Why doctors shouldn’t have to choose between medicine and family

For the past few Sundays, the New York Times has published provocative op-eds involving physicians.

The first tackled physician bullying.  Next was the cost of medical education.  And, most recently, the phenomenon of part-time, mostly female, physicians.

This is obviously a live-wire topic, sure to generate passionate commentary.

In the piece, anesthesiologist Karen S. Sibert goes over ramifications of part-time physicians.  They comprise mostly of women, as 40% of female physicians between the ages of 35 and 44 reported working part time.

In the context of the primary care shortage, however, this presents problems to patients:

It isn’t fashionable (and certainly isn’t politically correct) to criticize “work-life balance” or part-time employment options. How can anyone deny people the right to change their minds about a career path and choose to spend more time with their families? I have great respect for stay-at-home parents, and I think it’s fine if journalists or chefs or lawyers choose to work part time or quit their jobs altogether. But it’s different for doctors. Someone needs to take care of the patients.

The Association of American Medical Colleges estimates that, 15 years from now, with the ranks of insured patients expanding, we will face a shortage of up to 150,000 doctors. As many doctors near retirement and aging baby boomers need more and more medical care, the shortage gets worse each year.

The United States isn’t alone in dealing with this issue. In Canada, for instance, the newsmagazine Macleans did a front-page story on the topic back in 2008. In it, the president of the Canadian Medical Association bluntly stated, “female doctors will not work the same hours or have the same lifespan of contributions to the medical system as males.”

Dr. Sibert is correct in pointing out that our health system cannot accommodate the incoming generation of physicians who prefer a better work-life balance.

She proposes that medical students be forced to choose:

Students who aspire to go to medical school should think about the consequences if they decide to work part time or leave clinical medicine. It’s fair to ask them — women especially — to consider the conflicting demands that medicine and parenthood make before they accept (and deny to others) sought-after positions in medical school and residency.

Indeed, her wry advice to a medical student who valued work-life balance was, “If you want to be a doctor, be a doctor.”

In other words, medicine or family.  Not both.

If that’s truly the case, it’s unlikely that many medical students will sacrifice their family for their career.

And, to be honest, why should they?

Physicians today are often vilified in the media, as well as by health policy experts. As we reform our health system, it is the physicians who are often targeted as ones most responsible for soaring health costs, and yet their concerns often are ignored. The bureaucratic hoops doctors have to jump through to care for their patients continue to worsen.  To top it off, there is constant pressure to replace physicians with less expensive options.

Simply put, doctors, and the work they do, are becoming devalued by society. It’s no wonder that physicians’ commitment to the profession is wavering.

It’s one reason why physicians today, both male and female, prioritize work-life balance.  Those who don’t risk burning out. And as internist Robert Centor poignantly notes, “I would rather see a committed part-time physician than a burned out full-time physician.”

Instead of pointing the finger at part-time doctors, it is our health system that needs to change, and adapt to physicians who choose to place both medicine and their family on an equal pedestal.

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

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