doctors

Medical Moms Continue To Struggle In A Male-Dominated Culture

As she prepared for the birth of her twins and the prospect of caring for three children under 18 months old, Dr. Hala Sabry felt anxious for the first time in her life. An emergency room physician, wife and mother in Southern California, Sabry lacked the option of taking years off to care for her growing family, Chicago Tribune writes.

Though she was accustomed to making split-second, life-or-death decisions in the emergency room, trying to figure out how to arrange and pay for child care for three small children while continuing to work was causing her chest pains and shortness of breath. “How am I going to do all this?” she wondered.

Many physician moms say it is challenging to be both a doctor and a mother. Dr. Uzma Yunus, a psychiatrist and mother of two from Glenview, knows firsthand the sacrifices physician moms make to succeed at work and care for their families. Sometimes, she says, it means skipping meals when a patient emergency causes the doctor to fall behind in her schedule. And often it means giving up downtime because, after working a full day (or night), she must also tend to children at home who need to be toilet trained, fed and cared for.

“There are so many times when we are putting ourselves below other people’s needs, whether it’s our children, our families or our patients,” Yunus says. “That becomes a very strong contributing issue to burnout.”

Over the years, women have made great strides in the medical profession. In 2014 they represented nearly half (47.5 percent) of all medical school graduates — up from less than 7 percent in 1966.

Today, women physicians represent about a third of all medical doctors and even form the majority in some specialties, such as pediatrics and obstetrics/gynecology.

But the profession doesn’t always treat women fairly. According to two recent studies in the Journal of the American Medical Association, women physicians are paid less and promoted less often than their male counterparts.

Another challenge is that physician training takes place during a woman’s prime reproductive years, but pregnancy is difficult in an environment that includes heavy workloads and long hours. Women who become pregnant may be “labeled selfish” and suffer the resentment of their peers, says Dr. Monique Tello, a primary care physician at the Massachusetts General Hospital (MGH), who deliberately sought out (and found) a woman-friendly practice after she completed her training.

Though improvements are being made, medical facilities are still struggling to meet the needs of those who are both medical doctors and mothers. Physician moms continue to struggle with a male-dominated culture and an institutional resistance to change that makes it hard for them to thrive.

A research letter published in the May issue of JAMA Internal Medicine reports, “Despite substantial increases in the number of female physicians — the majority of whom are mothers — our findings suggest that gender-based discrimination remains common in medicine, and that discrimination specifically based on motherhood is an important reason.”

Researchers analyzed the responses to a survey of nearly 6,000 physician mothers who were members of the Physician Moms Group (PMG), an online community of over 60,000 from all medical specialties and every practice type. (Sabry founded the PMG in 2014.)

Nearly four out of five reported workplace discrimination of some kind, with two-thirds reporting gender discrimination and one-third reporting maternal discrimination. Maternal discrimination included inadequate pregnancy or maternity leave and lack of on-site accommodations for breastfeeding. Maternal discrimination was associated with higher rates of self-reported burnout.

One doctor who participated in the survey said she was told by her employer that she would have six weeks of maternity leave but “I had to take all of my six weeks of vacation and then had no vacation for the rest of the year, which was basically impossible with a new baby at home.”

Providing physician moms with a breast-pumping area is another need that often goes unmet. Busy physicians cannot leave their clinic to search for a place to pump or to nurse their baby, says Tello. She says she has seen facilities that either lacked a dedicated area for pumping or had a room that was situated too far away from patients, forcing doctors to take time out to get there and back.

Considering the results of the survey, Dr. Eleni Linos, assistant professor at the University of California San Francisco School of Medicine and one of the study’s authors, said, “What struck me is these women are playing so many roles. They are doctors to their patients, mothers to their children, caregivers to their sick relatives, teachers to their students.” The study was intended to identify areas in which employers could make improvements.

Research shows that everyone benefits when the system accommodates women doctors. According to a February 2017 study published in JAMA Internal Medicine, hospital mortality and readmission rates were significantly lower for patients treated by female physicians than by their male counterparts.

Conditions are gradually improving as more women enter the profession and begin to change the culture. Dr. Rachel Salas, an associate professor of neurology at Johns Hopkins Medicine and the mother of two boys, says she was able to find a practice with family-friendly policies.

The director of her division, the Johns Hopkins Center for Sleep, is also a physician mom, and the rest of her team all have young children and understand issues like snow days or illnesses that keep children out of school and require flexibility. “I definitely can empathize and know what a lot of (other physician moms) are experiencing,” says Salas. “I have been really very fortunate.”

Some medical facilities and hospitals have begun to develop more mom-friendly policies, and Linos says she’d like this trend to continue. “I’d love to see more workplaces, more hospitals and clinics provide paid maternity leave, places for new mothers to pump or nurse, and child care facilities on-site,” she says. “I think these … policies really make sense for everyone.”

The first step in solving a problem, says Sabry is to acknowledge that it exists. She hopes that increased attention will encourage discussion and foster “a big change” that benefits not only today’s physician moms, but also the next generation of female doctors.

“Everybody wants a happy doctor,” says Sabry. “One who is optimized to the patient because her essential needs have been met is better able to help others.”

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  • stmariz2

    Yeah so? It’s tough for all physicians to just drop out of working. Suppose you want to pursue another career and maybe come back? Welcome to retraining. Suppose you want to stop working and keep your medical license? Good luck with that. If you don’t carry a malpractice policy,and your state doesn’t offer an inexpensive prescription only writing license for you and your family, you are SOL. Life isn’t fair. So children are a constitutional right? Welcome to getting crapped on. It’s the American way.
    “…women physicians are paid less and promoted less often than their male counterparts.” This meme is not reality based. There is no CPT code for male or female physician. Salary in the real world is based on negotiation. You don’t like the offer, you walk. Promotions? To what? You’re still a physician. If it’s in academics you are a pencil pusher or clinical researcher. That’s not where the money is anyway.
    “Research shows that everyone benefits when the system accommodates women
    doctors. According to a February 2017 study published in JAMA Internal
    Medicine, hospital mortality and readmission rates were significantly
    lower for patients treated by female physicians than by their male
    counterparts.” More crap. Accommodation is code for ‘someone else will have to pick up the slack’ and what that means is all the men, and the women, who have other priorities in life. And that nonsense about women hospital mortality and readmission is just insulting to men and lying with statistics.
    “The first step in solving a problem, says Sabry is to acknowledge that it exists.” This I can agree with. The issue though is what is the problem? Men may answer that the problem is that some women demand ‘accommodation’ and the answer is suck it up and stop complaining because that’s life and you really can’t have it all, no matter what your mom from the 60’s thought. Life is full of trade-offs. And anyway, let your man go tell his boss that he needs paternity leave. As a female physician you probably make much more than him and the trade-off will be that his co-workers will just have to pick up his slack. Remember that you are needed more because “hospital mortality and readmission rates were significantly
    lower for patients treated by female physicians than by their male
    counterparts.”

    • Wally Wally

      (Because Amren has banned me from commenting, for some odd reason, I’m forced to respond here to a comment you made for the following Amren article:didn’t know bad new act scores show huge achievement gaps)

      Thomas Sowell has written what on first pass appears to be compelling evidence of past black scholastic achievement.

      I’m a black baby boomer and Thomas Sowell is absolutely correct in his assessment of past black scholastic achievement. I grew up in black Washington DC where all classes of blacks, from welfare recipients to doctors, shared the same neighborhood. And black kids from all classes did as well as their white counterparts in the K thru 12 curriculum. What was missing was an opportunity to use all of that education we were absorbing. We were full citizens with minimal job opportunities. Affirmative Action was a very necessary evil.

      I smile when I hear you race realists proclaim: “a 15 point deficiency in IQ is why contemporary black kids can’t master the K thru 12 curriculum”. “How much IQ horsepower is needed to master the K thru 12 curriculum” is a question I’ve posed to several of your amren brethren – data you’d need to logically make the proclamation above; none has provided an answer. Besides, unless black IQ has significantly decreased over the years, how could blacks of a previous generation have done so well academically without the requisite IQ horsepower? Your(race realist) logic has some serious holes.

      • stmariz2

        Thanks for using this trick around discus to respond. The difference for race IQ persists no matter what IQ test has been used over time. It’s telling us about averages and not that there isn’t variation among people in a given race which of course there is. But to claim it all boils down to racism and lack of opportunity is preposterous. Outside of the US, explain Haiti or sub-Saharan Africa using that logic. Neither South Africa nor Rhodesia have benefitted by a change in racial control. At some point when whites are no longer present, ‘blame the whitey’ will no longer work. They do it in Poland but there it’s blame the non-existent exterminated Jews.
        As for your points, it’s not that average black IQ has diminished, it’s that the gap persists. There’s nothing inherently wrong with it but what is wrong is the expectations that come along with thinking that you can change it by throwing money we don’t have at it and it will make a difference. Many studies have shown that at some point you reach a shoulder on the curve regarding expense and outcome. Also, if it doesn’t take much horsepower to master K-12 curriculum why do non-Asian minorities do so much worse on SAT and ACT exams than Asians? Finally you seem to claim that in a time of much worse racism, blacks had it better in this country at least academically. That seems a stretch. If you read enough Sowell you see that he tracks people from their point of geographic origin. You lump all blacks in DC by varying profession, not who these people really are. Sowell should ask is there an ethnic commonality among those DC blacks he writes about. He doesn’t write that all whites and Asians are the same and because of that he left a big hole in his argument regarding isolated black achievement.

        • Wally Wally

          But to claim it all boils down to racism and lack of opportunity is preposterous.

          Well racism was certainly responsible for the lack of opportunity at the time Affirmative Action was put into place. Now I don’t fully blame racism on the plight of many blacks today who are not getting educated, but whites don’t get off scot free for what’s happening in black ghettos today. The truth of the matter is, if freed blacks had been given full access to the tools they were entitled to as full citizens, the black development trajectory would have been drastically different than it is today. Decades of Jim Crow oppression definitely had a negative effect on black development in America.

          Outside of the US, explain Haiti or sub-Saharan Africa using that logic.

          Well I don’t know enough about the internals of Haiti or sub-Saharan Africa, so it would be difficult for me to argue that point. But if you can show me scientific evidence proving what happens to American blacks can be predicted based on what happens to blacks in other countries and vice versa, I’ll listen.

          As for your points, it’s not that average black IQ has diminished, it’s that the gap persists.

          But as Thomas Sowell shows in his book, generations ago, the gap had closed significantly, only to widen with newer generations. But my point was, the gap isn’t due to IQ differences, as believed by race realists, but something less exotic. Mastering the K thru 12 curriculum requires steady hard work. That requires: (1)parent(s) who care and understand the importance of education; (2)parent(s) capable of helping their kids navigate the subject matter; (3)parent(s) who stay laser focused on the progress of their kids education, making needed adjustments when necessary. You’re going to be hard pressed to cover those criteria with, single, barely-of-age mothers, who themselves — lack a solid education and who are raising their kids in a gang infested neighborhood where the prevailing attitude is: “getting an education is acting white”. IQ would be the last excuse for a widening gap on my list.

          • stmariz2

            I agree that Jim Crow laws were unjust, but so is AA since it craps on people who are not responsible for the past deeds of others. In most religions and in law, two wrongs don’t make a right.
            As for providing a general explanation for blacks in America today and their similarity to Haitians and Africans post-colonialism, I offer the phrase res ipsa loquitur. It’s really up to you to disprove it. I believe I proved it by pointing out where T Sowell has painted himself in a corner by analyzing other races and ethnic groups but leaving blacks unexamined. I really would like some analytical explanation as to why blacks should be looked upon as a homogenous group while other groups are more thoroughly dissected, though I agree with his assessment of those groups until other more compelling explanations are offered.
            As for black pathologic behaviors, you can blame the government all you want but personal responsibility seems to fall off most people’s radar. As for why races differ, looking for a government solution to ‘fix’ the problem will lead us to the ‘unintended consequences’ that are best avoided. Nurture till the cows come home but nature apparently has its own ideas.