Lifestyle matters for specialties that want to survive

Medical students today consider lifestyle an essential criteria when choosing a specialty.

It’s become a cliche that most are looking towards the ROAD (radiology, ophthalmology, anesthesiology and dermatology) to happiness.

There’s been some recent media attention at how women are lured to specialties that offer a greater balance between their family lifestyle and professional demands.

Claudia Golden, a Harvard economics professor, recently noted that,

high-paying careers that offer more help in balancing work and family are the ones that end up luring the largest numbers of women. Surprisingly, colon and rectal surgery is one of these, because of rapid growth in routine colonoscopies that can be scheduled in advance, giving doctors control over their time. Goldin says 31% of colon and rectal surgeons under 35 years of age were female in 2007, compared with only 3% of those ages 55 to 64, and 12% of those ages 45 to 54, reflecting the fact that younger women are flocking to the field.

Of course, what’s not said is the grueling training that it takes to become a colorectal surgeon — but the numbers cited above do not lie. The new generation of doctors — both men and women — want greater control of their time. That means more shift-work and a predictable call schedule.

The term for this, as Dr. Golden notes, is “career cost to family.” Other specialties that have a low career cost to family include pediatrics, dermatology and veterinary medicine.

Professions that emphasize a better family balance will thrive going forward. Those that don’t, such as general surgery and obstetrics for instance, are likely to find it more difficult to attract the applicants they once did.

Physicians now are considering new criteria that ensures a better balance when considering a job:

Are people in the field being hit with big and lasting pay penalties for taking time off for family, or for working part-time? Or is the relationship between work performed and pay fairly “linear”–that is, people are paid commensurate with the number of hours worked or patients or clients served? Working parents pay a high career cost in career fields where pay criteria tend to be more vague and subjective, such as status within an organization.

And you know what? They should. Doctors have been exposed to burnout from long hours and an environment that discourages work-life balance for far too long. And patients are the one bearing much of that brunt, with studies correlating burnt out doctors with poorer care.

Every specialty should take lifestyle into account going forward, whether they like it or not. Failing to do so will only repel them from the best applicants.

 is an internal medicine physician and on the Board of Contributors at USA Today.  He is founder and editor of KevinMD.com, also on FacebookTwitterGoogle+, and LinkedIn.

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  • http://fertilityfile.com IVF-MD

    I’m a faculty adviser for two separate mentorship programs at UC-Irvine for the undergrad students, many of whom are pre-med and pre-law. One of the talks I give centers on stepping back and looking at the big picture in career choice and how it should be based on one overriding theme – your future happiness. Four key factors for happiness include 1) a meaningful purpose 2) financial stability 3) health and energy 4) quality relationships.

    So how does choosing medicine fit the bill for future happiness under this paradigm? A medical career can fulfill the first two, but you have to balance not compromising the last two. One could argue that with respect to #1 the spiritual fulfillment that comes from doing a perfect botox administration vs skillfully reading a frozen section under the microscope vs saving a child’s life might be a bit different. But that’s for each individual to figure out. With respect to #2, fields in medicine where the compensation is coming from a third party (insurance or government) and not coming directly from the patient who benefits are predicted to continue on the downward trend. With respect to #3 and #4, work that disproportionately saps ones time, energy and spirit will leave less time, energy and spirit to devote to staying healthy and nurturing meaningful personal relationships.

    Kevin, you’ve hit the nail right on the head with this post. Lifestyle does matter. No matter how some people try to deny it, ones own happiness is always the driving force behind life decisions and finding a career where one can help others while keeping a balance of ones own needs is arguably one of the most important tasks we all face.

  • Muddy Waters

    Can’t blame them one bit. In an age of decreasing reimbursements, why would anyone want to work HARDER or for longer hours. Welcome to the beginning of socialized medicine, where you get only the bare minimum out of your workforce because the incentives to achieve have been eliminated.

  • http://www.myheartsisters.org Carolyn Thomas

    When I asked my young med school friend Sara which specialty in medicine she would like to practice one day, she joked: “Well, dermatology of course – because of the 3 Ts!”

    I asked: “What are the 3 T’s?” Her reply:

    1. you work TUESDAY to THURSDAY
    2. you work TEN to TWO
    3. you have plenty of TIME off

    Gone are the days when young med students should abandon quality of life factors to tolerate the life-sucking career demands of medical practice like our old family doctor did. He made house calls, was on call 24/7, delivered babies in the middle of the night yet still showed up for his first 8:30 office appointment, and even gave his patients his home phone number “just in case”.

    Where is the work-life balance in THAT work ethic? And can you imagine being the spouse or children of such a workaholic?

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