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The Medical Professionalism Blog

Part-Time Women

In a recent op-ed in The New York Times, Dr. Karen S. Sibert opines that female physicians working part-time are contributing to a physician shortage and are “not making full use of their training” and the societal resources invested in medical education and residency.  She also has the following message for current and aspiring female medical students:

“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.  They must understand that medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve.”

As a female medical student and co-President of the Penn Medicine Elizabeth Blackwell Society (the female medical student association) I would like to respond to her injunction:

1. I take issue with the idea of singling out part-time female physicians as failing to uphold the “moral obligation to serve.”

There are those who get their medical degree and take jobs with consulting firms, while plenty of others go into cosmetic surgery.  As primary care physicians are so badly needed, Dr. Sibert, an anesthesiologist, could thus be taken to task as well. Even with the shortage of primary care physicians, I do not question Dr. Sibert’s decision to practice anesthesiology, and I would ask her not to judge those who find that part-time work is more suitable.

Interestingly, Dr. Sibert also notes that “women are more likely to go into primary care fields—where the doctor shortage is most pronounced—than men are.” I am curious why she does not see that as a failure of male physicians to uphold the obligation to serve.

I find Dr. Sibert’s view of a physician’s obligation to serve as not just too narrow, but also detrimental to an entire generation of medical students. She is reinforcing the stereotype that women are somehow less devoted to the practice of medicine than their male counterparts.  I have fallen victim to this line of thinking on a personal level. During a medical school interview, I was asked how I would balance work and having a family.  The male applicant interviewed after me was not asked the same question.

2. I am not willing to concede that working part-time constitutes a failure to serve.

Dr. Sibert effortlessly conflates working part-time as irresponsible and unprofessional.  If women were entering medical school with the intention of practicing “medicine-lite,” I would agree with her.  But every female medical student I have met has espoused a genuine passion for medicine and health care.

Working “part-time” can mean any number of things.  I would also argue that perhaps these physicians are better able to take care of their patients.  It is shortsighted and simplistic to assume that we can judge relative contributions to patient care by hours marked on a pay stub.

3. This article is part of the problem, not the solution

Physician shortage is a real issue.  As a profession, we need to unite to find solutions rather than point fingers.  The tone of this article almost seems indicative of the culture of hazing that, as a first year medical student, already seems prevalent in the medical profession.  The attitude toward medical education/work seems to be: “If I had to suffer through it, so do you.”

Indeed, finger pointing is more than just useless, it is counterproductive.  This culture of shame and blame surrounding familial obligations makes medicine seem very unappealing to family-oriented future doctors (the very sort of people I’d like to be taking care of me and my family).

I would argue that medicine needs to follow the lead of corporations who have realized that a need for flexibility and work-life balance can be a powerful and inexpensive incentive to retain stellar employees.  Medicine should embrace flexibility to ensure that all physicians can be at their best and uphold the obligation to serve the population.

I agree wholeheartedly that we need to engender a sense of obligation in the physicians of the future.  Being a doctor is an honor and a privilege for reasons far beyond her stated justification that there are limited spots in medical schools and residencies. So, Dr. Sibert, as a female medical student, I urge you to use your intellect and dedication to help find a solution that ensures that the profession has stellar physicians who can meet societal needs rather than perpetuate the antiquated notion that women–and women alone–must decide between family and their profession.

 

Hayley GoldbachHayley Goldbach just finished her first year of medical school at the Perelman School of Medicine at the University of Pennsylvania. She is currently the Co-President of the Elizabeth Blackwell Society (the women’s medical student association) and President of the Dermatology Interest Group. She also volunteers at Covenant House, an emergency shelter for homeless teenagers in Germantown, PA.

Hayley grew up outside of Boston, MA. She developed an early interest in journalism and appeared as the “roving reporter” for nine years on NPR’s “From the Top.” She received her BS from Brown University where she graduated in 2009 magna cum laude and was elected to Phi Beta Kappa. Her extracurricular activities included teaching health to under-served students and teaching ethics in a prison as well as being captain of the equestrian team.

Before starting medical school she took a year off and worked in Malawi with Project Peanut Butter, an NGO that treats pediatric malnutrition.

Her interests include international health, professionalism, and health disparities.

7 Comments to Part-Time Women

  • July 18, 2011 at 3:44 pm | Permalink

    Hayley, what a wonderful response to an article that I found frustrating and hurtful. As a woman who is a physician and a mother (and other things), I believe I make important contributions professionally while helping the next generation grow up healthy in mind and spirit. To paraphrase a great teacher, the Dalai Lama, there are many paths to contributing to society–to making the world a little better. Just because I am not on your path doesn’t mean I am lost.

    • Hayley G's Gravatar Hayley G
      September 7, 2011 at 10:45 pm | Permalink

      Dr. Lynn: many (belated) thanks for your comments. I think that quote is perfect!

  • Hayley G's Gravatar Hayley G
    July 14, 2011 at 10:47 am | Permalink

    Thank you so much for your comments. I agree that the medical profession should work together to find a solution for this issue instead of engaging in divisive finger pointing (especially when it concerns personal decisions). And I also agree that the AMA should be leading the charge on this front.

    I welcome any more thoughts on the matter!

  • anon's Gravatar anon
    July 13, 2011 at 6:46 pm | Permalink

    Why not take up the doctor shortage with the AMA?

  • Geoffrey Lewis's Gravatar Geoffrey Lewis
    July 10, 2011 at 9:18 pm | Permalink

    What a brilliant response and who could possibly argue with Ms. Goldbach’s thinking? She is the epitome of the dedicated servant health professionals should aspire to be. Her urging that Dr. Sibert use her intellect to find a solution that will ensure that the profession has the physicians necessary to meet societal needs demonstrates a wisdom far beyond her age and experience. One can only hope that those with far more experience heed her advice.
    How fortunate are we and the society as a whole to have young, bright, energetic and committed people like Hayley Goldbach. She will no doubt bring great honor to her chosen profession while at the same time making a significant and positive difference in the society at large!

  • Elliott's Gravatar Elliott
    July 10, 2011 at 7:26 pm | Permalink

    I applaud your view, and find it refreshing compared to the seemingly Scroog-ish view of Sibert. The lack of primary care doctors seems to be more of industry issue and not a gender issue, in which case Sibert’s argument feels forced and misguided.

  • Samantha Maye's Gravatar Samantha Maye
    July 10, 2011 at 6:05 pm | Permalink

    Wonderful article – eloquent and beautifully written. I second Hayley’s sentiment entirely. Thanks for bringing this to our attention.

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