Instead of training more doctors, why don’t we keep the ones we have now?


In an article from the Pew Charitable Trusts, an upcoming scarcity of OB/GYNs in the U.S. is predicted with a potential shortage of 22,000 OB/GYNs by the year 2050. Reasons given for the shortage are a growing population, female OB/GYNs retiring early and working part-time, residents entering sub-specialties and changing physician attitudes about work-life balance. Suggestions in the article to combat the shortage are increasing OB/GYN residency spots and supporting a larger role for midwives.

Wait, rewind. One of the reasons for the shortage is that female OB/GYNs work part-time and retire early, ten years earlier than their male counterparts according to the article. And the suggestions to fix the problem are to create more OB/GYNs and midwives? Am I the only one who sees the problem here? Why are we not focusing on retaining the OB/GYNs that we have now?

Why is no one asking the question why the women in OB/GYN retire early and work part-time? Dr. Laura Baecher-Lind began to address the topic in her article, “Women in Leadership Positions Within Obstetrics and Gynecology: Does the Past Explain the Present?”, published in Obsterics & Gynecology, December 2012. In her research, Dr. Baecher-Lind found that women in obstetrics and gynecology are significantly underrepresented in leadership roles, even when accounting for historical differences in those that were entering the field. She suggested ways to address the issue including flexible work schedules, mentoring, and more accessible child care.

While I agree that all potential solutions to address the OB/GYN shortage should be examined, I am deeply disturbed that the article from The Pew didn’t even propose a solution to retaining the majority of the OB/GYNs that are entering the workforce. I think the real problem is that it seems no one sees this as a problem. We should be looking into ways to keep the talented, smart, female OB/GYNs working and providing health care for the women in this country. I have no issue with women who want to work part-time or retire early; the issue I have is when women want to work more but feel society is not giving them the resources to do so. Sheryl Sandberg famously talked about this in her book, Lean In. She also wisely discussed the ways that women limit themselves in their careers.

As I type this, I am looking around at a class of physician executive MBA students. There are 10 women out of 35 in the class. Why? Why are we not in leadership roles? Why are we as women putting ourselves through the rigors of medical school and residency and then working part-time or even retiring early? I don’t have those answers, but someone needs to find them and find them soon. We need more research, more solutions and more progress to address the issue of representation of professional women in the workplace. If we don’t fix the problem, and we don’t do it soon, in a huge bit of irony, the very women who are leaving the workforce, will have less access to health care for themselves.

Jaclyn van Nes is an obstetrician-gynecologist.

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