things like the Army and ROTC. However, even those arrangements could allow for part time work at some point and credit for "time served". As a non-doctor, I'm personally offended that Dr. Sibert feels that women should pay 200,000 for medical school and be forced to work full time for their entire careers for the privilege. My favorite doctors are women and the best ones I have had are those who happen to work part time. Dr. Sibert is a dinosaur. The good thing is that doctors like her will soon retire and be replaced by thoughtful, compassionate men and women who want to have a relatively balanced life and will understand their patient's needs as well. That said, more partners of female doctors need to step up to the plate. I believe more people in this country should be encouraged to do part time work for the benefit of their children. And actually, once we get better and broader health coverage for all americans (which I'm sure Dr. Sibert opposes...she sounds like one of those doctors who can't stand a few thousand dollars less in her bank account) this may be possible. I say this as a non-doctor, but as a full time working parent who just returned to 100% time after working for one year at 75% time. Frankly, it really bothers me that Michelle's husband laughed in that way. That is what needs to change. Michelle: train your boys better!

This seems to have just gotten silly with absurd comments.

100% agree with Jen - "Tax Payer subsidized medical education" may be true to a SMALL degree, but I'm in $35,000/yr of debt for each of my 4 years of medical school, and that's on the low side. That $140,000 I'll graduate in the hole does not take into account residual undergrad debt, nor does it take into account 80 hr work weeks for the 3+ years I'm in residency making $40,000/yr. Basically, I will be in a practice a very long time before paying that back.

If other commenters think doctors are "overpaid" they need to look at the money and time required to become a doctor. Primary Health doctors make far less than many other professions, despite being out $200,000 and 11 years of their life for training.

If you're against "allowing" (don't even get me started on that - medicine is a PUBLIC field in the US, if I want to quit after going through all this, that is my choice) people to work part time as doctors, why stop there?

I mean, plenty of competent physicians retire at 50...why are we allowing this? They should be working until they can't function, after all - they are public servants, right? They don't deserve to enjoy their life...easy for you to say...since it's not affecting you and all.

Bottom Line: We all paid to get here. We worked hard to get here. (not just the women, everyone) If we want to quit to be parents (or bakers or lawn mowers or teachers or lawyers) that is nobody's choice but us. When one of you pays back their school loans and gives them your youth then you make them feel guilty about the decision they make regarding their life.

I don't understand where she gets off blaming the physician shortage on PT women anyway. Saying "the government can't pay for more people to be in residency" sounds a lot like there are way more facets of that problem than women who work part-time. Like...the fact that $73 billion/year in hospital bills are never paid...maybe if we tackle the insurance problem and get unnecessary hospital visits and erroneous testing under control we'll have some money to put into training more physicians. The doctor shortage may be, in a very, very small fraction, contributed to by women, but even if every PT female physician worked full time there will still be a huge shortage. Her placing blame on people making personal decisions for themselves in that article was wholly irresponsible...I expect more out of my colleagues.