Female Physicians Responsible for Shortage of Doctors?




Group of female doctors

A few weeks ago I read an interesting article on the topic of the shortage of physicians in the United States. Apparently, the increasing population and the baby boomers entering retirement is going to put a huge strain on this country. In terms of Social Security and Medicare, it already is. There is no doubt that the climate of decreasing reimbursements is due to the government’s inability to pay for the healthcare of so many aging people.

Thus, the shortage of physicians will increase as more doctors are needed to take care of our aging population.

One person’s analysis of some data shows that one key reason compounding this shortage is the changing demographic of the physician workforce. Currently, women make up an increasing part of the medical school populace, with most schools over half women. It is argued that the data show that women physicians:

  • have less longevity than their male counterparts,
  • take more time off for maternity and family matters, and
  • work less hours and take less overnight call.

Now I am not going to argue any of these points because I am not in the business of making enemies. However, I think those general points can be applied to the younger and newer generations of physicians, physicians-in-training, and medical students. Younger doctors are not working as long or hard as older physicians did. This is largely due to lifestyle considerations and well as work-hour restrictions in training.

Time are changing and the next generation of physicians are not going to stay up all night and take call at any hour of the day to maintain the physician-patient relationship.

Do female physicians work less than their male counterparts? Do they take less call? Do they get pregnant and leave the workforce for longer than male doctors? Maybe. Maybe not.

The point is that this is not necessarily a phenomenon of women, but of a new generation of physicians who demand sanity , mental and physical health in their own lives. After all, shouldn’t physicians take care of themselves the way they expect their patients to?

  • Kelly Jad’on

    Dr. Sandeep Jauhar, the author of Intern: A Doctor’s Initiation is a cardiologist and the director of the Heart Failure Program at Long Island Jewish Medical Center. He too has written about the coming doctor shortage in the United States. Read his point of view: A Doctor Shortage in the United States?

    Kelly Jad’on, Director, Basil & Spice: Author & Book Views On a Healthy Life!

  • http://www.kelsohouseadultfostercare.blogspot.com Kelso House AFC

    I am not sure I am convinced that new younger doctors are “working less” than any doctors used to. I have a good friend who has recently finished medical school at Michigan State University, and is now a D.O.. During his internship, he routinely worked 100 hours a week, and did 24 hour days. Now that he is an official doctor, he is still working 60 hours per week, and is on call 24/7 for several days per week. He has a wife and three boys under 5 years of age. His is tired – and he is still young.

    I have been a long time critic of this doctor stress-load. As a Patient, I have witnessed first-hand the results of tired doctors. I for one would much rather have a fresh, happy, smiling doctor, who is well-rested, gets to see his / her family and enjoy a good vacation once in a while. I do not feel comfortable placing my personal care in the hands of someone who may be stressed, tired, overworked, and possibly even resentful ! So, I say – more power to women and younger male doctors who may be taking control of their careers in this direction. I think it will ultimately be better for all of us this way.

    And – perhaps that doctor shortage will start to take care of itself once people realize that doctors no longer have to live in this stressful way.

    I’ll give an example: when my friend was first considering becoming a physician, he spoke about his plans with long-time doctors. What many of them told him: you don’t want to do this – are you crazy? Become a physician’s assistant instead – you make good money and get a 40-hour workweek. You’ll get to take vacations and see your family.

    If this is the kind of advice that is coming straight from the horses’ mouths, then is it really surprising when, combined with other factors, it is leading to a shortage of doctors?

    To sum up – I’m glad younger doctors are starting to work less and place more importance upon the happiness of their own lives. I think this will make for saner, happier doctors, and better patient care.

    http://www.kelsohouseadultfostercare.blogspot.com

  • Elixabeth

    I agree! I would much rather go to a less stressed out doctor that has a good quality of life. I was dating a nurse for a bit and it wasn’t really a lot of fun visiting him because he worked all the time. After working 12 hour shifts he just wanted to come home and go to bed, so I spent a lot more time exploring the city alone rather then hanging out with him. If you are dating someone working 8 hrs a day they would be tired, but still able to go out after work. On days he was working he just went directly to bed. I got coffee with him in the morning but that was about it. And you want people with these kinds of stresses working on you if you go to the ICU? No wonder there are so many unnecessary deaths. The medical workers are all exhausted. The shortage of nurses is acute also but as it takes less time to train nurses, they can be replaced more frequently but that’s not good either. It means there are more inexperienced people working at hospitals then there would be otherwise. My ex already shows signs of stress and exhaustian and he’s still in his 20s!! He’s been working there for less then 5 years!

  • C Bob

    A major portion of the stress that burns out physicians and nurses relates to the unrealistic expectations of our public, to the worsening obesity epidemic, and to archaic government policies that were behind the Ponzi schemes of Social Security and Medicare/Medicaid.

    1. Governmental regulations have forced hospitals and ERs to accept all cases regardless of capacity to pay. While noble in it’s intent, this action has diconnected consumers from cost and has led to the totally unrealistic pricing quagmire that comes out of hospital billing systems now. Cost does matter, and saying that cost doesn’t matter in an emergency does not change the economic forces of nature. Saying you don’t believe in gravity does not allow you to fly. Hospitals have cost shifted and insurance costs have risen so high as a result that we now see medical costs as uncontrollable because few emergyency room patients even can conceive of paying without some third part to soak. Government regulations started this mess.

    2. The public expects that you can eat all you want, drink excessively, and smoke too much and abuse drugs and that after all that you can still hope that some government program or insurance company will be there to “fix you up” medically when you can no longer work to take care of yourself. There are many medical conditions beyond such an easy fix, and if someone burns out the heart, their liver or their kidney, or their lungs due to abuse there will never be enough money in the system to pay for all the organ transplants and bypasses and dialysis machines to fix that. Preventive care only works when people see the death and misery that results from not bothering to get it. Public expectations of medicine to preventive these tragedies is unrealistic. Patching people up from their own abuse is very expensive, and those who expect the government to be able to afford to do it are unrealistic in their expectations.

    3. Social Security age was determined 100+ years ago when less than 2% of people lived to 65+. Medicare similarly has extended lives far beyond what Congress could have envisioned 40 years ago. Pay rates to physicians, nurses and hospitals have not really kept up with inflation when adjusted for inflation on a per patient served basis, and in Medicine there simply are not many ways to do assembly line savings. I cannot as a family doctor see 100 people per day and provide quality care, but to keep costs down that is what I would be encouraged to try to do. Medicine is too personal and too varied to be safely done on an assembly line. Aging peoples needs have placed a burden on the Medicare system that it cannot financially tax people enough to pay. We need to accept death gracefully so as to begin to set limits on the costs that are reasonable to expect government to pay.

    Finally. a politician or group of politicians who will speak to these issues with realism, and with some degree of charisma needs to be elected. Obama started, but sold out to Big Insurance and Big Government. If I could figure out how to get that person elected I would certainly do everything I could to help him, but I have yet to see how to solve that political question. Any ideas on bringing sense to medical politics and how to get policy makers elected who will set intelligent cost constrained policy would be greatly appreciated. A Public Option policy is called for that would be linked to a freeing up of regulations currently heaped on private providers. Once freed of all the government liability and regulatory burdens it would be possible to provide very cost effective care to those patients desiring to pay. And for those who won’t or can’t pay ? They could see what little the taxpayer can provide for them. The patient needs the freedom to choose, and unfortunately I fear the taxpayer will not be willing to spend much, but government needs to start to make that statement through at least a minimal bare bones Public Option hospital system despite all the gaps and flaws it would certainly have. Such a system coupled with ability of private systems to turn away unfunded patients would bring sanity to our currently crazy system. Medicare/Medicaid based on a private/public mix with large gaps on the lower income working class has not provided a workable long term solution, and has thrust government regulation squarely in the middle ot all workings of hospitals. We have an overburdening regulatory system that even a VA hospital system could not live with. Some radical re-designs are called for, but they need not be expensive, the policies just need to be thought out so as to encourage people to want to start taking care of themselves and to think personally about their own costs and care again.

JC, MD

Dr. JC is a medical doctor who has a passion for health promotion and education.
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