After 10 consecutive overnight calls and operating on five open globes — a serious injury that ruptures the eyeball, requiring emergency surgery — within the last four of those days, I found myself exhausted and, at 31 weeks pregnant, in preterm labor.
As the chief resident in my program, I was in charge of the call schedule — so I should have heeded my obstetrician’s advice to lighten my workload. Instead, I was trying to save my free nights for my postpartum months, when I was sure to get no sleep and would need to be home to breastfeed. With a 3-year-old at home and a newborn on the way, I knew how grueling the upcoming months would be. I was also avoiding rising conflict with my co-residents, who were grumbling about the importance of “carrying your own weight” and not getting “special treatment.” From their perspective, prioritizing my health and that of my unborn child made me selfish.
My experience is hardly an isolated one. Though 37% of all doctors in the U.S. are women, and women are the growing majority among medical students and trainees, two-thirds of women physicians report experiencing gender discrimination from a medical colleague, while 57% of them have experienced it from their patients. Moms have it especially tough: A 2018 study found that a whopping 80% of mothers and would-be mothers in medicine faced discrimination based on their motherhood status, despite clear evidence that working moms are more focused, efficient and responsible.
These prejudices, and the ensuing roadblocks, come with serious consequences. Women physicians have taken on a crushing load of childcare and household tasks compared with male physicians and report a higher level of burnout. It’s no surprise, then, that more and more women are choosing to leave medicine or cut back their hours, according to a recent Harvard Business Review analysis. This exodus is detrimental for patients — as a growing body of research suggests, female doctors often produce better medical outcomes than their male counterparts.
When women can’t make it in medicine, it is, quite literally, a matter of life and death.
Case in point: A 2021 JAMA Surgery study concluded that when both male and female patients were treated by women surgeons, they saw better health outcomes. Another study of more than 580,000 heart patients demonstrated that all patients, but especially women, were less likely to die if the doctor treating them was a woman. And a 2017 Harvard study comparing hospital mortality and readmission rates between genders found that patients treated by women physicians were less likely to die or be readmitted to the hospital. When the research findings were applied to the entire Medicare population, that translated to 32,000 potential lives saved.
When women can’t make it in medicine, it is, quite literally, a matter of life and death.
Dr. Melissa McNeil, a professor of medicine at Brown University who has had extensive experience in training women doctors, says that the way women communicate with their patients offers some insight into their success.
“We are by nature communicators. We like to talk to our patients. We like to hear their stories. We like to give them time,” she says. Practicing medicine that way, she explains, may be one reason women doctors produce better health outcomes.
Indeed, research shows that mutual participation — in which the physician approaches the doctor-patient relationship with humility, acknowledges her position of power, uses empathetic listening and is sensitive to a patient’s values — is linked to improved health outcomes and greater patient trust.
Of course, this is a complex topic and one that requires continued, longitudinal studies. But such preliminary research should prompt both the medical community and the general public to find ways to nurture and support women in the medical profession. Instead, the Harvard study resulted in numerous defensive letters to the editor, with one author going as far as calling it fake medical news. One wonders why anyone would minimize the tens of thousands of lives saved at the hands of women physicians.
The medical community should heed women physicians’ calls for systemic change. Researchers at Stanford University and the University of Michigan offered some solutions in a 2021 study published in the medical journal Lancet: Institutions should recruit and retain women, expand paid parental leave and flexible schedules for caregiving, and ensure women researchers receive adequate funding.
Such reforms need to start at the medical school level and extend through training and advanced career stages. Institutions should particularly aim to improve communication, expand mentorship, increase diversity, support family-positive systems and eliminate the gender pay gap, which will, in turn, benefit all physicians and promote community health.
As it stands, women physician message boards are inundated with stories that highlight the lack of institutional support, forcing women to come up with their own creative and jaw-dropping solutions, like pumping breastmilk in hospital bathrooms or rounding on patients with an infant strapped to their back. No other sector would consider this acceptable or legal.
I still remember being called by my daughter’s preschool: “Dr. Ali, your little one is unwell, she’s thrown up five times this morning.” I looked at my watch and then at the daunting list of patients still waiting to be seen with dread. My response — “So she’s not throwing up right now?” — was met by a long and awkward silence. “You will need to come pick her up,” came the firm reply.
And yet the indoctrination was so deep that I felt more guilt leaving work than I did about deserting my sick child.
The lack of institutional support forces women to come up with their own creative and jaw-dropping solutions, like pumping breastmilk in hospital bathrooms or rounding on patients with an infant strapped to their back.
When trained women physicians have to choose between working and having a family, that’s a loss to both them and their patients, says McNeil. “We need to find ways to make sure that our women physicians can be successful in both realms.” She adds that when more than half of current medical students are women, the medical community loses a tremendous amount of intellectual capital when those women are later forced to cut back their hours or drop out of the profession altogether. It also prevents them from advancing in leadership — which makes it more difficult for systems to change.
As women doctors, we need to demand justice and equity for ourselves. But we can’t do it alone. The medical community and the institutions that comprise it must do more to directly address the biases limiting the longevity and success of women’s medical careers. We know that women physicians provide excellent care — so let’s make it easier for them to continue to work in medicine.
