"If you become chief resident are you just going to get pregnant and have a baby?" asked the silver-haired male attending physician as I sat interviewing for the prestigious academic position of chief internal medicine resident. "That's what all the female chiefs do, and I'm tired of it," he added, shaking his head in clear disgust.
Gobsmacked by the blatant sexism of his interview technique, I laughed nervously and made some lame joke about working so much that I barely had time to see my husband, let alone make babies with him. Feeling absolutely professionally alone, with no good means of reporting the incident, I quietly pulled my application and plowed on through residency and life, eventually giving birth to a son at the very end of my training.
My experience is hardly unique: 4 out of 5 physician mothers say they experience workplace discrimination, according the results of a study published last week in JAMA Internal Medicine.
The researchers were inspired to study the topic after reading thousands of Facebook posts on the difficulties of balancing medicine and motherhood on a popular social and professional network forum called Physician Moms Group (aka PMG), an active community with more than 65,000 members. I'm one of those members, and I've found it invaluable for navigating medicine as a woman and mother. From discussions on how to efficiently breast pump between patients to advocating for fair contract negotiations, it's exactly the professional support system I needed years ago when interviewing for that chief residency position.
Dr. Hala Sabry, one of the study's co-authors and founder of PMG, knows that good medicine is based in evidence. So when Dr. Eleni Linos, a researcher at the University of California, San Francisco, approached her about surveying the group for data, she knew it was the right decision. Although PMG had been quietly supporting thousands of doctor moms on an individual level for over two years, this was the group's chance to effect change on a wide scale. Sabry says: "We wanted to have data that went beyond anecdotal stories."
The team surveyed nearly 6,000 physician mothers over a wide range of specialties, from pediatrics to surgery, to assess for perceived workplace discrimination and desired workplace changes. Although I did not participate in the study, I was struck by how common maternal discrimination was. Even Sabry and her colleagues say they were surprised by the high percentages.
While previous studies have long demonstrated gender discrimination within medicine, from pay discrepancies to academic advancement, this was one of the first to investigate the role that motherhood plays in physician career satisfaction.
Of all respondents, 77.9 percent reported discrimination. Nearly two thirds reported gender discrimination and one third reported maternal discrimination, defined as discrimination based on pregnancy, maternity leave or breast feeding,
Almost all of the women reporting maternal discrimination attributed it to pregnancy or maternity leave, and nearly half attributed it to breast feeding. The most common manifestation of discrimination overall was disrespectful treatment by nursing or other support staff, followed by reported exclusion from administrative decision-making , and claimed pay and benefits not equivalent to those of male counterparts.
Nearly half of all the doctors who said they experienced maternal discrimination also reported burnout. This is not new a new finding, and not unique to women: A 2014 national survey found that more than 50 percent of physicians report professional burnout, at rates two times greater than non-physician working adults. But women physicians had higher self-reported burnout risk than their male colleagues.
Although this study may not be surprising to any woman trying to balance work and motherhood, the results may have big-time consequences for the health of the country.
Female physicians represent a third of all practicing physicians, and keeping them in the work force is an important part of providing adequate health care to the country. By the year 2025, a shortage of nearly 90,000 physicians is predicted, according to the Association of American Medical Colleges, as the medical establishment seeks to care for a growing and aging population. An aging medical workforce will only worsen the shortage. Over 40 percent of practicing physicians are 55 years are older, and a wave of physician retirement is expected over the next 10 years.
But attracting and retaining female physicians is not only important from a numbers perspective, but from a morale and care perspective. Studies have found that women are not only more optimistic about the state of medicine than their male counterparts, but they also may offer better care. One recent study found that patients of female physicians have significantly lower mortality rates compared to those of their male peers.
Ultimately, Sabry hopes that the research garnered from the Facebook group will lead to "happier and more fulfilled physicians, leading to better healers." She and her fellow study authors say health care employers could decrease maternal discrimination and burnout by promoting policies such as longer paid maternity leave, backup child care, lactation support and increased schedule flexibility. A healthy piece of advice that should be adopted in and out of medicine.
Alexandra Sowa is an internist and obesity medicine specialist in New York City and clinical instructor in medicine at Weill Cornell Medical College. You can find her on Twitter at @AlexandraSowaMD.