90.9 WBUR - Boston's NPR news station
Top Stories:
PLEDGE NOW
The ‘Mommy Track’ Debate In Medicine

One female doctor argues that not working full-time is a waste of a medical education and a disservice to both patients and the profession. Others argue that trying to have it all is impossible. We explore what we should expect from our doctors — both as professionals and as parents.

Medicine is a demanding field. Here medical students and paramedics rush a man with gunshot wounds to the operating room. (AP)

Medicine is a demanding field. Here medical students and paramedics rush a man with gunshot wounds to the operating room. (AP)

Karen Sibert is a doctor and mother in Los Angeles. Four kids. A practice in anesthesiology. A big career.

And this week she threw a big rock in the pond of women in medicine. In a high-profile essay that has rocketed through the online world, Dr. Sibert said too many woman doctors are taking too much time off to take care of their own kids.

Working part-time. Leaving the field. She portrayed these personal decisions as a betrayal of a higher calling, and a problem for the country.

The pushback has been fierce.

This hour On Point: Dr. Karen Sibert, and the debate over work, family and medicine.

- Tom Ashbrook

Guests:

Karen Sibert, an anesthesiologist practicing in Los Angeles. She recently wrote the New York Times op-ed Don’t Quit This Day Job.

Kathleen Fairfield , the associate chief of medicine at Maine Medical Center and the volunteer medical director at the Free Clinic of Portland. She’s a primary care physician and an epidemiologist and also researches shared decision making in primary care.

Maureen Connelly, the dean for faculty affairs and assistant professor of population medicine at Harvard Medical School. Her research has focused on women in academic medicine, and she is the principle investigator of the faculty survey at Harvard’s medical and dental schools. She practiced internal medicine before joining the dean’s office.

And later in the hour, we’ll hear some of the commencement address by Facebook’s Chief Operating Officer Sheryl Sandberg this year at Barnard College.

Please follow our community rules when engaging in comment discussion on this site.
  • http://richardsnotes.org Richard

    I don’t think doctors have a moral obligation to work full time any more than I think any other helping or service professional has that obligation. And, if too much work makes for a workaholic doctor with no home life and crappy bedside skills, I’d rather have the part timer.

    There’s probably a threshold of involvement a doctor needs in his or her practice and profession to keep skills up and be in tune with the latest developments but after that I’d say it’s up to an individual.No doubt some doctors feel the need to keep a high patient load and make more money to offset college loans and malpractice insurance so there’s probably at least a bit of an economic influence on how much an individual doctor works.

    • Kurt

      Seems like you contradict yourself, or else your idea of “moral obligation” differs from my own.  How can doctors have a “threshold of involvement” required to maintain their skills and not have an obligation to work more time than other professions?  Doesn’t the one necessitate the other?  I can think of few professions that require the degree of technical skill we demand of doctors, and of those, none, from concert pianists, to gymnasts, to F1 drivers, work part-time.

      • Terry Tree Tree

        Kurt,  Didn’t Paul Newman, and James Garner drive F-1, somewhat competitively, between movies?  Some people can multi-task, some people HAVE to multi-task, such as mothers.  Seems that I’ve heard or read of some concert pianists, that do other things.  Few parents have the option to only be parents.  Most parents must also make an income.

        • ThresherK

          Sports cars, in a variety of circuits, yes. (SCCA was once joked to stand for “See Cruise Crash Again” after Tom Cruise had a spate of wrecks.)

          But not F1, if I remember, not against the likes of Michael Shumacher and such.

      • http://richardsnotes.org Richard

        I don’t see one necessitating the other but that’s just me. Everyone is different, including doctors. Some doctors can’t get enough work, some doctors may do better with less. I don’t think it’s up to an outside force, be it the AMA or society to put pressure on doctors to fall one way or the other. What I want in a doctor is someone who knows his or her stuff, has a life outside of medicine to give him/her perspective, and comes to work eager to listen, learn, and help.

        Our family doctor is just such a man. He has a full time practice but he does take time off to do other things and lets his patients know about it. We’ve been very happy with him for 12 years now and he’s a bit younger than us so he may be our last doctor. Fine by me.

    • Terry Tree Tree

      Richard,    If doctors would follow their Hipocratic Oath, their moral obligation as a citizen of earth, and the economic sensible thing to do, malpractice insurance would be a lot lower.  Doctors are the people that have far and away the most power to get rid of doctors that commit the crimes of malpractice!  There are myriad cases of doctors , dentists, nurses, medical administrators, and other health care personnel moving to new places to malpractice, like Catholic priests were moved to molest new children.  That is aiding and abetting a crime, which is a crime.  They don’t go to jail, any more than the bishops, and cardinals that aided those criminals!

    • http://richardsnotes.org Richard

      Odd, the headline and caption of this show changed considerably since I posted my first comment. Oh well, it seems I was close anyway.

  • David

    Define part time? Does that just mean 20 hours a week of labor or does it take into account hours studying and learning new skills? What about people who can learn quicker? Do they need to spend the same amount of time? I agree with Richard in that it is up to an individual.

  • Terry Tree Tree

    Parenthood, REAL PARENTHOOD, is important, as it is the only way to bring up decent citizens.  Medicine, REAL MEDICINE, is important, as people need proper health care, to be able to be productive citizens.  Some people can do both their ‘Day Job, and be decent parents.  Some people cannot do either very well, at all.  I had to be both parents, work construction, for my income to raise my children, fight for custody, and deal with a child abduction.  Part of that time, I was also a Volunteer Fire Fighter, because most people that were better off, wouldn’t.  My children are more successful than I, and decent citizens, which I am proud of.  If I had been rich, I could have been a full-time parent.  Each individual, has to make their own choices, according to their abilities, and circumstances. 

  • Anne

    It’s interesting that there are no men on the panel today.  What do these men (who apparently work 4.5 more hours per week) think?  

    What about men who want to take paternity leave?  This conversation seems one-sided to me.

  • LinP

    I had a female primary care physician who worked part time for a number of years–two days a week. IT DID NOT WORK AT ALL!!!! Luckily I need my doctor very infrequently, but I could never get hold of her. I never got to see her as she was hardly in the office. I was bounced from doc to doc in the office.

    What would have worked, IMO, is if she would have officially “job shared” with another physician in the practice. I would have happily and willingly seen either physician and/or a NP who I felt had a connection to me and a history with me. Instead, I totally resented her part-time status and greatly resented being thrown at other doctors in the practice who had no idea who I was. I ended up complaining to the director of the practice on several occasions. She eventually left.

    That said, I am the mother of 4 who was profiled in the Boston Globe and Boston Herald years ago as one of the first women executives to job share. I then opened my own business and kept my hours flexible and part time. I think raising children is equally important as being a physician, and support women working out how to do both successfully–and I believe it can be done. BUT…how a physician structures that part time gig needs to make the patient feel they have continuity of care.

    • Guest

      I think job sharing could be a good option. I have a female primary care physician that works full time and I can NEVER get an appointment with her. I will be switching to someone else in the office, so I am not sure that is necessarily an issue of part-time versus full-time, but perhaps how the practice is set up and run. 

  • Amy

    If your headline is accurate, then I have a problem with this way of viewing the world.
    I have a friend who is a part time doctor. She has three young children, one who has severe disabilities. She COULD stop working altogether, but THAT would be a waste of her degree. Even with daycare and a nanny, she works tremendously hard to keep everything going. We need to support women like her, not make them feel they are inadequate.
    Is your guest saying that the needs of patients are more important than the needs of ones own family?  I think not.
    The sad point is that women/children are always the losers. Women lose out on careers and children lose out on having a parent who cares more about them than work.

  • Kurt

    The whole medical training system is skewed against anybody (male or female) who is family oriented. Young adults in their late 20s and 30s are naturally inclined to marry and have families. In the “olden days” the wife took care of the home life while the (male) doctor had his fine high and mighty profession. Too many docs in charge of medical education are stuck in this fossilized mind set. Medicine needs to build in more options for docs at all phases of life. Older docs take care of their ageing parents. Younger ones want kids. Doctors, above all, should be human and share in all facets of human life, not just the areas of medical problems. Otherwise, we will wind up with warped individuals, alcoholic, depressed, drug-addicted, as too many older workaholic docs have been. (and it’s a problem shared by lawyers and others with demanding career tracks). The system is what’s at fault.

    • Guest

      I think you begin to touch on a point that seems to be ignored. Years ago there were more doctors who dedicated their whole lives to their patients, but many of them (mostly men) had a spouse at home caring for their children and house. As a 20 something female I was raised to believe in having a career that is just important and profitable, if not more so, than my partners. However, in many families with working women, the partner also works too, which leaves neither parent home with children. In order to go back to the quintessential physicians, we would need to reverse this idea that both partners can be successful in their careers. That is not going to happen.

  • Mike W.

    It’s admirable
    to be good at your profession.  But no one admires an absent parent.
     I’d seriously question anyone’s judgment who believes caring
    for those who aren’t of your blood is more important than those who are.
     I’m glad I didn’t have a mother with a viewpoint like Karen’s.

  • TW

    As long as my girlfriend doctor has my dinner on the table when I get, I don’t care whether she works full or part time.

  • Cate

    Stop saying “women doctors.” This out-of-date sexist phrasing has got to go. If you need to specify gender, the grammatically (and politically) correct phrase is “female doctor.”

  • Terry Tree Tree

    A mother that is a doctor, telling mothers that are doctors, not to be one or the other.  Maybe we could get Halliburton to recruit doctors overseas, by telling them they’ll get good jobs in Quatar, or Saudi Arabia, then shanghai them to low-paying jobs in the U.S., by taking their passports.  Doctor shortage solved! 

  • Meg VT

    I wholly prefer a doctor who is a mother and works part time to one who is charging toward the top of the field and making choices that are unhealthy for herself and her family.
    It is so important to have a doctor with values that match your own.  Is that not a relevant need as well?

  • guest

    Thank you, Dr. Sibert, for writing what so many think.  With a critical shortage of physicians on the horizon, we don’t need anyone — male or female — dabbling in medicine.  And frankly, physicians who chose to work part-time don’t choose to take the evening, night or weekend shifts, leaving this to those they leave behind.
    You can’t pop in and out of medicine.  Skills deteriorate quickly, particularly surgical skills.Of course, one solution is to make medicine career that doesn’t demand the long, grueling hours that physicians are currently subjected to.  I think there a number of physicians who would be delighted to cut back to a 40 hr work week. But that would mean doubling the number of physicians (and the number of medical school slots) in the US.  

  • Ellen Dibble

    I have a few doctors who are part-timing it, or have done so.  In one case, the physician has always known he needed extra time to do research and breathe, get away from the pressures.  That one was a kind of trailblazer too, so the pressures were various.
       But there are pressures about dealing with insurance companies, all kinds of non-medical things.  One has to be an administrator with a lot of will.  A physician with serious medical problems developed a group to fill in for him for years while his iff-ish well-being was waivering.  
       In both cases, these physicians have conserved their commitment and idealism and are the mainstays of practices that can absorb as much as they can offer.  They will probably work well past what we consider retirement age.
        That’s what I see for women too.  They need to be the kind of doctor they set out to be.   If women have children, they may end up working till they are older than otherwise.  But if they want a “life,” they should have it.

  • Denny Brennan

    The current physician-centric care delivery model and the current demand for clinical resources have to change to demonstrate value on the health dollar. This changes the equation and actually encourages the use of teams of varied skills acting as a “doctor” in the future where part-timers will fit.

  • BHA in Vermont

    I can’t disagree with Dr. Sibert. It is extremely difficult to get into medical school. There are a limited number of slots. Do you give those slots to people who will then NOT work a full career full time?

    • Anonymous

      What is the bottleneck here?  Can more schools/classes (supply) be created if there’s greater demand?  I’ve heard the AMA has something to do with managing/limit the number of physicians, tho I don’t really know.  https://secure.wikimedia.org/wikipedia/en/wiki/American_Medical_Association#Criticisms

      In any event I don’t understand WHY there are so few med school slots if doctor shortage is an issue.

  • Eric

    What a holier-than-thou attitude!!

  • Rosalind Lee

    I cannot believe this! I know many people who are male MDs who do not practice medicine and instead develop medical software or devices. And what about the new MD-MBA degrees! These people never practice clinical medicine and have no intention of doing so! Go after them
     http://dms.dartmouth.edu/admissions/curriculum/mdmba/

    • Lara

      Very good point!

    • BHA in Vermont

      Which is very sad. There is no need to go to medical school to create medical devices or software. Do specific training in the area you want, for example hip joints if you want to create a better one.

  • Mike

    Is she suggesting that medical students sign a contract like cadets do for ROTC?  If this is the case, the government should foot the bill for the education of the student, like they do for ROTC contracted cadets.  But if the student is footing the bill through their own financing, how can you  expect to prevent them from doing what they want?

  • Anonymous

    If Dr. Seibert argues that the amount of societal and governmental money that is spent on training doctors creates a “moral obligation” for doctors to practise full time, is she willing to take that “moral obligation” to the logical extreme?

    We have a major shortage of primary care doctors – shouldn’t that moral obligation include requiring them to enter primary care instead of the lucrative specialist positions? (Noting that she is a an anesthesiologist…). There are shortages of doctors in many rural areas, inner cities, and low income community health clinics – is she willing to accept the “moral obligation” that a medical degree confers to mandate service in one of those settings?

    Her argument is a huge slippery slope that I don’t think she would be willing to slide down herself.

    • Kurt

      No, because that’s crazy.  All she’s advised is, in fact, advising.  

      I might further note that based on the information that Dr. Sibert has four kids and a grandchild, her choice to become a “specialist”, (if general anesthesia can even be called that) came some 30+ years ago, at a very different time for medicine in the United States.

    • Sarah

      I agree!  I am a third year (my final year) internal medicine resident and I was incensed to hear this argument coming from an anesthesiologist.  I think a huge part of the reason we have such a shortage of primary care physicians is that NO ONE chooses it as a field anymore.  Many women and men in my medical school class chose “lifestyle” specialities such as anesthesia, dermatology, etc.  Many of their reasons were that they would afford them much more work/life balance in their futures (which is absolutely reasonable).  And currently in my internal medicine residency class, at least 90% of people are choosing to further subspecialize and not practice general internal medicine.  

      I don’t think it is fair to attack the physicians who actually opt in to be primary care physicians who may choose to work part time.  At least they are providing some amount of primary care whereas the bulk of graduating medical students and residents are opting for subspecialty tracks.  

      And please remember, Dr. Seibert, that primary care is not and will never be a 9-5 job.  We can’t forget about the patient once they recover from anesthesia and get sent back to the floor.

  • Kurt

    So blame women doctors because Congress (dare I say Republicans?) refuse to pay for more medical training positions, so there would be more doctors, so that doctors of any sex could have a more-normal life? Extending training programs to get enough cases to be “experienced” would certainly be possible, were it not for MONEY. Penny-wise pound foolish Congressmen are to blame here, NOT women doctors. Cheesh.

  • Juliann

    I think the Dr. is right. Too many women go into the profession taking a non-commital attitude because they know they are going to leave to have their own families. I think they go to med school just to say they did.

  • Heidideidi in Burlington, VT

    Our society places erroneous and unattainable double standards on women. Not only are women supposed to get married, have children, and be exceptional mothers, women are also expected to support their families and do the housework, shopping, etc. It’s a societal trap that cannot be won.

  • Anna

    The company my friend worked for sponsored his college education. When he finished, he decided he did not want to work in that field. He had to pay back all the education expenses the company paid for him.

  • Wyatt

    The guest makes a point. But also remember that Graduate Medical Education (residency) is government funded. At the least, physicians should consider a minimum number of years of service as repayment to the taxpayers.

  • Anon

    Infuriating. Karen, you are small-minded and sexist. You need to examine your underlying and very sexist assumptions. I cannot believe you are getting so much publicity for someone so backward thinking and old-fashioned. This is not a “mommy issue” this is a society issue. What happened to feminism? Did it die in the abortion debate? Where did the arguments for real equality between the sexes, both for child-rearing and intellectual and professional life go?  This moral argument is also hollow. I am a physician in Boston and I know from my experience that there are many ethical and moral decisions made by doctors that are far heavier than the decision to work less than “full time” after undergoing medical training. For example, aren’t Harvard Med School graduates and the Harvard Medical School dropping their ethical obligations when 2/3rds of graduates go into the easiest and highest paying fields: radiology, anesthesiology, dermatology, etc? I think you miss the forest.

  • Peri Winkle

    My mother’s part-time doctor did not provide her adequate care.  I can’t know whether that was because she was working part time in order to spend more time with her young child or not, and I refuse to pass judgment on her choice to do that.  I do think the medical profession makes outrageous time demands on every member of it, which happens in no small part because it restricts entry to the profession in order to ensure high wages for those it allows in.

    That said, a part-time doctor is not as accessible as one who works full time.  A doctor whose life is equally focused on something other than his or her profession cannot give the same attention to it as someone who works full time.  That’s common sense.  My mother’s health has improved vastly since she changed doctors.  That was a very difficult decision for her to make, but with support from her family and her other doctors, she was able to make it, and we’re all glad she did.

  • Abbe

    Why aren’t we talking about male doctors who reduce their work schedule or take a step back to rear children? Of course we aren’t. Every mother is confronted with choosing career advancement over parenting in our culture. When fathers in greater numbers, whether they are artists in Park Slope Brooklyn or GPs in Wellesley Massachusetts are being discussed in the same light, we are where we were thirty or forty years ago.  So much for progress.

  • Peter Smyth

    Would the “moral obligation” argument not also apply to, say teachers?

  • Julie

    I am a family doctor and a parent.  Working 4 days a week is more than i can handle in terms of paperwork/phone calls/ administrative duties/call, usually more than 50 hrs a week.  My spouse works 3 days a week, generating a full-time load of work.  This is a very demanding and depleting job.  I find it sometimes impossible to be a good parent at the end of the day, which is unacceptable to me.  I am quickly burning out.  What is the balance?  A lot of specialties are like mine, overburdened by bureaucracy which is strangling the real work at hand–ie, sitting with people, helping them with their health issues.  And then how not to be so depleted at the end of the day?

    Also, as the child of a pediatrician, i have to speak for the offspring of doctors.  My dad worked till 9 every night, till after my bedtime.  He worked most week ends and made house calls.  43 years later he is still remembered by a lot of folks in my hometown, but he died of a heart attack when I was 5.  I think those former patients may have more memories of him than i do.  I think about this every day as I head off to my office.

  • Heidideidi in Burlington, VT

    My mother worked full time through 8 pregnancies (pre maternity leave era), she raised 9 children while she worked full time in order to provide for those children (dad absent). She has only just retired at 76.

    I would have preferred her to have been around more when I was growing up, but that wasn’t in the cards.

  • Heidideidi in Burlington, VT

    Re the primary care deficit and disparities in health care, we need to recruit more people from minority populations to address both issues.

  • Jandybanandy

    NO doc gets back to you same day.  It takes weeks to get an appointment.  Whether they are part or full time.  I know many bright talented well-round people who tried, applied, and could not get accepted to medical school.  It is not because they are not qualified.  It is because there are not enough seats in medical school.  Sandberg is working hard to maintain the image that doctors are a breed of Special Human and the shortage is due to the fact that there simply are not that many brilliant people.

    How dare she tell any person what they owe society. 

  • Jenni Acosta

    Perhaps one approach could be recruiting mothers of older children for medical training.  There are many women looking for ways to change their careers or sequence back into full time work.  Many women are ready to re-enter and would not leave after medical school and medical training.

  • Muriel

    Both men and women who decide to work part time, whatever their professions medical or otherwise, to both take care of their career and of their families should be commanded for it.  People who say that they work 80 hour-weeks and take care of their children are not being honest.  What hours are left for family life and childcare if you work 80 hour-weeks.  Someone else is raising their children.

    Are there any male doctors deciding to work part time as well?  Should we also talk about them, or is it a problem just when women do it?

    • Sailwestx

      Living in LA I am sure she had full time live in help (likely a hispanic woman working for below minimum wage WITHOUT health benefits).

  • Ellen Dibble

    You will have much more of a lack of women in medicine if they are told they can never adapt their careers to motherhood.

  • Ellen Dibble

    Nurse practitioners can take a lot of the burden off primary physicians.  
    To the caller who was thinking of going to medical school at age 33.

  • Tricia, So. Burlington, VT

    I would prefer a woman physician. I have tried unsuccessfully for years to find one who works full time. I had one primary care doctor for a year and a half and I never met her. Appointments were always with a resident because her hours were so limited.

    All my doctors both primary and specialists are now male because they are more committed and responsive. Medicine is a very special field that cannot and should not be done part time.

    • Dave

      Try Dr. Jennifer Gilwee.  Her office is at 1 Timber Lane in South Burlington.  She’s my Aunt and she rocks :)

  • Kerry

    The moral
    obligation of medicine is to do no harm.

    I think
    the problem is that doctors have created their own problem in that the hours
    they have worked in the past has excided what they should. This standard is not
    acceptable anymore.

    What is
    the problem of a doctor only working 40 hrs a week. If this is the standard of
    hours then the system need to accommodate this and create more spaces to train
    more doctors.

  • Vermontague

    The public be damned. If the US Congress can’t/won’t function responsibly, and the people of this country won’t demand responsibility from Congress (we have the attention span of a gnat, and half the intelligence!)…. that’s not the responsibility of a woman MD who wants to raise her family responsibly.

  • LR,MD

    I have never wanted so badly to call into this show. This is making me angry!! I’m a doctor with two kids, working part time. Doesn’t she get that for most of us working part time, if our only option was full time work we would quit?!! 

    What was she going to tell the brilliant and promising 20 year old? If she doesn’t want to work full time then don’t do it at all?
    We also don’t all have the same financial incentive to work– my full time salary was $105,000, the anesthesiologist in California probably makes 4 times that.Also, why aren’t we talking about all those who get an MD and then go into venture capital? Should they be required to practice medicine to give back to society before they go make more money?

  • Shane

    I don’t want to make assumptions about what Dr. Sibert is implying, but the problem with these kinds of conversations is we spend so much time focusing on the choices women have to make to balance the competing responsibilities in their lives and not nearly enough time talking about the societal and institutional structures that put women in this difficult position. With or without doctors working part-time, we are not going to solve our problem of not having enough care providers by just training more doctors – we will need to train many more Nurse Practitioners and Physician Assistants too. Also, what about stay-at-home dads? This is a much broader conversation and it will need holistic solutions, yet all pressure still falls disproportionately upon women.

  • Patrick C.

    Unless I missed some comments, entirely missing from this discussion is the role of fathers.  My father was the cook, house cleaner, and primary emotional parent when I was growing up.  The lack of discussion about the role father can take – which would allow heterosexual female doctors to work full time is sexist.  As a single man who has dated female doctors I’ve also found that they do indeed want it all and reject all men who veer too close into what they perceive as “their territory” – being the primary parent.  Yes, there are exceptions, but they are few and far between. 

    The way to allow women to work full time as doctors is for them to marry men who are interested in being the primary parent.  First obstacle: They have to accept and desire such men first.  And perhaps before that:  The role of fathers as primary parents shouldn’t be so blatantly ignored in discussions such as this.  As I listen to this debate, and many others like it, I’m amazed at how old fashioned and sexist the comments are in how they completely ignore fathers.  It causes me to appreciate my late father even more.  Born in 1933, he never realized how advanced he was as a human being.

  • Thyams

    Women are much more likely than men to join the lower-paying ranks of primary care, family medicine, pediatrics, and internal medicine. Regardless of whether women physicians choose to spend part of their careers working part-time, they are filling essential medical roles that U.S.-trained male medical graduates are much less likely to assume. If women are not given the choice about how to structure their lives, they may reject medicine as a career choice altogether – and if you think we have a shortage of primary care physicians now because women are working part-time, imagine the problem if women abandon the ranks of primary care, pediatrics, and family medicine altogether because they can’t maintain some work-family balance. 

  • LR,MD

    I gave up my part-time practice because my patients did not have sufficient support on my days off. My patients were sick and on complicated medications. A better alternative would have been a better system to cover my patients while I was off, not to give up my practice, but that wasn’t an option for me. I would not consider going back full time while my kids are young.

    • Lara

      The system is putting people into complicated scenarios by putting them on complicated meds and not truly helping them to get relief of their illnesses, versus trying to actually help them via less complicated means, such as preventative care, which can actually be fun in acquiring the knowledge and beneficial in how one feels. 
      Thanks for providing your opinion and your medical practice experience…which is what we REALLY need to be talking about as well.

  • Lara

    Sheryl Sandberg raises some very interesting points, however,
    Doctors who have children make MUCH BETTER doctors!  They offer the understanding and compassion that many doctors lack.
     
    Also, the public needs doctors who have had life experiences that understand women have several different stages of their lives and maybe these mothers may create a different paradigm due to having the proper time with their children and seeing for themselves the realities of dealing with illness amd how BETTER to PREVENT it, than the current paradigm, which is clearly NOT working to the public’s advantage. 
     
    We NEED doctors who know these realities and who create more effective ways at doctoring.  I implore more doctors to spend time with their families!

    • Lara

      I do agree that the conversation is an important one to have!

  • Thomasmancuso1

    As an MD whose primary care is an MD whose practice is part time, I am very satisfied with the care I receive.  I think the guest MD is going much much too far in her outrageous position.  Many of my partners have part time clinical practices, many of these are female, many of these women are parents and all are excellent, committed, hard working clinicians.  Their choices in their professional and personal lives are theirs alone, not subject to your guests opinions

  • BHA in Vermont

    The medical schools also need to change. I have a friend who is a psychologist. Got her MD 25 years ago. She has never done primary care, never intended to do primary care, but still had to get the full MD complete with surgical training she knew she would never use. Not a smart use of the people and facilities training future primary care doctors.

  • Philippe

    Tom, please ask your quests how much of their time is spent dealing with actual medicine and how much is spent dealing with administation (ie insurance claims).  Wouldn’t this short fall in doctors be alliviated if they could focus on the job of seeing patients?

  • Jennifer Halverson

    If an individual wants to take a space in medical school in residency (that deprives someone else from taking that space), and they utilize tax dollars to fund part of that education then it does seem that they should consider that working part-time may not fulfill the need of taking care of patients.
    I also fully agree that a part-time inexperienced doctor will not be able to provide the same level of care as an experienced doctor.

  • steve

    its a free country 
    if you want to be a part time Dr great we need more educated people raising kids. 

  • Dave in CT

    Sure this tempest in a teapot sells books and fuels talk shows, but as long as a person is not being negligent, I thought the pursuit of happiness, as they define, was the whole American concept.

    Why the micromanagement of adults?

    • Dave in CT

      …..as a Neurobiology PhD pursuing an organic/native gardening alternative career, while doing Mr. Mom.

      How I contribute my biological education and insights in biology to society or community is up to me isn’t it?

      • Robert Riversong

        You’re confusing “pursuit of happiness” with “pursuit of selfishness”.

        Every one of us has a primary responsibility to society – that’s the social contract that makes society possible.

        • Dave in CT

          The difference between socialistic fascism and freedom, is being able to make choices about what, when and how to contribute to society yourself. Everyone is an individual with different circumstances, strengths, weaknesses, challenges etc.

          Who is anyone to to anyone else what is the best path?

  • Ellen Dibble

    From what I heard, back in the 1980s, there were indeed something like the contracts being discussed, at least for my state, where a physician could get scholarship medical education so long as there was an agreement to serve, I believe it was, in the small towns where primary physicians were especially needed — for X number of years.

  • http://www.facebook.com/profile.php?id=100000568330086 Jacob Sommer

    Doctors are not supposed to be inhuman.  They have lives outside of medicine.  If a doctor has children they should not neglect them without good cause and suitable substitution – just like anybody else in society.

    If physicians should be required to spend more time at work to the detriment of their families, they should be paid adequately to properly take care of their family while they are not around.  Skyrocketing malpractice insurance makes this difficult and would drive more doctors away from general practice, which is exactly what we do not need right now.  We are critically short of GPs.

  • http://twitter.com/drphilxr Philip Kousoubris

    I am the male physician in a 2 physician working boston family – both in academics, the wife more so. I wouldn’t recommend increasing hours for either – if you know anything about the increasing regulations and hours demanded of attending doctors – unless you have 2 nannies or a large extended family. Let’s be practical – we have one healthy balanced child – and more would overwhelm us as we work full time. 

  • Robert Riversong

    Should there be a social contract for physicians? I would take it one step further. Doctors, like all professionals who spend hundreds of thousands of dollars on their education and training, perceive their careers as their own and choose the best paying track with the most golfing hours to compensate for the years of investment.

    Let’s instead make medical training free (as in Cuba) in return for a lifetime commitment to serve the community with modest compensation

  • Internist

    I am an internist working 85% time so I can have a few hours a week with my young child. I spend one day a week with him and 4 in the clinic. However, I see more patients per week than most of my collegues in my practice. I am amazed that Dr. Sibert choses to attack women who choose to spend non-clinical time with children. How about hthe more than 50% of my collegues that see patients only 1-2 sessions per week?? Yes they are often working in research and education, however, if Dr. Sibert’s argument about part time workers and the effect on lack of access, it should not matter what a person is doing in his or her non-clinical time.

  • Ellen Dibble

    Maybe Sibert doesn’t know about the extent of flexibility we are getting into.  When I was waiting for surgery for breast cancer (that had spread), my surgeon gave birth.  I went to the next surgeon’s office down the hall, another young female.  Not pregnant.  I had to wait a month.
       Exhibit No. 2, last week…  well, anyway, patients have to know how to play the field.  When to wait for the specialist and hope he isn’t off on his honeymoon, without his PC.

  • Abigail in Cambridge

    argh! This conversation is making me so annoyed. Your speaker says medical students don’t know what to expect; the real issue is that men and women don’t know what to expect when they decide to marry and raise a family; the domestic inequity issues are what raise this debate. If there were as many men who can be domestically capable as women, then this would be a non-issue except perhaps for doctors who marry doctors. Men need to step up to the plate and be prepared to manage home and family and domestic issues as equally as women do.

    • Patrick C.

      As I mentioned in my comments, women REJECT men who seek non-traditional roles.  The men you are referring to – those who don’t do housework etc., are already married.  That’s where a lot of these decisions get made.  AFTER getting married.

      If women want to avoid this conflict altogether they need to make a conscious choice to marry men who will be the primary parent while they work as doctors.  As a single man there is no way you can tell me that a huge percentage of women seek out men with non-traditional goals.  The adage women are sex objects, men are success objects still holds true.  Fifty years ago male doctors would marry secretaries without blinking and no one would question the choice.  Female doctors?  Absolutely positively is not happening to any great degree. When female doctors behave like male doctors did in the past (marrying “down” economically) then this argument about each doing their fair share will be over.

      • Kurt

        Patrick–You are very right. It’s ok for women to opt out of a career for a few years to take care of the family, but a man who does so faces severe “re-entry” sanctions in the job market, too, when he does decide to work more hours outside the home.

        The real problem is inflexible work schedules. The field of medicine could be much more civilized for doctors if there were single payer insurance coverage. Right away, you’d increase the hours available for clinical work seeing patients by nearly 50%. The government could also help spread medical care around more–if we need more primary care doctors, there should be far fewer anesthesiologist (for example) training positions available (and funded by taxpayers). Dr. Sibert should be told to go work full time in primary care–and see how she likes those hours. That women working part time is the crux of the problem is just SO bogus.

  • Deborah Raz

    If the main issue is the shortage doctors providing primary care, why isn’t Dr. Sibert advocating for a reallocation of financial incentives toward primary care and away from highly paid subspecialties.  Women are overrepresented in primary care probably because market forces, as always, are pushing men into the more lucrative specialties… 

  • Samantha Walravens

    @font-face {
    font-family: “Times New Roman”;
    }p.MsoNormal, li.MsoNormal, div.MsoNormal { margin: 0in 0in 0.0001pt; font-size: 12pt; font-family: “Times New Roman”; }table.MsoNormalTable { font-size: 10pt; font-family: “Times New Roman”; }div.Section1 { page: Section1; }

    Dr. Sibert contributed an essay to my new book, TORN:
    True Stories of Kids, Career & the Conflict of Modern Motherhood. Her essay
    in my book talked about how she WAS able to raise 4 kids and practice medicine
    full time—albeit, with a lot of compromise in both directions.

     

    When we discuss women and careers, we need to look at the changing face of the workplace
    today, where the idea of 9-5 office is rapidly becoming outdated.  The model of working husband and
    stay-at-home mother is a thing of the past. Flex-time, part-time and time off for having children is part of the deal. The workplace needs to change, not the women and their decisions.

     

    Moreover, we need to look at the underlying cause of the
    shortfall of doctors today. Is it women dropping out or going part time?Or is it the culture/economics of the medical
    profession—exorbitant cost of malpractice insurance, the fraternity-boy
    attitude and rigor of residency programs, etc?

     

     

  • Debbie

    Call me crazy, but the “moral obligation” is to the patients you took an oath to serve.

  • Stephanie Howard

    I work in Innovation Strategy, and think that an important “problem statement” has been identified by the article’s author.  However, she has not gone through a proper process to open the variety of opportunities to solve the problem, and has honed in on one (unrealistic) solution.  If the problem is that in certain areas of medicine (i.e. general surgery) there are not enough experienced doctors being trained, the training system needs to be re-designed.  There are multiple ways to do this, and processes to guide the stakeholders to various solutions.

  • Kate

    As a recent college graduate with many friends in medical school, I am surprised by Siebert’s assertion that there is any sort of “moral obligation” to be a physician after attending med school. Medical school seems just one of several options that people from my socio-economic/academic background face–JD, MD, PhD. It is a very expensive investment which pays off with the reward of a medical career. There is a perceptible sense of entitlement to these options due to the hard work we put in in high school and our top 10 colleges and universities (though I’d argue it’s more our backgrounds than our work ethic that got us here). If you choose not to use your degree after a while, I’m pretty sure we’d all say we have that right. Getting an MD is just another rung in the achievement ladder. Would a criminal defense lawyer have a “moral obligation” to keep practicing law because he or she is keeping innocent people out of prison? That just sounds absurd.

    • JonathanTE

      Kate, I don’t follow your argument. It sounds as though you are saying, “Because high-achieving students have medical school available to them, there is no moral obligation for students who make the medical school choice to then follow through and utilize their medical training.” This is a non sequitur. If there is a moral obligation to practice medicine (or do related work promoting health care, as Dr. Sibert reiterated numerous times), then the obligation exists regardless of the fact that the prospective medical student also had law school as an alternative career option. Unquestionably, trained doctors have a legal right to practice medicine or drop it. That’s a different question than whether or not there is a moral obligation to use medical training. People need medical care. Some moral perspectives (including, clearly, Dr. Sibert’s) conclude that health care is not like the average “good” in a market system; unlike french fry producers, for example, those with the ability to provide care do have a moral obligation (within limits) to act upon that ability. Why a person chose to enter the medical field is mostly irrelevant to the question of obligation once in the field. Alternatively, one could argue that there is no moral obligation whatsoever, but again that would have nothing to do with why a person enters the medical field.

    • Michael

      Kate, your self-centered mindset is at the crux of the issue. We shouldn’t be wasting scare educational resources on those “people [like you] from [your] socio-economic/academic background” who feel it’s simply a choice to be made from among others available to those of your privilege, and that there’s no further issue here than you/their right to pursue the career in question or not. This is about a profession with a tradition of being practiced for the needs and ultimate benefit of others, a profession for which we have a dire need, and, alas, a dire shortage. The moral obligation comes from callously taking the scarce educational resource and choosing to not put it to its intended use, but to simply, outrageously!, view it as “another rung in the achievement ladder.”

      • Kurt

        I agree with what you say. So plastic surgeons who just do boob jobs, nose jobs, and butt and tummy tucks — even though they may work full time–are also being morally negligent, since they’re cosmetic, not medical practitioners (I’m not talking about plastic surgeons who treat trauma patients or those who treat people disfigured by disease or malformations from birth). Dr. Sibert doesn’t mention those. Or the anesthesiologists who only work with cosmetic surgeons. If the issue’s primary care, then put a moratorium on subspecialty training and slots in med schools for such.

  • Ifn_gamma

    Dr. Sibert says her kids aren’t axe murderers.  Gee, congratulations on that!  But some of us have higher goals in child rearing.

  • Samantha Walravens

    Dr. Sibert contributed an essay to my new book, TORN:
    True Stories of Kids, Career & the Conflict of Modern Motherhood. Her essay in my book talked about how she WAS able to raise 4 kids and practice medicine full time—albeit, with a lot of compromise in both directions.

    When we discuss women and careers, we need to look at the changing face of the workplace today, where the idea of 9-5 office is rapidly becoming outdated.  The model of working husband and stay-at-home
    mother is a thing of the past. Flex-time, part-time and time off for
    having children is part of the deal. The workplace needs to change, not
    the women and their decisions.

    Moreover, we need to look at the underlying cause of the
    shortfall of doctors today. Is it women dropping out or going part time?Or is it the culture/economics of the medical profession—exorbitant cost of malpractice insurance, the fraternity-boy attitude and rigor of residency programs, etc?

     

  • Printplex

    Dr. Sibert is to be commended. The earlier woman physician caller who started by saying that she loves her part time situation is the other — self-centered — extreme. As the son of a late 24/7 old-time family doctor and obstetrician, whose patients ALWAYS came first, who would answer calls in the middle of the night, and see patients whenever they needed him, I have a different understanding and appreciation for the physician’s moral obligation. At issue primarily is the limited resource of educating and creating doctors. Why don’t these people get that it’s not about THEM, but about the age-old moral imperative of caring for the patient? 

    • Kurt

      We could build more medical schools and fewer football stadiums at our universities and then have enough seats to train the doctors we need. The money is there. It’s a matter of priorities. Once trained, doctors have a moral obligation to treat patients, yes, but with more of them working, they can work fewer hours individually and still care for more patients. Docs can also “share” patients, so that a patient will see only one or two alternative docs within a practice, and all of them will eventually know him or her, so if the main doc isn’t available in the middle of the night, somebody who knows her/him and her medical condition can also treat him/her knowledgeably and well. The 24/7 model is outmoded and a recipe for burn-out. You father could do what he did back then because there were so few insurance hoops to jump through. Doctors today are clamoring for single-payer insurance because then their time will finally be freed to attend to patients and not to paperwork. That is where the real waste of talent lies.

    • Crow1128

      This is absurd. You are saying in order to be a physician one has to sacrifice 100% of one’s life? If you can’t live a satisying life for yourself, you can’t be any good to others……I agree with an earlier posting that this kind of talk will scare of potential newcomers to the field.  A secret in life:  don’t be judgemental toward other people. Everyone has their own path. Walk your own and allow others to be who they are. You will live a much happier life.

  • Samantha, Buffalo, NY

    I think it’s not just in medical field that it is hard for women to come back from an extended maternity leave. I think we need a better maternity leave policy, versus non-existent one that we have now.

    If women were able to take 1 year off, then come back, slowing, part time to their jobs, and increase her involvement in her career back to full time over time, that would be great.

  • Sgates22

    Outrageous that this one MD mother who has chosen one of the highest paying, best lifestyle specialities herself, now has the nerve to publically denounce MD moms who work “part time!” Bringing up our next generation to be compassionate, competent people is also of utmost importance, and a nanny cannot usually replace a parent in this.
      That being said doctors do have a moral obligation to do the best for their patients, including arranging good care when they are not available, and not all doctors can work the 70-80 hours a week which constitutes full time, year after year after year…so the solution of course is in the system! (Anyone who studies health care delivery can tell you this). There are practices where medical records can be accessed from home, where doctors do a good job covering each other. These are the practices of the future. The kind of stone-throwing to which NPR is subjecting us, especially from those who live in glass houses themselves, has no place in the debate.

  • Russ Weis

    For years I’ve wondered about how we train doctors in this country. For instance, are the many sleepless hours during residency absolutely necessary? I’ve never gotten any good answer to the question of why we limit the numbers of doctors-in-training so stringently. Sure, we want only the best and most committed individuals, but in the light of the apparent M.D. shortage, are we not doing ourselves a disservice by not focusing on what appear to be systemic problems of supply and demand, rather than by placing the onus on individuals to work x amount of hours?

    • Nkanafan

      Well said.  There is insufficient funding of physician residency training programs to meet supply needs and lack of commitment to meeting the needs of our nation’s health.  The solution is not to ask doctors to NOT QUIT THAT DAY JOB.  What a short sighted view Dr. Sibert has. 

  • Lara

    I have the respect for women who choose to foster and nurture their children even more so than those who choose to foster only their career!

    • Crow1128

      I have long believed that women with such advanced degrees and the correlating high-status they are regarded with in society—-who then choose to stay home to make their children their priority—they are TRUE HEROES!

  • Samantha, Buffalo, NY

    Also, while on this extended maternity leave, women need to stay involved in their jobs. Maybe working on smaller scale projects, or several hours per week.

    I asked my employer to work part time from home while on maternity leave, and was told no. They would rather not have anyone working, than have someone contributing at part time level.
    It’s SAD!!!

    Policy and company’s policies need to change.

  • JonathanTE

    Several callers and guests seem to be reacting to Dr. Sibert by arguing that individual circumstances make part-time work a good choice for particular doctors, as though Dr. Sibert were saying that no doctor should ever work part time. As I hear her, she seems to be arguing that the moral obligation to do the work of doctoring is an important factor that fellow doctors should consider. She’s not saying that this obligation trumps all other factors, only that it is a serious factor that many fellow doctors may be ignoring entirely as they choose their career path. If all doctors do consider the moral obligation to their career, some of them will still choose part time work, and appropriately so for their situations, but others who would have chosen part time work without considering the obligation will come to a different conclusion and will put more time and effort into their doctoring.

    • Nkanafan

      Nonsense again!  Stop making excuses for her.   The content and message of her essay is clear.  Physicians on the whole are guided by the care of patients first, and don’t need you are anyone else telling them about moral obligations to their career!  If they feel they can provide the best patient care and work part time, fine!  They don’t need to feel morally obligated to work full time and see the most patients possible in the increasingly short periods of time we have to see patients!  

  • Lara

    She was definetely addressing women in her message!

  • Samantha, Buffalo, NY

    I originally posted that we need to have an extended maternity leave policy where a woman can take 1 year off and then slowly come back into her previous job on part time basis and slowly increase her involvement to full time work.

  • Steve

    The issue is not about woman doctors.  The issue is why our society hasn’t done more to provide day care for working parents, and dare I say, patients.  We have encouraged women to enter the workforce at all levels but done very little to support single parents or two-working parents.  Medicine, of all fields, should be helping with this given the demands of the profession and the number of women engaged in the field. We need to shift the focus from individuals to our shared responsibility.

  • Betsy Pinkston

    I am a female pediatrician in solo practice who has raised 3 children with the help of a very supportive husband. Both of us have rotated on and off by working occasionally part time, mostly full time, and in my case at times 60 hr weeks. I just happened to turn on this program on a morning off. I truly believe that it is important for medicine to be flexible enough for both parents to work reduced hours when it is needed to care for children.  It would be impossible for both parents to work 60 hr weeks and provide adequate support for the children.  At the same time I lost a part time pediatrician married to a full time physician who chose to give up even a minimal part time job to stay home with her children.  That I feel is not fair to the many qualified candidates who would have loved to go to medical school and were unable to be admitted.  I do believe there is a moral obligation to practice, but not necessarily full time. 

  • Rosey

    Hi, Tom,
    I think it is hard to take seriously Karen Sibert’s “words of wisdom” when she has already raised her kids, and chose a field with flexible hours, with no ongoing patient care (i.e., no need for calling patients back) before she had 4 kids. She sounds smug, and as though she’s going for a headline. She would likely approve of our career routes: my husband & I completed our training about the same time she did, &  actually had established careers before we became parents, at which time my husband & I both decreased our hours to roughly 35-40 hrs. per week, plus occasional night & week-end call, with no outside child care until pre-school. But I think she not-very-convincingly sidestepped your assertion that she scapegoats only women physicians, and also conveniently ignores some key points: (1.) What is the definition of “part-time” in medicine–it usually means 30-40-50 hours per week, not 20. (2.) Also, how is the system supporting the best use of physicians’ time? One of your callers sounded as though she would much prefer her doctor being reimbursed for patient phone calls, rather than the doc satisfying the myriad administrative demands of multiple third-party payers? Is that caller willing to pay for same-day call-backs for non-emergency consultations with her MD? She prob. shouldn’t have to make that choice, but someone has to cover that cost, one way or another (for example, the MD “pays” perhaps by joining a bigger group, spending less face time with patients, to allow for non-reimbursed call time, etc.). I’m not talking about big salaries for MD’s, I’m just wondering who pays & how we pay for the services & access we want & expect. (3.) Who are the part-time anesthesia “providers” she described as providing less quality care: are they only physicians? Do they include nurse-anesthetists? And what were their hours? She reminds me of the “Tiger Mom” brouhaha, except that Amy Chua’s book actually held somewhat more nuance than did her “headlines.”

    • Internist

      Agree! Lest noone reading this discussion think that part time is 20 hours a week. I am 85% time and still work 50+ hours a week not including overnight and weekend call.

  • Angela

    This is not just an issue in medicine, it’s across professional fields. The worry is that women have taken spots in schools and in companies and then have not paid back those investments to their professions and those businesses. I read a story about the fact that there were no female sushi chefs in Japan because no one wants to invest the training in an employee who will have children and leave the profession. Make no mistake about it, equal opportunity laws are not a protection. As an employer and a mother, I know that the high cost of labor makes businesses consider their ROI on a female hire. I worry that eventually, this will have a backlash– or perhaps the $0.77 that women make per dollar of men’s pay is exactly that tax.
    I also worry that not enough women care beyond their personal circumstance to stick it out through the tough times for the long term good of their professions and future opportunities for their daughters…

    • Paul M

      But, but, but …. it’s true! They do exactly that! A sushi chef has got every right to take that into account before investing years passing on his skills to an apprentice.

  • Dave in CT

    OT

    Rand Paul and Dennis Kucinich on CNN

    10 Congressmen, Including Paul, Sue Obama Over Libyan War; Update: Rand & Kucinich on CNN

    http://www.dailypaul.com/

    Just more evidence that the mainstream Dems and Repubs are a corrupt, corporate, military establishment and that real change, broad enough to reach America, will only come from a progressive/libertarian alliance.

  • Arden W.

    What a fabulous hour of programming.  The op-ed piece did create a firestorm and I
    am happy to see the conversation continue in an intelligent, meaningful way.  I want all doctors to be satisfied in their
    work – and I would love to see this discussion make its way to Washington to see some
    real change.

     

    As a member of the sometimes vilified healthcare
    administration world (I am an analyst for the operating rooms at a hospital in New York City) I have
    tremendous respect for the sacrifices and commitments made by doctors.  But perhaps I am biased, Karen Sibert is my
    mother.

     

    I am so proud of you, Mom!!!

  • Tmtwomey

    I would like to know who cared for Dr. Sibert’s children when they were infants.  When I was trying to “balance” infant-to-be with career I did not find workable, flexible full time or part time work.  I asked countless mothers that I met who were working who was caring for their child(ren).  The answer – a family member, usually their mother.  Well, that’s great if that is available.  
    As far as moral responsibility goes, I think we have a moral responsibility to our children and to those who care for them.  We need to value parenting and other forms of child care.  We need to stop treating parenting as a “hobby” that does not add value to our society at large. 
    And we need to stop pretending that SAHMs are only those whose spouses make large amounts of money.  Many families with modest incomes (ie: $45,000 yr) choose for one parent to stay at home while the children are young  — because they believe it is what is best for the child(ren). 
    If we really valued parenting, we would have much more flex time, part time options, SAHParents would not face a stigma or have to find a way to cover the gap in their resume, we would facilitate re-entry into the workforce for those who did choose time at home with the children, and more men would want to do it.
    Furthermore, it isn’t a matter of lack of resources — it is a matter of priorities. 

  • Judith

    Oh, I have a lot so say on this topic…

    I graduated from Dartmouth Medical School in 1992, trained there in General Internal Medicine, and practiced for 10 years before circumstances made taking time off the right decision for me.  When my son was born in 2001, I made the change to part time.  Overall, it was a great situation- really the best of both worlds, made easier for me since I’d worked at the institution full time for 6+ years and was a known entity, and had partners willing to cover my work on my days off.  However, as time went on, resentment among my partners did build, and I found myself more and more often coming in to the office on my “days off”, often with infant in tow, to check lab results, make phone calls, etc.  The pager was never off, and I ended up doing close to full time work for half the pay.  Primary care is difficult to do part time: patients, their problems, lab results, test results, etc. don’t go away when you’re out of the office. 

    When my son was diagnosed with autism, we relocated to MA. We had a 3 yr old with a devastating diagnosis and an infant daughter.  Negotiating a new city, special needs services, IEP’s, and the emotional and logistical havoc that autism threw us into was all I could handle- there was no way I was going to look for the perfect part time job as well.  As time has gone on, I’ve found myself reluctant to delegate the care of my children, especially a 10 year old with severe disability, to a hired assistant.  That is somewhat of an emotional desicion on my part.  But the downsides of going back to work make it easier to justify: it is hard to be a GOOD primary care provider if one doesn’t have good and reliable coverage, and the hassles of paperwork, documentation and coding requirements, and insurance regulations has, to many, begun to eclipse the rewards of patient care.  And then there’s the diminishing compensation.  Why on earth would I double the work and stress in my life without fair compensation that would cover the significant cost of the care of a special needs child?

    I regret not using the skills I worked so very hard to acquire in medical school, residency, and the early years of my practice. (I did, however, fully pay off the 6-figure student loan it took to get me there.)  But I am glad I chose the path I did- the human body is fascinating!  I think “moral obligation” to practice medicine once training is complete goes a bit far.  My moral obligation is, first and foremost, to the children I brought into this world.  Any obligation to serve the people of this country with the skills one acquires in medical school would be a whole lot easier to justify if the government were to foot more of the astronomical cost of medical school.

    Working part time can work, and may represent the best of both worlds for many.  Job sharing would be ideal: 2 practitioners share a panel of patients and split the days of the week- then patients are covered, and time off is really time off.  Streamlining documentation and coding requirements and insurance paperwork, as well as improving the ridiculous reimbursement rates out there, would go a very long way toward drawing some of us back.

    I fully intend to enter the practice of medicine again.  Just waiting for the right job.

  • Robert Riversong

    The real issues here
    are much more broad and systemic.

     

    First, we’ve created
    an inordinately complex and expensive medical system based on extremely
    technical training and high-technology and pharmaceutical-based treatments – a system
    which works well for acute and surgical intervention (and the Pharma
    corporations) but very poorly for chronic care and more poorly yet for
    preventative care. No one, neither patients nor physicians nor society, can afford
    such an excessively sophisticated system.

     

    Second, we’ve made
    an overly-costly medical system even more unnecessarily expensive by installing
    for-profit insurance companies in the middle, requiring inordinate amounts of
    time wasted in paperwork and administration of medicine.

     

    Third, we’ve made
    medical education excessively long, demanding and expensive, which almost
    requires a career track into the most lucrative specialties as well as a sense
    of entitlement.

     

    Fourth, modern
    feminism has diminished the value of child-raising as a primary commitment
    while elevating the more lucrative professions in the eyes of young women (and
    society continues to denigrate the men who choose to be stay-at-home dads).

     

    Fifth, we’ve
    tolerated a debt-based economy and lifestyle which now requires two money earners
    (at least) per family and creates impossible dilemmas when that conflicts with
    child-rearing.

     

    And sixth, we fail
    to realize that the world of today simply cannot afford more upper middle-class
    children who consume the preponderance of the world’s material and energy resources
    while having the lion’s share of impact on a global climate which is
    approaching catastrophic limits. We need, in other words, to understand that,
    in the affluent world, we have a moral obligation NOT to bring more human
    biomass onto this finite planet and that personal satisfaction can be achieved,
    instead, by commitment to the basic needs of society.

    • Robert

      Apologies for the formatting SNAFU. I wrote this in WORD and cut and pasted it into the comment box. It didn’t look like this at that time.

  • KM

    I hope I’m one among many to make this point: Most work is not family-friendly for any parent. It is a function of class privilege that any parent can afford to cut back work hours to devote more time to parenting. Doctors are among the upper classes in status if not salary and benefits. The number of women and men who would cut back hours is much higher than the number who do: most can’t afford it lose health care if they do and thus again, can’t afford it; know that to do so damages their future career path; aren’t supported by family/life-balance friendly work policies. The suggestion that doctors not work part time or that they be discouraged from doing so is a step backward. What we need is a new mindset about work-life balance, about parenting, etc. Of course many women docs cut back hours after residency. The hours required in residency are brutal and ridiculously so.

    PS I am married to a resident so my perspective is grounded in real world experience. I’d be happy if my wife could afford to work part time but student loan debt won’t allow for that. Again, class privilege in the mix.

  • Dave

    I tried to call into todays show about part time physicians but could not get through. As a MALE physician who has chosen to work part time to spend more time with my nine year old daughter I wanted to beable to comment. I did have one question for the producer and host though. As in many media outlets I feel that the listener should begiven more info about the “expert”. I had read the article in the NY Times and my first question was “what is this woman’s agenda”. Everyone has opinions (and there is a rude saying about a body part we all have also) but how is that HER’S was published as an op-ed in the Sunday NY Times. Is her husband on the board of the Heritage Foundation or something? Is she planning to run for public office? And althoughI don’t think he needed to be overly invasive couldn’t the host have at least asked what her husbands job was and how many household help they employed so she could work full time with 4 children. Having lived in LA I know that EVERY physician with children there hasa hispanic nanny/housekeeper (usually live in for the wealthier doctors).Dave Shapiro, MDBuffalo, NY-anima sana in corpere sano

  • Anonymous

    i listened to this story today on NPR. The women doctors were calling in to voice their opposition to the article; each and every one of them expressed the very same sentiments… “it works well for ME, I have less stress in MY life working like this” it was all about ME MY and I. not one of them had a word to say about those they serve…. their patients.

    Do it all the way or not at all. you Can’t have it both ways.

    • Rachel

      I’m pretty sure if your doctor is happy and well rested you will receive better care than if your doctor of sleep deprived, stressed out, and unhappy. I would prefer the doctor that takes care of their own health first. You are of no good to anyone if you aren’t good to yourself first.

    • Anonymous

      intolerance served up cold and raw.

    • Nkanafan

      Nonsense!  See my comments above about my wife.  You are clueless.

    • DRemmy

      Maxbianco- I disagree with you. Increasingly, with work-sharing and other similar initiatives, physicians are working in teams. If you went to see your primary care physician, you probably wouldn’t know if they worked ‘part-time’ (by the way, part-time in this context means 40-50hrs per week!!!) You also wouldn’t know that your primary care physician presents your case to several other ‘part-time’ colleagues. In the end, you end up getting several sets of trained eyes making sure that nothing about you (medically) falls through the cracks. 

      Such a system can be implemented in numerous fields of medicine. And it’s an all-around better system. There are only a few fields where this is difficult to implement- primarily surgery. In surgical fields, you have to practice, practice, practice! Since that only comprises a small fraction of the physician work force, I would urge to re-consider your “Do it all the way or not at all. You can’t have it both ways” comment.”

    • Robin

      Good grief, I am one of those female physicians who called in.  If that is what you took away from my input, then you really were not listening.  Yes I said working part time was manageable for me, but I also said it was better for my patients and my family.  Frankly, I think a refreshed physician is better any day of the week than an overworked tired burned out physician.  By being mentally and physically fresh, my patients are getting the best out of me that I have to offer.  So is my family.  So yes, I did say “my” alot… my patients, my family, my physical and emotional well-being.  Sorry if those “my’s” seem selfish to you.  Actually, part time MD’s are often the least selfish, the least greedy, , because they are willing to sacrifice half their income and take their careers off a fast-track to do what they believe is right for their loved ones.  Guess we all have different ideas about what it means to be selfish.

    • Terry Tree Tree

      WHY NOT?   CAn men not have it both ways?  NO male doctors do part-time?  NO male doctors have families?  NO male doctors CARE?

  • Adell Nguyen

    I think Dr. Sibert is crazy — too young!  She wants to take us back to the days when women were denied opportunities in all kinds of work because “you’ll just get married and leave.”

  • Jessie

    I whole-heartedly agree with Dr. Sibert that people should not take the
    decision to enter the medical profession lightly. But that said, there is only so much that a person can know about an experience before actually going through it. A 21 year old
    college senior cannot possibly know what it is to be a 38 year old full
    time working mother. When the time comes, she may find that she is able
    to gracefully balance a full time career and several children as Dr. Sibert claims
    to have done. Then again, she may not. Anyone who thinks that at the age of 21 she knows which of these camps she will ultimately fall into is likely a fool – and should not be considered for medical school.

    Women now make up approximately 50% medical students and presumably the majority of them hope to someday have children. I fear that if Dr. Sibert makes her point too stridently, she will plant seeds of doubt in the minds of bright women who are
    interested in both medicine and a family, scaring them away
    from the profession altogether. If Dr. Sibert’s primary concern is the
    shortage doctors going forward, she will have accomplished nothing but
    undermining her own cause.

    I am not persuaded by the argument that we the taxpayers are “owed”
    something by doctors whose residencies we have paid for. By that logic,
    we are also owed something by every person who attended public school or
    public university, for we have invested heavily in their educations as well. Knowing that 1) the majority of people who become doctors will want to have children and that 2) children are time intensive endeavors, the only realistic response from the public is to anticipate that a certain percentage of doctors will become part time for a portion of their careers. We should build this fact into our economic models of paying for medical training. 

    Lastly, if we are to speak of doctors having a moral obligation to practice in some particular manner, I agree with other commentators who have written that it is a far more compelling case to argue that doctors have a moral obligation to work in low prestigious high need fields such as primary care or in low-income, rural or inner city settings. I also believe that doctors have a moral obligation to be well rested and mentally alert. If working part time allows them accomplish that goal, then it is well worth it. 

      

  • Andrea

    Anesthesiology – try working in the trenches of primary care – sorting out multi-organ malfunction  in non-compliant patients over long periods of time  – seeing 30 plus patients a day, managing the business end of a practice – nursing homes, hospital, office care – and NOT getting paid the big bucks that anesthesiologists typically make (they are usually the only Porsche owners in the hospital parking lot here) -If America needs and wants more physicians, let us tax millionaires, hedge fund billionaires at a higher rate, then plow those dollars into funding education and more residency slots for the dedicated and smart men and women who spend years studying before they ever see a real pay check – And then, pay the ones who go into primary care and general surgery more than the gucci loafer, sports ca, nanny hiring anesthesiologists  – just because we dedicate our lives to patient care does not mean we lose the right to choose the balance that works for our loved-ones –

    • Robin

      I thought the exact same thing.  Anesthesiology – ha – is the field that doctors go into when they don’t want to have to deal with patients.  (And most of them will admit that to other doctors, even if not to their friends). Most of their patients are totally unconscious the whole time and they read the newspaper in the operating room, no joke. 

      • Sam Wilson

        Robin,

        I didnt know that Anesthesiologist get paid that handsomely. In fact while standing in an OR during2 C-Sections, I thought he was the least paid guy in the OR.

         

        • DRemmy

          You should checks the stats regarding physician pay. In an operating room, every physician (anesthesiologist, surgeon, Ob-Gyn, etc.) present is getting a higher pay than primary care physicians. With that said, there’s a saying in medicine that when you consider what field to practice in, there’s always the ROAD…radiology, opthalmology, anesthesiology, and dermatology. Relative to almost every other field of medicine, the ratio of earnings-to-hours worked is VERY desirable. The surgeons who are present in an operating room actually have a less favorable ratio- I believe that this is what many commenters are driving at.

    • an anesthesiologist

      Again–it’s time you went into the OR to see what it’s really like as an anesthesiologist. We don’t just “put the patient to sleep and wake them up again”. We spend long, LONG hours managing the perioperative care of, very often, extremely sick patients. It’s insulting, and divisive, to put down one medical specialty over the other by saying “poor me, see how hard I work.” We ALL work hard and we should stick together. For the record, I own a Honda Civic, live in my scrubs, and wear running shoes.

      • Terry Tree Tree

        An anesthesiologist caused this attention on you, because she evidently thinks family is unimportant! 
           If your post is true, I thank you and admire you.  Other physicans on here have had FAR different experience with some of you.

  • Anonymous

    I love both my children’s pediatrician AND my ob-gyn because both are mothers – whether they took time off when their children were young does not matter to me and I can’t see why it would make them any less effective.  To the contrary, having experienced childbirth and child-raising adds quite a bit of value to their roles and in my opinion has made both of them highly effective medical professionals.

  • Robin

    What really needs to be addressed is adapting the current primary care model to facilitate part time work.  I am “the happy part time doctor” that called into the show.  What I did not have time to say, is that I job share – so that when I am not at work, my partner covers for me entirely, and vice versa.  Our patients know both fo us equally well.  It allows me to be at home knowing that work is not piling up on the desk, and that patients’ needs are met.  Furthermore, as colleagues, we bounce ideas off each other and I think our patients get the benefit of 2 physicians thinking about their problems.  We have a great part time system that addresses the concerns some posters have about follow up and availability.

    • Judith

      I agree completely- job sharing could be a great solution for many (see my earlier comments below). Primary care medicine is VERY hard to do part time, but what you are describing is sharing a full time position, which to me is very different. I believe that arrangement makes ALL the difference between being a “happy part time doctor” versus one who either is compelled to work many extra hours to do the job right, or is worrying that patients and their lab/test results are falling through the cracks.

    • Terry Tree Tree

      GREAT SOLUTION!!  Much better than the AMA’s keeping Malpracticers killing and maiming people, insurance companies adding to the codes designating type of care, over-worked medical people making more mistakes, and such!

  • Guest

    While all physicians are physicians, different specialties require very different skill sets and have different demands. I don’t believe that any future policy regarding the working hours of physicians can lump all of these specialties into one. 

    Furthermore, I know many doctors that do not work “full time,” but who spend a good amount of their non-work time volunteering for free clinics. Options for more flexible work schedules for doctors may allow better access to healthcare for some people by freeing up some time for those doctors to volunteer. 

  • Birdseye

    In the increasingly feminicentric hand-wringing over the balance of work and parenting, it was refreshing to encounter again this afternoon a female’s commentary from several years ago in the St. Pete Times. It reminded me of an exchange between a woman and man I overheard recently, when the woman asked “How come nobody ever hears men agonizing over the career/parenting balance?” The man responded, “Maybe because nobody ever told men we could have it all.”

    Here’s the piece:

    By ROBYN E. BLUMNER
    St. Petersburg Times
     About five years ago, a friend of mine left her job as a partner in a large law firm — a job she had been dissatisfied with anyway — to stay home after the birth of a daughter. Her husband, a law professor, suddenly became the couple’s sole support.

    I have often wondered about this arrangement. Deep down does the husband enjoy the new division of labor? Is it really okay with him that he went from being half a power couple to being the dad in Father Knows Best? Society may accept the choice of a professional woman to shuck it all to spend time with her children, but is this what today’s men bargained for?

    The women’s movement’s promise to men was if they scootched over, gave women economic opportunity and offered to take on parenting and household responsibilities, they would, in exchange, be welcomed into the nursery and relieved of the sole burden of supporting a family. Yet, in the real world, women are not so ready to let men off the financial hook or to relinquish their role as primary parent. Women want the choice to leave the work world when motherhood calls (or when work becomes unsatisfying or too demanding) and they want their husbands to be there to pick up the income slack.

    That choice is rarely seriously offered men — a double standard that I believe is the reason the last vestiges of employment discrimination exist. After 30 years of women competing in business, they are still more likely than their male colleagues to treat work as a secondary consideration, seeking to cut down on hours, travel and responsibility after children arrive. In a two-earner family, who is the one who stays home with a sick child? Inevitably employers draw on that experience — consciously or not — in hiring and promoting. Why do you think the most successful women in corporate America tend to be childless? Nearly 50 percent of top corporate women don’t have children, compared to 19 percent of men in that category. Childless women rise in the corporate world because they don’t have family competing for their attentions. Women with children often choose to leave work or step off the fast track.

    And don’t blame sexism. The men only get to “have it all” by becoming a remote presence in their children’s lives — something women don’t want for themselves. We’ve all heard the classic grumble of professional women that they need a wife too. But it is a bluff. High-powered women don’t seek husbands who will play that subordinate role.

    These conclusions are not just my own observations, but are documented in the book “Flux: Women on Sex, Work, Love, Kids & Life in a Half-Changed World” by Peggy Orenstein. Starting in 1996, the author spent years talking to college-educated women of various age groups across the country. She uses the term “half-changed world” to describe the way in which women have staked their claim in the workplace while retaining most of the child rearing responsibilities. Orenstein discovered why that is. “Young women like to talk about an ideal world,” writes Orenstein of the myriad twentysomethings she’s interviewed. “In an ideal world they could be anything they wanted to be without being limited by sex. . . .

    When pressed for details about how they imagine child care working on this decidedly non-ideal planet, however, women revealed that they expect — and often even wanted — the responsibility to fall squarely on themselves.”

    Orenstein offers the case of Abbey Green, then a go-getter at DC Comics in New York who was resisting marriage to her boyfriend who worked there as well. Green admitted somewhat sheepishly that her reluctance was due to his limited earning potential. “Somewhere in my unconscious,” says Green, “I have to admit, I thought that when I settled down and had kids, I wouldn’t have to work.”

    In chapter after chapter, Orenstein documents the traditional demands women intend to make and do make on the men in their lives. She says experts have found that “the more conventional a couple’s division of labor, the less satisfied they are with themselves, their relationship, and their role as parents.” Yet it is women — educated, professionally successful, and ostensibly liberated women — who are pushing for this paradigm.

    Apparently, what today’s women want isn’t all that different from what their mothers wanted. Other than having their choices couched in feminist parlance and having had a flirtatious dalliance with ambition in their 20s, women still want the luxury of relying on their husband’s income and having their children call to them — not their husbands — for comfort after a nightmare.

    Nearly every woman Orenstein spoke with understood that independence and equality in marriage and society comes from generating an income — and a superior one at that. But those same women, when pushed, admitted to desiring the dependent role.

    There was a time when the law, patriarchy and entrenched sexism kept women from economic achievement. Now, the greatest enemy to equality is women themselves, and it turns out the gender stuck with the rawest part of the deal is the guys.

    • Michelle

      I think a lot of what is said here is true. But it is said from a decidedly misogynistic undercurrent.  We are all, always, exploring the possibilities–call it Evolution if you will. 

      You can’t blame the women of the early 20th century for wanting the freedom to enter the workforce.  Because they hadn’t had it before, en masse, they had no way of knowing how it would turn out. All they knew at the time was that they felt stifled, limited, and rightfully so.

      The women of the early 21st century now know that having a full-time career and a family can also be stifling.  Part of the reason being that truly supportive support systems for families haven’t been created along with the rise in female workers. 

      But there is also nature to consider.  Most women DO have a strong need and desire to be near their children, it’s biological.  And often the strength of that need can surprise the most “liberated” among us.  I don’t think it’s helpful to blame women, as this article and book do, for wanting it all and then realizing they can’t really have it.

      And I don’t really think men, real men, mind having their wife and children financially dependent on them–that’s biological too. In my experience, men are happier when they know they have a mission and they feel respected for their contribution to the family. It seems to me that the husbands of the high-powered women are the most miserable.  Their wives expect them to earn, earn, earn, and then come home and fold the laundry and read bedtime stories.  I think that is why you find so many of them looking defeated and exhausted–because they ‘don’t get no respect’ from their equally-earning wives.

      • Guest

        Misogynist? the comment you are responding to makes excellent points – it is your comment that is an excellent example of your appalling misandry – you even use that vile phrase “real men”.

        You have women who believe that men and women are essentially the same and that any difference, apart from the obvious, is a ‘social construct’. It’s insane. You on the other hand prefer the more traditional view that men and women are different .. but you think it’s still fine for women to play around with “choices” as if this is not the case.

        You think that we shouldn’t blame women for wanting everything and then finding out they can’t have it?  You know what that shows – women are spoiled, selfish children who cannot be held accountable for their actions. It’s all shrieking demands for equality – but not real equality – only the things that suit while cheerfully accepting any special treatment, and demanding more, at every opportunity.  More women in course? Fine. Quotas, funding, sponsorship just for women – also fine. It’s not sexist at all to discriminate against men, is it?

        Our legal and social systems support women in making any choice they want – have a child, or kill it, have a job or expect someone else to pay for things – what choices do men get?

        As a part of this – Women also get the “pass” for behaviour that gets men locked up – still no demands for equal sentencing are there? Women want equal numbers of top roles and positions – yet make no demands for equal numbers in any of the dangerous and disgusting jobs that men do.  No, instead men are told to “man up” and put up with even more crap.

        While you’re “exploring the possibilities” you ignore simple facts. There are a finite number of jobs and university places – if you have a woman who takes one of these so she can play at having a job only to drop it when she feels like it to pop out some brats – you rob someone else of that chance.  Man or woman – someone else could have done more, saved more and made the best use of the opportunity.

        • Terry Tree Tree

          As a man, I DISAGREE totally!!
              Men had ALL the work advantages, for CENTURIES!!   Many men have dumped their family obligations, and families, for the ‘free’ life.  The un-educated, un-employed wife, THEN has ALL the family responsibilities, with NONE of the advantages!  The children SUFFER!!  That causes a lot of children to go bad, making MORE of the dead-beat dads(?), increasing the cycle. 
               Tell me that some men don’t change careers, occupations, or their mind about how much overtime they are going to NOT work, in order to become a better parent!

  • Diana Marsh

    When you consider how many students receive federal money/grants, isn’t this a bit ridiculous? Because medical docs are in demand, is there any less demand for other highly trained individuals?  How about bioengineering, environmental engineering, etc.  To propose that female docs owe society more  than other skilled professionals says a lot about the author’s sense of self!

  • Doc62186

    I’m a somewhat shocked about the strong reaction to this article. I have been a member of the bat sh*t crazy club of MDs for what is considered to be a very short time, yet I very early on came to terms with the fact that this field is permeated with the egotistical madness that drives people to write essays filled with the pomp and unjustified indignation as Mrs. Silbert has done here. I’m not saying that everyone is like this, but if you really went to medical school you cannot say that you’re surprised to find that there is a physician with marbles loose enough to honestly believe she’s better than everyone around her and that she would scream as loudly as possible from atop her cyber podium in order to make sure that you all knew. God I hate doctors…
    -MD from MA
    YA BROOINS 

  • white noise

    I guess I do have similar concerns to Dr. Sibert. I don’t have the answer, but while some might argue how part-time work affects the QUALITY of work(although in surgery error rate correlates inversely with experience with a given procedure), clearly we need more QUANTITY. With that in mind, if we as doctors want to improve health, we have to be concerned about the quantity of care we can provide. The people I encounter who talk about balance definitely provide less quantity. It is quite painful to balance the care for your patients with the care for your family, but we shouldn’t pretend that we aren’t sacrificing one for the other.

  • Diana Marsh

    Sorry some of you out there hate physicians because 95% of physicians have worked hard and are dedicated to practicing medicine that they believe is best for their patients. What is needed is an organized backlash from physicians against the greedy insurance industry and government control.  If the public only knew what physicians have to adjust to!
    Insurance premiums are high because there is no protection from lawsuits. Doctors have to order an abundance of tests for everyone to avoid being sued.  Incredibly greedy managed care has made practicing medicine hell, and now tell doctors how to practice medicine!! Take for example the managed care software that case managers use in hospitals, home agencies, nursing homes, rehabs, hospices, etc. to level patients for appropriate care. The ‘art’ of medicine is being lost!!

    Get real!  I am not a physician but work in the medical field.  Most medical personnel are terrified to speak out for fear of being sued.

    • Kurt

      People wouldn’t sue doctors so much if doctors who made mistakes would own up to them and not try to cover them up. Patients who have been injured or killed by medical mistakes (4x amount of prescribed chemo drugs, items left inside surgical patients), psychiatrists who have sex with patients they are supposedly treating, docs who are on drugs (anesthesiologists, for example), docs who leave their patient on the operating table during a surgery to go to the ATM for cash for drugs (happened in MA), deserve to be sued. Doctors need to insist on single-payer health insurance, to rid themselves and the system of time-consuming and wasteful paperwork and inequitable reimbursements. “Managed” care means insurance=managed. If we want doctor managed,then demand this from our politicians. A single-payer system can allocate medical care more equitably in society while compensating doctors fairly for their education and time and not overcompensating doctors not doing primary care. Docs will never be able to practice the art of medicine while they’re filling out insurance forms for 10 different companies.  We need government control so that we don’t have corporate “control”–insurance companies that have the choke collar on doctors and patients alike (and employers who still try to provide coverage for employees).

      • Paul M

        I live in oz. Here, as In most of the developed world, the insurance paperwork nightmare you describe just doesnt happen.

        Perhaps docs in the us could go on a insurance Paperwork strike and bill their patients. If the patients want to claim, sure: they get the records that the doctor has, but it’s simply not the doctors job to put in all the codes that the insurer wants.

        That aside, the medical industry is easily big enough to get economies of scale re debt collection.

    • Terry Tree Tree

      AMA could have cut REAL costs decades ago.  A uniform insurance form, Convicting Medical-malpracticesers, instead of protecting them!  Followint “FIRST, DO NO HARM!, and other things would have kept costs DOWN, with actual, desired results UP!

  • Tandem300

    The question of how gender or motherism(sic?) affect medical availability can be further complicated by issues of ageism. An increasing number of physicians (men and woman) are entering medical school at much older ages. Their expected years of contribution to the medical field can therefore be expected to be reduced. I am only raising issues and facts without a solution. In fact, I myself retired early from Emergency Medicine, and did so with some guilt. It is also true that their are some physicians that should not be trying to work the extended or even full time hours they are working (especially if motivation is essentially financial).

  • Earphy

    When do men step up to the plate and be required to put in as many hours parenting as women are expected to do in rearing children?
    Fact is the father is just as responsible for the existence of the children as the mother. True, career women have training and should use their expertise – just as men do. We need to recognize that parents are equal in their responsibilities for the children they create – not continue to expect Mom to do it all. We need more full time fathers to offset the balance of society’s power to let men off the hook for thei responsibilities.

    • A look

      You should take a look at “Birdseye” below …

  • Circusmcgurkus

    I am just floored.  The gains for equality, respect and rights for women are being assaulted by a woman who thinks that only her way of doing things is the “right way”.  We get that Dr. Sibert worked hard for her degree and her career but the world has changed and she really cannot believe that whether it is society or the medical culture or the government ANYONE has the right or authority to tell ANYONE how to live her life, what should be important and where her loyalties lie. 

    It is jaw dropping that these ideas are coming from an educated, professional woman. It would be wise for Dr. Sibert to understand that all of life is a risk – education, investment, everything.  She has no more ownership over another person’s (extraordinarily expensive) education than anyone else has.  Who is she to declare that just because the medical industry took a risk on educating any individual that there is some bizarre obligation to that industry?  It is reactionary and barbaric to presume that all people who enter medicine must remain in medicine.

    If folks decide they no longer want to work in an overbearing, unsatisfying, stifling profession for whatever reason do we abandon the 13th Amendment abolishing slavery so that Dr. Sibert can be satisfied?  She rightly says she is not a policy maker.  I am not saying she should keep her opinions to herself – that would be hypocritical.  But, she might want to consider allowing for the profession to find its way without insisting that the way things always have been is the only way.  In fact, medical residents CANNOT legally work the amount of hours she did in her residency.  This is what most of us call PROGRESS.  To pretend that someone who works p/t is “dabbling” is insulting. 

    Most women can handle a number of different roles but they are also smart enough to know how much they need to give to each in order to be effective at all.  If that’s p/t work, or academic medicine, or time off – whether to raise a family or pursue other opportunities, the education these women earned belongs to THEM, not the medical establishment, and I am just astonished that Dr. Sibert does not trust women to make their own choices.  Nobody knows what it is like to be a doctor until she becomes one.  Nobody knows what it is like to be a parent until she becomes one.  All kids are different with different needs as are parents.  I feel confident that any woman who can get through medical school and residency can figure out how to balance her own life without giving up her career or her time with her kids.

    Patients need to take much more responsibility for their own health and we need partners in our physicians, not dictators, to help us live well.  Dr. Sibert might want to consider coming down from atop that high horse and realize that we cannot survive without lawyers or teachers or police officers or sanitation workers. Doctors are no different from any other profession and it is high time they realized that.  They are not better, not smarter, not more responsible for ordered society than anyone else.  The idea of freedom and equality is that each of us, regardless of race, religion, gender, age, creed or station in life is able and duty bound to live our own life to its fullest potential without anyone else telling us what that potential is.

  • Katie

    I am a medicine resident with a 2.5 year old daughter who was born while I was a 4th year medical student.  It had been an incredible struggle to find balance between a needy young child and the intense demands of residency, and has only been possible because I have a flexible and understanding husband who has picked up a huge amount of slack.  Working 60-80 hours per week has a huge negative impact on our life as a family and I have no intention to continue to do it when I finish training.  Hours like this shouldn’t be considered full time, but should be viewed more like working 2 jobs.  I really don’t think anyone would expect a woman with young children to work 2 full time jobs if she had the choice not to.  

  • Nkanafan

    Dr. Sibert is an anesthesiologist saying this?!?!?  Her comments are not based on any good evidence and are certainly not based on experience!  Dr. Sibert is not a clinician!  She puts people to sleep and wakes them up for surgery!  She has not published in this area and is appears to be pushing herself into the spotlight for personal gain.  My wife is a pediatric infectious diseases physician at a top medical school in the country.  She works 65% time and is home with our children every day.  She sees MORE patients than most of her full time colleagues, teaches students, gives MANY presentations, publishes papers and writes book chapters, runs an international adoption clinic, and is the go to media person for infectious disease issues for her institution.  So, Medicare dollars were used to pay for her residency, and now she is squandering our hard earned tax dollars playing with our children at the playground!  My wife is able to give BACK to the American people because she has developed the balance she wants.  I think we have gotten our return on investment from her and would venture to say there are MANY doctors in this country just like her.  It is sad that Dr. Sibert’s essay has gotten this attention, while doctors like my wife work very hard for her patients, her family, and her community.  I just wish she had more time for herself. 

  • Ssalkat

    I have three kids and have always worked full time as a family physician. I have always felt I needed to be available full time to my patients.  The problem with full time is that full time is usually at least 50 hours by the time I make phone calls and complete paper work.  Part time as a family doc would be more than  40-50 hours.  My husband has always stayed home full time and it works for us.

  • TMB

    What Dr. Sibert has failed to realize is that the system is broken not the people trained in the system.  Her problem lies with the society and/or legislature.  Society doesn’t own physicians and the Medicare dollars spent “training” physicians turns out to be minimum wage at best, at least for those of us who trained before the ACGME required hours restrictions.  And we actually did work as residents and medical students.  It is not as though we sat around breathing valuable air and giving nothing back.  We took care of patients and decided how to interpret tests and physical signs and yes, we were supervised, but in many instances remotely.   I think the moral obligation argument is a thin one, at best. 

    Since Dr. Sibert is concerned about the primary care physician shortage, wouldn’t it be great if she re-trained to take up the clarion call to become a primary care doctor who works full time?

    I am a pediatrician and love seeing kids, but when I have to spend several hours per week filling out insurance forms and trying to figure out the right codes to use so that individual insurances will actually pay me for my services, it reduces the joy that I get out of practicing medicine.     

    • Nkanafan

      Spot on!  The other point made on the show was her desire to discuss this with young girls and women.  As a pediatrician myself, I wouldn’t allow her toxic moral obligation argument to come anywhere near children!  We need MORE women who want to go into medicine with the idea that they can do good work and work part time, leaving time for family, personal health, and volunteering.  A trained physician’s impact goes way beyond seeing patients in the clinic or putting them to sleep in the OR.

    • Kurt

      Dr. Sibert may practice at a hospital in Los Angeles, but she’s also listed in W. Hollywood and Beverly Hills. I think she is far removed from the realities of primary care medicine and primary care motherhood, too. She spoke as if people going into medicine were too dumb to realize that the hours would be long and hard. Her entire tone is insulting. Rather than castigate women, why not advocate in Congress for more medical school slots for primary care doctors, forgive them all their medical school loans, etc., etc. Then society can also fulfill its own moral obligation to provide health care for all, not just the few who can afford a Beverly Hills anesthesiologist’s care. If there were more doctors, they all wouldn’t have to work so hard.

      Medical schools ought to consider mid-career people as med students. There are lots of us bio majors who would still make good docs but never got the chance in our 20s and 30s. So we’d practice for 25 years, not 50. We wouldn’t need to specialize but could definitely provide the basics. The federal gov’t does this when training military Phys. Assistants. It could do it for a civilian medical corps, too. It’s just a matter of money. Bombers or docs? I know what I’d vote for.

  • Sheri

    Listening to this discussion made me so angry. Everyone regardless of profession has the right to change that profession. A choice you made when you were 20 may not still be right for you when you are 40.

    I am not an MD but I am a research scientist with a PhD. So I too spent years in school, some of which was paid for by the government. I struggle to have family/work balance. I knew this going into the field. This discussion is dangerous because one could apply it to all professions requiring a higher level degree.

    One could argue that often educated technical professionals beget more educated technical professionals. Yet it is so very hard to have a family and work in these careers. So we have less kids. We don’t have the time. Don’t these same professionals have an obligation to society to help with the next generation?

  • Crow1128

    I saw a post that the daughter of this doctor added, which was supportive. But I have always wondered how the (grown?) children feel of those moms who went high-profile in exclaiming that “staying home with the kids” wasn’t important enough (for them). I would rather be the child of a mother who proclaimed “I honor my mothering instincts to be there 100% for my children!”  What a difference experiencing THAT kind of love and connection…….

  • Yarshu2

    It’s hard to believe this was written by an educated woman in 2011. What a disgrace to women everywhere. Doctors already give so much of themselves between their education and their weekly hours that this woman believes that they should not have the joys of raising a family? I feel terrible for her children.

    I work at a very prestigious medical school that supports woman, families and child care and believes the work life balance is of the utmost importance.

    • joefishjrf

      Although this conversation centers around the dilema faced by women doctors( and mothers),  I want to point out that fathers face a similar dilema.  Quite frequently (even today), father is the sole income earner and the well being of his wife, and their children through college, as well as of his wife and himself  through their retirement years.  depend on his maintaining or increasing that income throughout his working years, the same years when his(their) children are most sensitive to parental influence and needy of parental support. This dilema is intensified for any man who leaves the fold  of large, stable corporations, and enters  into his own business {a doctor or lawyer in private practice} or any other person  running a small business, where the down-side risk is total financial disaster for the family. There seems to be no way to parse situations like this, other that to recognize that every mother and father  has at least two goals: { one related to supporting his/her childrenen emotionally and the  other materially and that these goals   often conflict; so that some compromise must be found, the wisdom of which compromise can never be determined until the entire situation has been played out.

    • Dentolo1

      Please tell me where you work. 

  • Dr. Sibert needs to examine her own motivations for writing that Op-Ed in the NY Times.  Perhaps she’s motivated by annoyance or jealousy, that she put in “full time” hours and those around her have better, more balanced lives?  Perhaps she just wants to point out to the world that, hey, look how tough she is – everyone should try to be as tough as her, raising 4 kids and nevertheless having a full-time career as an anesthesiologist.

    Most anesthesiologists go home when the shift is over, not when the case is completed.  They don’t have stacks of messages from patients who want call-backs or who want test-results, etc.  They have the privilege of being able to “box-in” their jobs to a certain set of hours.  Sure, more hours than many other full-time jobs out there, but relatively predictable hours nonetheless.  I don’t think a “part-time” pediatrician, who is most likely working more than 40 hours per week anyway, has it any easier.

    If she wants to drive good people away from medicine, then by all means, continue to insist that to be a doctor requires ultimate sacrifice, so forget about all the time missed with your family and just be glad you manage to ride a roller-coaster with them once in a while.  Perpetuate the fallacy that to work harder, longer hours is to work better.  There are plenty of 70-80 hour per week docs who would probably be kinder to and more thoughtful about their patients if they had a bit of breathing room, and a closer connection with their families.  I know plenty of docs who work incredible hours, yet don’t spend enough time with individual patients to really attend to certain details which might end up being critical.

    The whole system is flawed.  Her chest-thumping attitude is but one of the many ailments afflicting the culture and practice of medicine.

    -Subspecialist, male MD, after working way too many hours without having seen my family.

    • an anesthesiologist

      It’s a total fallacy that anesthesiology is “shift work”, and the sooner you get that fallacy out of your head, the better. Our hours are totally unpredictable and we still take plenty of work home with us. Why don’t you come into the OR one of these days and see how it really is?

      • Robin

        With all due respesct, I went to med school, and I saw what anesthesiologists do. They have “their moments”, but most of what they do is sit around and watch the vital signs. You can’t even compare it to the constant bombardment of primary care.  The surgeons used to joke that all the anesthesiologists cared about was making that the if the patient died, at least he/she had good vital signs till the very end.
          If Dr. Silbert wants to make the statement that all anesthesiologists should work full time – I still would disagree with her but at least she would have some context to make her argument.  She has no right, knowledge, or context to form a similar opinion about primary care.

        • Paul M

          Yeah, and those damn firemen just sit around, waiting for a fire. Oh, they have their moments.

    • an anesthesiologist

      It’s a total fallacy that anesthesiology is “shift work”, and the sooner you get that fallacy out of your head, the better. Our hours are totally unpredictable and we still take plenty of work home with us. Why don’t you come into the OR one of these days and see how it really is?

  • sara

    I am incensed by Dr. Silbert’s comments.  To say that physicians, male or female, have a moral obligation to care for patients is ridiculous.  Anyone who has an advanced degree and took out subsidized student loans to pay for thier education, regardless of the degree, was subsidized by the federal government. 

    The real issue is that corporate america is now running medicine.  This in turn, has created a very unsavory environment in which to practice as, most health care delivery systems are for profit, making it very difficult to provide the kind of patient care I think my patient’s deserve. This is because this country is running healthcare as a business, cutting costs, ie decreasing training for physician subsidy, decreasing physician reimbursement, decreasing patient access to healthcare, and increasing thier profit margin. 

    The real reason physicians are leaving thier “moral obligation” profession is because we are being asked to work harder and harder for less and less financial reimbursement and job satisfaction.  Not to mention, our care is dictated by bean counters, ie corporate america, who have absolutely no idea, nor care, about what it means to provide quality healthcare to our patients. 

    I am an anesthesiologist, and contrary to the fallacy that I have no responsibilties once I have finished one of my frequent 12 hour days or 36 hour calls in the operating room,  I do have many responsibilities to my patients, my group, and my hospitals on top of working my “part-time” 50 hour + work week.

    I only hope that moronic, albeit possibly edited for sensationalism, commentary like this leads to discussion about how to deliver excellent patient care outside of a corporate for profit model/system, and by default this should improve physician satisfaction and retention in the long term. 

  • sara

    I am incensed by Dr. Silbert’s comments.  To say that physicians, male or female, have a moral obligation to care for patients is ridiculous.  Anyone who has an advanced degree and took out subsidized student loans to pay for thier education, regardless of the degree, was subsidized by the federal government. 

    The real issue is that corporate america is now running medicine.  This in turn, has created a very unsavory environment in which to practice as, most health care delivery systems are for profit, making it very difficult to provide the kind of patient care I think my patient’s deserve. This is because this country is running healthcare as a business, cutting costs, ie decreasing training for physician subsidy, decreasing physician reimbursement, decreasing patient access to healthcare, and increasing thier profit margin. 

    The real reason physicians are leaving thier “moral obligation” profession is because we are being asked to work harder and harder for less and less financial reimbursement and job satisfaction.  Not to mention, our care is dictated by bean counters, ie corporate america, who have absolutely no idea, nor care, about what it means to provide quality healthcare to our patients. 

    I am an anesthesiologist, and contrary to the fallacy that I have no responsibilties once I have finished one of my frequent 12 hour days or 36 hour calls in the operating room,  I do have many responsibilities to my patients, my group, and my hospitals on top of working my “part-time” 50 hour + work week.

    I only hope that moronic, albeit possibly edited for sensationalism, commentary like this leads to discussion about how to deliver excellent patient care outside of a corporate for profit model/system, and by default this should improve physician satisfaction and retention in the long term. 

  • muppet

    This is exactly what my mom said to me as she was a doctor while I was growing up in the 70s.  She is a doctor who went back to work full-time when I was a week old.  Of her three children, one committed suicide, one is mentally ill and then there is myself.  I am a lawyer who is now a full-time SAHM.  Needless to say mt mother is disappointed in me but I am giving my kids the gift of full-term breastfeeding and a mother who is physically and mentally there.

    I have been raised by a Dr. Silbert and in my raising my mother sacrificed her children to her patients.  To this day I wonder why women like Dr. Silbert and my mother ever decided to breed….

  • Proud Barnard Grad

    I am a woman in my 30′s with MD and PhD degrees and I work as a physician-scientist. My husband (who is also an academic physician) and I have two young children.   We try hard to balance our desire to care for our children and be a part of their lives with the demands of our more-than-full-time careers. We have sacrificed and continue to sacrifice for our profession and our patients, and one of the reasons that I continue to believe in this lifestyle is that I view our situation as a choice that we are making…. we have invested the time, energy, and money to be where we are, and we get to decide how deeply we wish to stay here. I am deeply insulted by Dr. Sibert’s suggestion that I have a “moral obligation” to work full-time- that this isn’t a choice.  After dedicating 14 years of my life to “training” (8 MD/PhD, 3 residency, 3 fellowship), during most of which I worked 80+ hours per week while being paid below minimum wage, I feel the least I deserve is the ability to now choose how to balance my work and my home-life in a way that makes sense for me and my family. Dr. Sibert should take a little time away from the OR and be referred to Sheryl Sandberg’s beautiful Barnard commencement address…. her children, her colleagues, her trainees, and her patients will thank her for it. 

  • Sean Ryan

    I don’t buy the argument at all that the solution to not having enough physicians is to convince them to work more hours. It’s only one more sign that underlying economic model behind the medical industry is utterly broken.

  • Sherry

    Firstly, Cry me a river, Dr Sibert!  If you really cared so much about helping the poor, sick masses, you would have chosen to practice internal medicine in Appalachia, not anesthesiology in L.A.
    That being said, I am a female pediatric subspecialist and I work 85% time.  I wish I could work even less, but I cannot afford to due to being a fairly equal breadwinner with my husband.  I do not think doctors have any moral obligation to pay back the government for their investment.  We are human beings, like everyone else.  We have biological drives, we love our children, and it is in our genes to want to nurture them.  I wish the workplace for everybody, regardless of profession, was more amenable to promoting the true “family values” that conservatives are always bleating about but never legislating for 

  • Guest

    I am offended, insulted, and enraged at this op-ed.  Offended and
    insulted because it is NOT up to her to tell ANYONE what they should
    with their education.  Use it, don’t use it, work part-time, work full
    time, throw it all over your shoulder & go weave baskets in
    Bali–the last time I looked this is NOT a communist society, where your
    occupation is ASSIGNED TO YOU, and where the parameters of that
    occupation are decided by SOMEBODY ELSE.

    But I am enraged because she has twisted facts, used inflammatory
    language, relied on illogic, and outright lied.  And 90% of the people
    reading her article will not look beyond their noses to see if what she
    is saying is true.

    She says <<>>  Lie.  They received 46.9%.   

    https://www.aamc.org/download/161128/data/table1-facts2010school-web-pdf.pdf

    She says <<>>  How terrible.  Females
    work 4.5 FEWER hours than men.  They see FEWER patients.  How
    inflammatory.  But lets look at this when we add the REST of the facts
    in. 

    First of all, that survey was in 2006 .  Second, how
    many hours are they ACTUALLY working.  To find out, lets look at the
    FEDERAL BUREAU of LABOR STATS 2010-2011 edition.  Their most recent data
    is from 2007/2008.

    In 2008, 9% of all physicians and surgeons worked
    part-time.  So that leaves 91% who worked FULL TIME.  So even if
    females are working 4.5 hours less than men, they are STILL working FULL
    TIME–i.e. 40+ hours per week.

    43% of all physicians and surgeons worked 50 or more
    hours a week.  So even if females are working less hours than men,
    they are STILL working 50+ hours per week.   How horrendous.  How
    unfair.  Women doctors are working 50+ hours per week, and it is NOT
    ENOUGH, according to this hyena, anyway.

    Let me also state, that in my experience both as and with healthcare
    providers –for over 20 years AS a healthcare provider– that the reason
    women see fewer patients, is because they spend MORE TIME WITH EACH
    PATIENT.  Case in point:  I am a dental hygienist.  Normally I, or one
    of my FEMALE colleagues, provides care for my family.  My DH is now
    working in New Jersey, and needed his teeth cleaned.  Since he is only
    home on Saturday and Sunday, he decided to see a dentist in NJ.  Last
    night, he called and said, “I had my teeth cleaned today.”  I said,
    “Then why do you sound so glum?”  “Well, first, I asked Where’s the
    Dental Hygienist, and the assistant said WHAT’S THAT?  Then, the doctor
    came in, cleaned my teeth in 10 minutes, never went below the gumline
    ONCE, and never picked up a probe or an explorer to examine my teeth.”  I
    said, “Look on the bright side, At least he didn’t hurt you.”  Dh said,
    “Yeah, but he sure enough billed my insurance company.  And now if I
    want them REALLY cleaned and examined, I have to pay out of my pocket.” 

    She says <<>>

    However, according to 2007 data from the American Medical Association (AMA), only 32% of ALL
    physicians in patient care were in primary care.   First of all, how
    about pointing a finger at the OTHER 68% of ALL physicians–53.1% of
    which, are MEN?  Because these are jobs NOBODY wants.  NOBODY wants to
    do family practice, be on call 24/7/365, treat snotty, screaming kids,
    or spend their days looking into women’s crotches, especially in the
    inner city, and down on the farm, when the insurance is a headache to
    process, repayment is little to nothing, nobody wants to pay what’s
    left on the bill, and malpractice eats up what little profit there is. 
    But 80% of the people who DO take these thankless jobs, are women.  Go
    figure.

    She says <<>>  Whose fault is it, that these areas lack 
    care?  Instead of insinuating that women don’t want these jobs, when
    clearly FAR more women than men ARE taking them, how about asking why
    more MEN aren’t going into primary care?  Or why more physicians
    ALTOGETHER are not working in inner city and rural locations?  As if SHE
    was willing to work in the inner city, or where God lost his shoes.

    http://www.bls.gov/oco/ocos074.htm

    She says <<>>  But we’ve ALREADY established that only 9% of all
    doctors work part-time.  And that only 46.9% of that 9%, is female.  So
    that means this HUGE DRAIN on medical capacity is caused by 4.2% of all doctors???  Gimme a break.

    She says <<>>  All 9% of them.  Male AND female.

    And the coup de grace <<>>

    This begs the question exactly WHAT sought-after positions are being denied to applicants? 

    Acceptance to medical school is highly competitive. Most applicants
    must submit transcripts, scores from the Medical College Admission Test,
    and letters of recommendation. Schools also consider an applicant’s
    character, personality, leadership qualities, and participation in
    extracurricular activities. Most schools require an interview with
    members of the admissions committee.   The average GPA and MCAT …(is)
    3.64 and 30.4 for MD matriculant. http://www.aamc.org/data/facts/2006/2006mcatgpa.htm  
    The University of Minnesota Medical School received 3,360 applications
    for the 2010-11 academic year, about 100 more than last year.  “We
    could go up to 6,000, but if they’re no better in terms of their
    quality, you haven’t really achieved anything,” said Paul White,
    Associate Dean for Admissions at the University.  http://www.mndaily.com/2010/01/17/record-numbers-applying-u-med-school  

    Are you REALLY trying to make us believe there are all these
    qualified MALE applicants who are DENIED ACCEPTANCE to medical school? 
    Really??  Since only 46% of all applicants to medical school, are women,
    then 54% of the applicants ALREADY are those hard-working men.  https://www.aamc.org/download/161128/data/table1-facts2010school-web-pdf.pdf 

    So now it’s the women’s fault that they are the cream of the crop???  What a load of baloney. 

    And my final word on the subject is the same one I gave to a MALE
    dentist, who wanted me to work a 13 hour day, because HE did.  I said,
    “Tom, when you get to work at 6am, your wife is at home, walking and
    feeding your dog, getting your children up and ready for school, &
    making their breakfast and lunch.  Then BEFORE you come home at 7pm, she
    cleans your house,  does the family laundry, gets the kids from school,
    helps them with their homework, makes EVERYONE’s dinner, feeds them,
    keeps yours hot, gives them their bath, and has them shiny and happy
    when you walk in the door.  You HAVE a wife, who does all that for you. 
    Guess what?  I AM THE WIFE.”
     

  • guest

    No way to edit the previous comment.  The quotes referred to, that did not translate,  were in the original article.
    1) women received 48 percent of the medical degrees awarded in 2010.
    2) in 2006, a survey by the AMA & AAMC stated that even full-time female doctors reported working…
    3) this productivity gap is especially problematic because…
    4) In low income areas that lack primary and prenatal care…
    5) If medical training were in infinite supply…
    6) Students who aspire to go to medical school should think…
    And coup de grace, Medical schools can only afford to accept a fraction of the students who apply…

  • Pingback: TGIFive-Bite Friday

  • ermd

    Are you feeling guilty about having neglected your children Dr Sibert? I am an emergency medicine physician who recently cut back dramatically on my hours to raise my children. I am a better mother with a happier family. I am also a much better doctor since I am no longer exhausted, have more time for continuing medical education, and I am excited to see my patients. My patients are better served with my new situation.
    The growing doctor shortage is due to physicians’ dissatifaction with a broken system, as opposed to some of us scaling back temporarily.

  • Slipstream

    Dr. Sibert makes some good points, but I think there is no way to police the situation, or force women doctors to work longer hours, or anything like that.  It is just so hard to predict what people are going to do in situations like this.  I am sure a lot of the female physicians who are working long hours are doing it because they feel they must, or they cant afford not to.  I am sure that some of the others who have cut back on their work time had no intention to do so originally.

    It seems to me that the solution is to train more doctors.  For a long time the number of MDs granted has been kept artificially low, to insure that doctors stay in demand and receive high salaries. (At least this is what I have been told by people who know a thing or two about the field.)  Sibert says that it costs too much to train a lot of doctors who are going to work part-time or drop out of the field altogether.  I wonder if that is really true, or if she is just reciting the AMA line.

    • Terry Tree Tree

      AMA Line!

  • Hannah

    wow she is so inspiring I <3 her!

  • Roda

    What about the moral obligation to one’s children? Do we not have that? What is she thinking?

  • Crow1128

    Would one even want use a doctor who so completely misunderstands the basic concepts of caring for an infant ? If I took my newborn to a pedriatician who herself was the mother of a newborn—left at daycare– I’d switch doctors. Too much of a disconnect between being called an “expert” at caring for human health vs. actually caring for human health in the most fundamental and basic ways…..

    • Pmurray

      Switch to which doctor? The ones you would like to switch to are at home, being mommy. That’s the whole problem.

    • Terry Tree Tree

      Right ON!!

  • http://pulse.yahoo.com/_57JSJAYLWEB3TBWYSQC25AJMVA bluebird

    This is stupid. Doesn’t she consider that the shortage of doctors can be partly for the no work-life balance reason? I myself consider medicine a very attractive field, even though due to many reasons I converged towards math and IT. And I’m glad I did so because no matter how interesting the job is, it is is not worth to give up on my family because of it. Perhaps if something changed in the field (starting with the length of training for virtually any medical profession), we would have more healthcare providers. 

  • http://pulse.yahoo.com/_57JSJAYLWEB3TBWYSQC25AJMVA bluebird

    This is stupid. Doesn’t she consider that the shortage of doctors can be partly for the no work-life balance reason? I myself consider medicine a very attractive field, even though due to many reasons I converged towards math and IT. And I’m glad I did so because no matter how interesting the job is, it is is not worth to give up on my family because of it. Perhaps if something changed in the field (starting with the length of training for virtually any medical profession), we would have more healthcare providers. 

  • Terry Tree Tree

    Rich, sort of a doctor, CAN’T be a mom, telling other people to ruin their family and social lives to become a burned-out shell of a human being, obligated to gathering more money??

ONPOINT
TODAY
Jul 31, 2014
Russian President Vladimir Putin heads the Cabinet meeting in the Novo-Ogaryovo residence, outside Moscow, Russia, Wednesday, July 30, 2014.  (AP)

The US and Europe face off against Russia. Are we looking at Cold War II? Something hotter?

Jul 31, 2014
A comical sign suggest the modern workplace is anything but collegial . (KW Reinsch / Flickr)

When the boss is a bad apple. How some pretty dark traits can push some to the top.

RECENT
SHOWS
Jul 30, 2014
Janitta Swain, Writer/Exec. Producer/Co-Director Dinesh D'Souza, John Koopman, Caroline Granger and Don Taylor seen at the World Premiere of 'America: Imagine The World Without Her' at Regal Cinemas LA Live on Monday, June 30, 2014, in Los Angeles, CA. (AP)

Conservative firebrand Dinesh D’Souza says he wants an America without apologies. He’s also facing jail time. We’ll hear him out.

 
Jul 30, 2014
Smoke and fire from the explosion of an Israeli strike rises over Gaza City, Tuesday, July 29, 2014. Israel escalated its military campaign against Hamas on Tuesday, striking symbols of the group's control in Gaza and firing tank shells that shut down the strip's only power plant in the heaviest bombardment in the fighting so far. (AP)

Social media is changing how the world sees and talks about Israel and Gaza, Israelis and Palestinians. We’ll look at the impact.

On Point Blog
On Point Blog
Criticism, Conservatism And Dinesh D’Souza
Thursday, Jul 31, 2014

Best-selling conservative author and filmmaker Dinesh D’Souza and On Point host Tom Ashbrook disagree about what makes America great…or do they?

More »
Comment
 
This 15-Year-Old Caller Is Really Disappointed With Congress
Tuesday, Jul 29, 2014

In which a 15-year-old caller from Nashville expertly and elegantly analyzes our bickering, mostly ineffective 113th Congress.

More »
4 Comments
 
Our Week In The Web: July 25, 2014
Friday, Jul 25, 2014

Why the key to web victory is often taking a break and looking around, and more pie for your viewing (not eating) pleasure.

More »
Comment