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 "Experiences of discrimination resonate and relate with the
experiences of women in other fields, but some are unique to the
structure of medicine," said Dr. Eleni Linos of the University of
California, San Francisco. "And some (have) downstream consequences
that could affect not only the woman herself and her family and
career, but also the health care system and the patients she cares
for."
For example, Linos said, female physicians "might not be taken
seriously when giving medical instructions or recommendations in an
emergency situation. We had several stories from participants who
described situations where their medical advice was ignored or
brushed aside during a medical emergency that could affect a
patient's health."
As reported in The BMJ, Linos and colleagues recruited women in a
Facebook community called the Physician Moms Group, which has
approximately 60,000 doctor mom members. Ultimately, 5,782 doctor
moms filled out the researchers' survey, answering questions about
physical and reproductive health, perceived discrimination,
potential workplace changes and burnout.
On the topic of discrimination, participants were asked: "Have you
ever experienced any of the following forms of discrimination at
your workplace? (Please select all that apply)" Participants were
also told: "We want to hear your story and experience. Please
share."
Many doctor moms said expectations differed by gender. Women, they
said, especially those with families, were given limited
opportunities for advancement. As in many professions, pay was often
lower for women than for men.
Doctor moms also reported a lack of support during pregnancy and
after childbirth. They said family leave time was often described by
colleagues as "vacation" time. One woman wrote: "Was reminded every
day by my peers how 'irresponsible' I was getting pregnant." Another
told of how "attendings harassed me for pumping (breastmilk) more
than once during my shifts."
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Another mom wrote of how nurses were unwilling to do the same sorts
of tasks for her that they enthusiastically did for her male
colleagues.
Patients were sometimes biased, too. One doctor mom wrote: "Patients
and their families sometimes are condescending, ignorant (they
assume I'm not a physician because I'm female)."
The very structure of the medical workplace contributed to problems
for doctor moms, with policies and procedures that limit maternity
leave, lack of flexibility in physicians' schedules, lack of a place
to breastfeed or pump milk, and long - often overnight - work hours.
What's most important "are the unique aspects of medical training
and working as a physician that perpetuate or even exacerbate
maternal discrimination," said Dr. Albert Wu, an internist and
professor of health policy and management at the Johns Hopkins
Bloomberg School of Public Health. "This is the first study that I
know of to focus on physician moms. And while I was disappointed in
the profession I was not completely surprised."
While medicine is generally based on cutting edge research, "in
other ways, it's very conservative," Wu said. "It's interested in
maintaining its traditions, some of which date back to the Greeks.
There are very high expectations of physicians and there is also a
little bit of a machismo culture. You know, 'stiff upper lip,'
'soldier on,' and 'this is what you signed up for.'"
That culture developed when very few women were in medicine, Wu
said. Doctors, mostly male, had wives to take care of the children
and the home. "What we need now are policies that that accommodate
both women and men and that promote parenthood," Wu said.
SOURCE: http://bit.ly/2TeehJD The BMJ, online December 12, 2018.
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