Saturday, April 19, 2008

The real problem with our health care system: Female doctors ...

... now there's a Women's Bioethics Blog equivalent headline equivalent of those "Free Beer" postings on college campus bulletin boards. I only wish it was as facetious a headline.

What am I referring to? Why, an article in the April 28, 2008 issue of Businessweek, which you can hopefully read online here (although you may need a subscription). The take-home message: the looming shortage of doctors in the United States, estimated to be a deficit of 50-100K physicians by 2020, may be partially a result of the fact that female doctors work less than their male counterparts. They also see fewer patients, take time off to have children, and have the nerve to ask to work flexible schedules so they can actually nurture those kids they so unwisely produced. Thank god we've still got a couple of upstanding men who can pick up the slack. As one anonymously courageous male internist from New York so righteously complained: "The young women in our practice are always looking to get out of being on-call ... The rest of us have to pick up the slack."

On the plus side, women are more likely to go into understaffed, low-pay specialties like family practice, pediatrics and obstetrics. 

So who's at fault here I wonder? Could it be those selfish women who want: 1) to provide high quality and attentive preventive care, something our current system neglects; and 2) make sure that their kids aren't raised by Sesame Street and Nintendo? Or, could it be the current system that rewards those men (and women) who: 1) enter high paying and lucrative specialties; and 2) only see their kids on weekends during court-ordered and -supervised visits? Guess we'll have to choose ...

6 comments:

Anonymous said...

exactly.

Anonymous said...

Sad to say, us female med students hear this tripe on a daily basis. The old guard are still out there, working, and choosing the young doctors who gain entry to their specialties. Impressing the boss is the only way into the specialty. They seem to believe that competence is an all or nothing proposition, and that anything you do outside work has no relevance. I heard a registrar say yesterday "you have to practice working tired so you'll cope when you need to"??? What about all the mistakes you make when you're only practicing? Do those patients not count somehow?

Andie said...

What about having programs (such as paternity/family leave) that allow men to pick up the slack at home? And how about women demanding that men do just that? Why are women still expected to take care of all the home and childcare duties when they are now a part of the workforce?

Jaime said...

Last night Vermont Public Radio aired a fantastic debate/discussion on the policies of affirmative action in this country and how they are implemented for admissions process. The folks who debated were:

Ward Connerly: chairman of the American Civil Rights Institute, and member of the University of California Board of Regents.

Marvin Krislov: president of Oberlin College, and former vice president and general counsel at the University of Michigan.

Both arguments were superbly fascinating but I think one unexpected message that came from the discussion was that of gender in admissions and the workplace. It is UNDENIABLE and INCONTESTABLE that a women's role in society is still very much defined by male conventions...whether these manifest themselves overtly (less likely) or subversively (very common) is a moot point. The truth of such discrimination is in numbers, waving in front of society to see, just somehow, its impact is being strategically averted.

I am a pre-med student and have been exploring graduate/medical school for some time now. I've already heard the rumors of potential discrimination in my future applications or job searches. At my last scientific conference, I made it a point to ask the University representatives (many were deans and asst deans at medical schools) how women who have priorities of starting a family, without going too far past reproductive prime, manage the incredibly heavy workload and extensive time demands. Only one University Rep gave me more than 5 mins to discuss this concern...and thankfully, this particular Rep was a man.

I think we are starting the movement though. By more women pursuing careers in science and medicine, we are making the demands and modulating the system to serve the needs of EVERYONE. I'm going to do my best to be a contributing factor.

davegkugler said...

How about training more physicians so each of them can work less. I don't know general numbers, but I know at UW in Seattle approximately 5500 people applied for admittance to medical school this past year, and somewhere around 120 are accepted for Washington State (~200 total for the WWAMI states). With a coming "deficit of physicians", I can't grasp why we simply don't train more of them.

I think your latter points about the current system are spot on; with the extremely limited numbers of seats, only the most competitive (and 'competitive-types' of people) get in. These are people that plan on specializing, and sub-specializing, and are rewarded for doing such. It's fantastic that we still see doctors going into understaffed, lower-paying positions. If it skews such that these physicians are mostly women, then awesome, let's see more women physicians... which is also the trend, if you check. ;-]

Kelly Hills said...

Dave - well, I can answer for why UW admits such a small class. Many med school courses are shared resource, with MHE and other departments, which means that although the incoming class size is "small", in reality students are still ending up in huge classrooms. It's a matter of space, budget, resources, etc. To add in another 50 people would probably require entirely new classrooms, more professors, and more space - something that UW, not to mention most medical schools, simply don't have at a premium.