Women leaving medicine - a wealth of untapped training and experience?
The third bullet point in the Women Leaving Medicine Manifesto strikes at the heart of my real concern.
Image by Getty Images via @daylife
“Women leaving medicine represent a great wealth of training and experience that must be tapped, to continue to benefit society”.
When women leave their time-gobbling medical practices or drop out after a grueling residency, society loses out.
While families — children, elderly parents, siblings — may benefit (as may the physician herself even if she isn’t caring for a family), the huge investment of time, energy and money that went into a medical education and establishing a practice is wasted.
Or so it seems to the onlooker, and even to the physician herself who is often riddled with guilt and confusion.
This loss is most unfortunate in a time when the healthcare system is straining at the seams and talk of impending physician shortages is widespread.
Just what’s at stake here?
- the physician’s mental, emotional and physical well-being
- the security and integrity of her family — the infant still forming attachments, the toddler in search of new independence knowing that his mommy is there to back him up, the elementary school kid struggling with homework, the adolescent craving support as she navigates the minefields of middle and high school, her mom’s early-onset dementia dad is having to cope with, her dad’s colon cancer that is causing mom and her siblings to fall apart
- the physician’s financial situation should she choose to quit medical practice - unrelenting medical school debt repayment, loss of income to the family
- the health and welfare of a society that is under stress due to overwork, underemployment, poor lifestyle choices, increasingly sedentary occupations and leisure choices, information overload … you name it!
In this blog, I hope to explore along with you, what opportunities we have as individual women physicians and as a community or society to address this problem.
I guess my first questions are:
- Is there indeed a problem?
- Do the women leaving medicine really care if their ‘brain trusts’ and years of experience lie fallow for the years they take off?
- And if so, how should we respond?
What are your thoughts?
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- Americans will need doctors but physicians are leaving primary care (kevinmd.com)
- The Bureaucratic Doctor (lifescript.com)
Women physicians - keepers of the family flame
The second bullet point in the Women Leaving Medicine Manifesto is “women physicians have the right to nurture their families to the extent they desire”.
Parents age and get frail.
Babies need nursing and nurture.
Kids act out when their parental attachment is threatened.
And physicians, both men and women, flame out in the absence of self-care.
Fundamental to being human are the “Maslow’s needs” of adequate sleep, love and belonging, and security and well-being of the family. These may be counterbalanced by needs such as financial security and self-respect — both of which may be challenged by the decision to quit medical practice for an alternative non-clinical career or to step away entirely from the workplace.
Ultimately, the decision to stick it out or to quit medical practice for at least a period of time is deeply personal.
An article titled “But will it make you happy?” in the New York Times this weekend scratched the itch that I have been feeling to downsize , declutter, simplify my life. In response, I spent 4 hours cleaning our junk from the garage yesterday. Talk about experiences bringing happiness! Despite my aching muscles and dusty nose, I felt hugely satisfied last night.
Why bring this up?
Because I believe we are making our decisions about work versus staying home with the family way too complicated.
And what the N.Y. Times article implies is that we are not very good at figuring out what makes us truly happy. We work hard, we acquire, we own, we want to give our kids more, we fear the loss of our standard of living, we suffer!
As a family member and member of the human race, you - dear Dr. MD - have the right to know, prioritize and act according to your core values.
The indomitable Eleanor Roosevelt, whom I greatly admire, offered two pieces of wisdom that inspire my stubbornness when I am worried about what others will think:
Image via Wikipedia
No one can make you feel inferior without your consent.
and…
Do what you feel in your heart to be right - for you’ll be criticized anyway. You’ll be damned if you do, and damned if you don’t.
What do you really, really want?
What are you willing to do to make “it” happen?
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- The Bureaucratic Doctor (lifescript.com)
Slowing the Physician Brain Drain
I wrote my Women Leaving Medicine Manifesto with the encouragement of a small Mastermind group I’ve belonged to this summer.
Since the Manifesto represents my most pared-down thinking on a big topic, I plan to write a series of articles, each dedicated to one point of the document.
So here goes…
Point Number 1: Slowing the Physician Brain Drain is vital to the well-being of our society.
As a family physician who quit clinical practice over a decade ago, I am part of the group of doctors who have left medical practice in increasing numbers for any number of reasons.
Frustration - “too much red tape”, inadequate business training and skills
Lack of professional satisfaction
Lifestyle challenges
Unable to make ends meet (yes, it’s surprising to hear how many doctors quit practice because their overhead, including student loan debt and malpractice insurance, exceeds their practice revenues)
Burn-out
Boredom
While it serves my coaching business to help physicians transition successfully from practice to new and exciting non-clinical careers or entrepreneurial business ventures, I am increasingly troubled by what life will be like when there aren’t enough doctors around to take care of our future medical needs.
Sure, as a physician, I and my family are likely to be able to get excellent medical care should we need it, but what about the less fortunate, or the jobless? And what about the quality of care?
I believe that we must find ways to help physicians stay in clinical practice, and to remake medicine into the once-enticing profession for intelligent and driven young people that it was. Even if doctors choose to work only part-time.
And this work must:
- be emotionally rewarding
- be efficient, as opposed to pen-pushing, wasteful, redundant “busy work” (more than anything else, this is what drove me out of practice)
- offer intellectual stimulation, along with the opportunity for personal growth
- respect the needs of the clinician to attend to the personal demands on his or her time
- be financially rewarding
- be designed creatively to take advantage of the huge array of technological tools we now have, enabling people to work virtually at least some of the time
- restore the trust and “magic” of the beneficent doctor-patient relationship about which I recall taking an oath way too many years ago in medical school!
We can’t sustain this loss of doctors for long.
How can we physicians help stem the brain drain?
- Tom Silva: The Other Health Care Crisis (huffingtonpost.com)
“There are no coincidences!”
[This is a Guest Post]
“thank you ….the universe is always guiding me…and i will be very honest:
i have been out of an IM residency only six years. throughout medical school and residency i felt uncertain/not confident in my knowledge base of medicine, but i chose im by default…nothing else jumped out at me. outpatient clinic during residency was a huge disappointment (seeing pts every 10-15 minutes was not what i signed up for)….so i postponed actually practicing for about 4 yrs, and then i only got into it as nutritional/lifestyle change coach. nonetheless, i started practicing in an inner-city medicaid clinic, but after a year and a half….I’M DONE. I’M DONE, DONE, DONE!! i loved touching my pts…i loved talking to them and teaching/counseling….but i don’t care about m11q’s, disability forms, and potassium levels…..and i especially hate that these things took me away from my husband and my two babies. i was just another worker-bee, clearly fighting the hustle everyone else had down pat. but even though my heart left medicine 6 yrs ago…i feel scared to leave…..what the heck am i going to do? how am i going to help people now? if medicine was the noblest of professions, am i done for? this is all i have known since the 10th grade…..
i will end the ramble now…thank you for your patience….warmly, -yc”
