As burnout rates and doctor shortages rise, work-life balance issues affect everyone in medicine

We would not praise our patients for working long hours, sacrificing sleep, and prioritizing everything else over their own health. Yet that’s exactly what many doctors are doing—especially doctors who are also mothers.

“I’ve witnessed a woman surgeon operate at full term pregnancy until the moment her water broke intraoperatively. I’ve seen a woman surgeon perpetually survive on three hours of sleep and three Red Bulls a day just to see her kids and keep the household running,” wrote Simone Kantola, M.D. on KevinMD.com. “And [I’ve seen] a woman surgeon eat, pump breast milk, text the nanny, and dictate notes simultaneously because her schedule wouldn’t allow adequate break time.”

Four out of five physician mothers say they experience workplace discrimination.

It’s no wonder that burnout rates among female physicians are at an all-time high (55 percent, according to a recent Medscape survey). On top of that, women in medicine face gender bias and sexism. Four out of five physician mothers say they experience workplace discrimination, according the results of a study published in JAMA Internal Medicine. Nearly two-thirds reported gender discrimination and one-third reported maternal discrimination, defined as discrimination based on pregnancy, maternity leave, or breastfeeding.

For more on this topic, see Recognizing Gender Bias in Your Practice

Read on for a discussion of what can be done to improve the situation, and why we need to figure out it sooner rather than later—not just for women, but for the health of the country.

Stop asking, ‘How do you do it all?’

To change the reality of so many doctors who are also mothers, we must change the questions we ask them, suggested Miriam A. Knoll, M.D., in another post on KevinMD.com. Instead of “ ‘How do you do it?’—which is often asked with the implication that it really can’t all be done” she was struck by a female colleague who asked her, “So what’s your story?”

Every doctor and mother’s “story”—i.e., how she coordinates childcare, household responsibilities, marriage and family life, etc.—is as unique as she is, noted Dr. Knoll. Some trade a long commute for living near family, while some trade working remotely at night for leaving early to pick up their kids at school.

‘Mothers are doing what all human beings do every day: making decisions about our lives, careers, and relationships.’

“We mothers think through each situation and make a decision about what’s best overall. We sacrifice on some things and not others. We prioritize day by day, month by month, year by year. Mothers are doing what all human beings do every day: making decisions about our lives, careers, and relationships, and hoping for the best,” wrote Dr. Knoll.

Why work-life balance is everyone’s issue, not just mothers’

Redirecting the conversation from only being about mothers to include everyone is key. “The first thing we need to do is to stop focusing on parenting and childcare as women’s issues,” said Caprice Greenberg, M.D., in her 2017 Presidential Address for the Association for Academic Surgery. “I want to suggest to you that parenting and other issues of work-life balance are critical for everyone, regardless of gender or parental status.”

Issues of work-life balance affect everyone, as evidenced by the 51 percent burnout rate among doctors in 2017.

This is especially true when you consider the alarming rates of burnout in medicine. According to Medscape’s 2017 Physician Lifestyle Report, burnout rates among doctors are now 51 percent—up from 40 percent in 2013, the first year Medscape began tracking it. The report also found that burnout is higher among female doctors in general than male doctors (55 percent vs. 45 percent).

For more on this topic, see Doctor Burnout: How to Spot It and Fix It

Retaining female providers is key as doctor shortage looms

We need to figure this out, or the health of the country is at risk. The U.S. is facing a major doctor shortage—a deficit of up to 94,700 physicians by 2025, according to the Association of American Medical Colleges.

Women represent a third of all practicing physicians in the U.S.

“Female physicians represent a third of all practicing physicians, and keeping them in the work force is an important part of providing adequate health care to the country,” stated NPR.

Women make a difference in medicine not only by their sheer numbers, but also from a care perspective. The NPR article cited data showing that women doctors have better outcomes: “One recent study found that patients of female physicians have significantly lower mortality rates compared to those of their male peers.”

The overlap between parenting and patient care

To truly support women who are both doctors and mothers, we need to shift our energy from debates and discussions to solutions. “Let’s instead focus on how we moms are currently managing, and how to make things better. Let’s stop assuming it can’t be done. And let’s not insult the physician-moms of the world by questioning their commitment to medicine, to their patients, to their research,” wrote Dr. Knoll.

‘I am stronger as a physician mother than I ever could be if only one of those titles applied.’

We must recognize the unique strengths of those who are both doctors and parents. “These jobs ask the same things of me: endless empathy, sleepless nights, questions that cannot be answered, unwavering work ethic, compromise, patience, and a careful balance between boss and confidante,” wrote Stephanie Graff, M.D., on KevinMD.com. “… I am stronger as a physician mother than I ever could be if only one of those titles applied.”

What are you doing to support women providers and improve work-life balance in your practice? Tell us in the comments below.


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