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Are Part-Time Doctors Bad for Medicine's Health?

Are Part-Time Doctors Bad For Your Health?

Ironically, I missed Dr. Karen Sibert's provocative opinion piece when it first hit the New York Times website last week because I was busy with my four kids. (I'm in that crunch time when school ends and summer activities haven't started yet.) Her piece calls for anyone going into medicine to work full-time or else find another job. Or as she put it, she has "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."

Needless to say, she struck a sensitive cord not only with part-time doctors but all of us moms trying to raise our kids and maintain a career. Dr. Sibert and I are both physicians. She works full-time and thinks all MDs should. I, on the other hand, went to medical school and never practiced.
I use my training (four years of medical school) to write about medicine and teach medical writing. She probably wouldn't agree with my life choices.

Yesterday, we were on NPR's Tell Me More together (well, our voices were together, but we were in separate studios). We talked work-life balance along with Dr. Michele Au, an anesthesiologist and author of This Won't Hurt a Bit (and other white lies): My Education in Medicine and Motherhood and Dr. Laura Ment, Dean of Admissions and Professor of Pediatrics and Pediatric Neurology at Yale School of Medicine.

The conversation was shockingly civilized compared with the inflammatory comments Dr. Sibert's opinion piece incited. (Some bloggers felt that Dr. Sibert was turning the clock back to the days when women could be rejected from medical school because they looked like the marrying type.) Listening to her chat though, I started to appreciate where she was coming from. Dr. Sibert is a dedicated professional who loves what she does. She said she wrote her piece in response to a disheartening conversation she had with a young female college student. The woman was considering going to medical school but wanted to make sure it was the sort of career that worked with raising a family. She was thinking she could do it part-time. Dr. Sibert, of course, would have been happier to talk to someone who wanted to know about the intellectual stimulation and gratification of becoming a healer.

When you are truly passionate about something, it's hard to understand those who don't share the love. I feel Dr. Sibert's pain. But here's what I don't get. Are part-time doctors apathetic? Do they care less about their patients? I'm not convinced. I know quite a few women who have chosen to be internists and pediatricians and work fewer hours when their children are younger and plan on adding time in the office as their children grow up.

Dr. Sibert tried to advance her argument by pointing out the doctor shortage and government funding for medical education. As she said in her New York Times piece:

"Since 2005 the part-time physician workforce has expanded by 62 percent, according to recent survey data from the American Medical Group Association, with nearly 4 in 10 female doctors between the ages of 35 and 44 reporting in 2010 that they worked part time. This may seem like a personal decision, but it has serious consequences for patients and the public. Medical education is supported by federal and state tax money both at the university level - student tuition doesn't come close to covering the schools' costs - and at the teaching hospitals where residents are trained. So if doctors aren't making full use of their training, taxpayers are losing their investment. With a growing shortage of doctors in America, we can no longer afford to continue training doctors who don't spend their careers in the full-time practice of medicine."

I understand there is shortage of doctors. We need more people to choose primary care specialties. We need doctors in underserved rural areas and in indigent neighborhoods. I don't think the relationship is as clear-cut as she suggests. What about the full-time doctors who choose to work for drug companies? Or the ones who become cosmetic surgeons? Are they more valued in the work force than the part-time geriatrician?

And while a lot of the banter since the publication of her article has been a rehashing of the mommy war debates, it strikes me that rather than talking about how women are juggling, we should focus on how to make the balance easier. For men and for women. Dr. Ment talked about all the strides that Yale has done to encourage a family-friendly environment including onsite daycare and maternity leaves that do not penalize the chances of attaining tenure.

Rather than encouraging women to judge each other's life choices, let's focus on what really matters. Let's figure out ways to encourage the best and the brightest and the most compassionate men and women into the field of medicine. Let's make primary care specialties a more palatable career option. And let's accept and value these passionate doctors, even if they are putting in fewer hours than their forefathers and foremothers.

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