A dichotomy has emerged as we consider the best way for women physicians to realize both their potential and their dreams in the service of patients and society. One position states that women have to internalize behaviors that are known to result in success and are based on a long history of professionalism, albeit developed for and by men physicians over the last 100 years. This is more along the lines of Sheryl Sandberg’s “Lean In” approach. Give the gal the chance and she, too, can rise to the top.
The other position states that the workplace, and in this case, the healthcare workplace, has to be more accommodating to the needs of women. Attitudes, expectations, schedules, and work models have to be reconsidered and re-designed so we can harness as much as the woman physician has to offer. Ann Marie Slaughter’s writings are most aligned with this approach.
Clearly, both have legitimate and useful points of view. Of course, both have to happen—women have to learn the secrets and be let into the club, and the club has to have doors that open for women. While the numbers of women physicians have burgeoned, just being let in is not enough.
The healthcare workplace is like no other. In most situations it depends on the creation of multiple intimate relationships mostly between the doctor and patient. Time constraints are unpredictable. The energy and talent that is needed to absorb the stress of people depending on you to be smart, caring, available, and affable are super-human at times.
So back to the original question. How much should the healthcare workplace change to accommodate women physicians? Only as much as is needed to preserve what is the best in medical practice and only as much is as needed to curb what is the worst in medical practice. The “trick” is to look at what we do, its aim, and how it is done. Can it be done differently with the same or dare I say, better outcomes? And what is it that we are going to look at? Anything that improves clinical care and gives us what we need–more energy to do better work through flexibility, predictability and control of our work and our lives.
But just because it is a difficult task, doesn’t mean it shouldn’t be done. And not just for the sake of women, but for the sake of all physicians and their patients. We are currently faced with the perfect storm for mass physician exodus from the physician workforce. Increasing regulations, decreasing rewards (both financial and personal), devaluation of the healer, and the explosion of endless hours spent in useless tasks that create work that takes us away from patient care.
The healthcare workplace should change. For women the situation is more acute as they have other societal burdens and life challenges that leave them with less reserve. The healthcare workplace should not take any more of that reserve away unless it is focused on patient care, with identifiable positive outcomes.
So while we are all bulking up our inner strength to lean into one tough job, each one of us, both male and female, should commit to focusing on one area to make the jobs of women physicians easier. Close the gender pay gap, eliminate the hostile work environment, create flexible scheduling , build systems that have more predictability, and grant us greater control, to name a few.
Some say that the feminization of medicine has devalued physician worth. Women ask for too much accommodation and when granted they trade off excessive financial and other incentives. Whether you believe this to be true or not, the present working conditions cannot be sustained. The healthcare workplace can and should accommodate all physicians the power and energy they need to be the best healers we want to be. Share your stories about how your workplace has accommodated to your needs and how everyone is better off because it did.
Linda Brodsky is a pediatric surgeon who blogs at Women MD Resources.