6 years. That’s how long nearly half of women physicians stay in full-time medicine. Their reason? The way-too-demanding push and pull of their family lives and their professional duties. That’s two years fewer than most of them spent getting that MD behind their name in the first place. I’ve sat in workshops with these women. I've talked with them over and over at conferences. I've watched their posts on Physician Mom Facebook groups. They have had it. They are having to pick between their dream careers and basic necessities and care for their family. And they are done.
As a working mom advocate, and a maternal-child health expert, I've spent countless hours collaborating with other leaders in the work-life integration space. And, as a fellow physician mom, I've also had countless hours hearing the stories of physician moms from hospital and private practice healthcare systems across the county. Formally and informally, they've spilled all the things they can’t say to their managers, leaders, and of course, medical system CEOs.
Their voices are lost in echo chambers of women and mom’s physician groups, both in person and virtually, throughout the country. There are few, if any, opportunities to voice concerns. But if there was, they’d say — “We aren’t compensated fairly for time off.” “We don’t have anyone to relieve us of our high stress jobs and patients will go without care if we take off for our families.” “The CEO and leaders of our hospital systems are swimming in money while we pay off 8 years of medical school and pay our way through expensive daycare bills and unpaid maternity leaves.” Finally, and most simply, they’d say, “We are burnt out.”
A proven problem, with little action
The research is there to back their valid complaints:
- According to a 2019 JAMA study, 55 percent of female providers who were responsible for five or more day-to-day household and parenting tasks considered changing careers. This study also noted female providers were still responsible for the day-to-day household duties within their home, compared to their male colleagues who relied on those female partners to handle things.
- A 2022 study lists the specific risk factors contributing to female physician burnout, including time constraints, increased household responsibilities compared to their male colleagues, and health necessities around childbearing, increased maternal age, and mental health.
- A 2023 study reported that in 2021, 56% of female providers reported they were burned out, compared to 41% in male physicians due to a lack of resources, less control over their schedules, more time spent with patients than male colleagues, imposter syndrome, gender bias, lower compensation, bias against mother physicians, and challenges in work-life integration.
- In a 2017 AMA study, 90 percent of mother physicians felt discriminated against during pregnancy and through postpartum. Pumping time and space is a consistent stressor.
The data speaks for moms. But is the data helping? At least there's some hope: Stanford residents are one group who pushed back and
unionized in 2022. Their success so far was reported by
Becker’s, and might be
a
rising trend in mom doctors saying, if we don’t speak up, who will?
A medical system that doesn’t align with physicians moms' values
Physicians as a group at-large are deeply committed to helping others, and physician moms are no different. We are natural leaders, healers, and researchers. We want to extend those same values to their families but are forced to choose, leading to burnout. We have increased numbers of electronic medical record demands and requests robbing our patients of face-to-face interaction and care. We have little control over our work environments, often working long shifts on back-to-back days, a schedule incongruent with raising children of our own. The pay for performance demands from insurance nags in the back of our minds, so we hurry up and do more.
And, ironically, the strapped health care system itself causes additional responsibility on providers who can’t refer patients to specialists, as there aren’t enough, especially for mental health care. The person who coined the phrase “between a rock and a hard place” must have been hanging out in the mind of an emergency care provider who some also call Mom.
The high stakes
The medical system is pushing burned out physician moms to keep going, even though we learned from the pandemic that doesn’t work, and has a high cost — to their patients, their families, and themselves. Burnout among physicians is linked to suicidal ideation, alcohol use, increased medical errors, and worse patient outcomes. So, ironically, those politicians, c-suite leaders, and stakeholders refusing to reform will likely face the consequences themselves of an overexerted healthcare system. But, more importantly, female physicians can't operate at the level they were trained to, and that their patients need, under the current circumstances.
Here’s an example: Jenna is a female physician on a pediatric ER floor. She works three 12 hour shifts back to back. Her child tests positive for COVID-19 a few hours before her shift. She knows there is nobody to take her place, no list of substitute doctors to call on. Her choices are:
- Ask a colleague for a favor, to cover her, even though she knows they are burnt out too. She also knows they won’t be fairly compensated for picking up an extra shift last minute.
- If nobody is available, the same ER operates with fewer doctors, leading to exceptionally long wait times for emergent patients, and others have to triage who will get timely quality care, who will have to wait, and who won’t even get care in time before they leave hoping to care elsewhere.
- She comes to work potentially sick from exposure, risking also the daycare provider or family member she left her daughter with, so her patients don’t suffer.
Meanwhile, male counterparts, who
cut their work hours at lower rates than women
for family concerns, continue forward and upward. In fact, women still take on an average of
8.5 hours more work at home each week than men. It’s a lose-lose-lose.
What would make a difference
We need CEOs, decision-makers, and managers who will see the direct correlation between happy doctor moms and high-quality care (and therefore profit). Mom physicians are speaking up about the clear and necessary asks for them to continue contributing to medicine, a must-have for the healthcare system to thrive.
- A people-first working environment
Ask your employees, and mom physicians in particular, what they want and need. Be prepared to meet a diverse set of needs, and a process to strategize how to solve additional problems as they arise. True wellness initiatives that matter must replace hollow attempts, such as wellness apps and evening programming. Instead, ask mom physicians what support they actually need to thrive.
- On-site childcare
A few university-based healthcare systems are implementing on-site solutions to those times when a parent has to help a kid for an hour, drop off medicine, deal with a behavior issue, or take care of other in the moment parenting to-dos that would otherwise mean canceling a whole shift. At UC Davis, leaders are considering the addition of on-site childcare.
The University of California Davis Medical Center and University of Texas Southwestern Medical Center have both implemented an allowance program to extend promotion and tenure for parents who take leave. Giving parents back hours of their commute will be hours they can spend on their own well-being, or with patients.
- Paid parental leave
Doctor moms will prioritize working for employers on the cutting edge of what every industry needs now — paid parental leave. The University of Michigan expanded its parental leave policy last year, giving birth mothers 12 paid leave, and all new parents 6 weeks of leave. Massachusetts General Hospital allows 8 weeks of paid leave for any parent. If they can do it, why can't everyone else?
- Flexible scheduling, reduced paperwork, and remote work options
Move over, brick and mortar medicine. This is where telemedicine outshines you 10 to 1. With more and more options for physician moms to work in their home environments, to manage their schedules with flexibility, and to reduce their workloads by using AI tools, there finally seems like there might be a light at the end of the work-life integration tunnel (psssst....that's why I made the switch myself to Blueberry Pediatrics).
I have a vision for the future, as do the rising classes of female physicians. It’s a future where they don’t have to pick between struggling patients and their struggling families. Where they can, indeed, “do it all” without feeling like they're not doing anything well, and where they can enjoy the fulfilling life they’ve built as they do it.
