should men be doctors?

14 Jun

In the last 72 hours or so, this article and this response have been making waves, well, pretty much everywhere, particularly throughout the medical community.  Like most of my peers, I have a lot to say, though I’m gathering I’m a bit more ambivalent than most (note: ambivalence does not equate apathy).  But I’m starting to get a mini-pit of anxiety in my stomach (or maybe it’s a gastric ulcer?) regarding our upcoming exam, so I’m just going to leave you with this excerpt from the response:

I think that argument gets it backwards. The problem is not that workers — mostly women at this point — are demanding too much, but rather that professions are archaically structured. Also, that the push for change still comes mostly from women. The answer is neither to shut up, nor to buck up. The answer is to recalibrate the hours and expectations of professions so that they can be done by the “new worker” — not a man with a wife at home (which is the assumption of the old structures) but rather a mother or father with a working partner and responsibilities at home.  (Lisa Belkin)

Clearly, I’m a big lover of women.  We’re fascinating (at times terrifying) creatures and, while I readily agree with Belkin, I don’t so much mind that we have to keep having this life/work balance debate over and over (and over) again, cycling around somewhat stale, though consistently provocative, arguments.  What gets my goat is how infrequently men enter the discussion…which is, by the way, a total disservice to all our men.  As complicated and frustrating as life/work choices are for women, I might argue that they are more limiting for men.  Who ever heard of a male physician taking paternity leave?

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3 Responses to “should men be doctors?”

  1. Eric June 15, 2011 at 4:15 pm #

    It’s silly to imagine that female physicians, by nature of their superior work/life balance (the numbers speak for themselves) are doing anything but setting an important new precedent: that doctors deserve to have lives outside of their careers.

    I don’t think one HAS to have a family to be fulfilled, happy or a good physician, but I appreciate that a number of commenters pointed out that from their perspective, part time docs offered a fresh perspective and a had a more caring attitude towards patients. Essentially: our families makes us better doctors.

    On a personal note, I really had trouble seeing past the argument that doctors are indebted to society because our education is partially taxpayer funded, as if having a life outside of work meant we were taking advantage of the welfare system or something. Not only do I think that we contribute a hefty share of the cost burden and make a lot of sacrifices, but this spending is essentially inconsequential when compared to health care spending, overall (barely one thousandth). More importantly, it’s a relatively stable amount of spending, which is important to note, considering that for the last decade or so, health care spending has increased by about $100 billion dollars per year (compare that to the $2 billion/year of tax money that goes to resident’s salaries).

    What’s more, during residency, we are already doctors, and though supervised and still in training, we work grueling hours and play an important role in patient care. We provide extremely cheap labor in hospitals, which helps to keep costs down.

    To say that we are obliged to prioritize our work above our families, like we are indentured servants or something, is unfair. May I remind you that medical education is free in most other developed nations? Over half of American medical students graduate with over $150,000 in debt.

    • annaojesus June 15, 2011 at 4:22 pm #

      Very well argued and articulated, my friend. Thank you. However, such prose deserves it’s own post: http://www.ericrosoff.com.

      More to come after I learn about Gilbert’s Syndrome.

  2. Jim Oppenheimer June 15, 2011 at 10:31 pm #

    People often respond to a difficult question not by answering it, but by answering something else, and that’s kind of what I see here.

    The original article makes a point, namely that one hell of a lot of money from various sources is spent to train the student to become a physician; and the slots for this training are severely limited. We could argue about why, and who’s right and who’s wrong, but the bottom line is that physicians do not grow on trees, and we’re looking at an increasing shortage of physicians.

    So, the reasoning goes, when a person is considering whether to become a physician, perhaps they ought to consider these facts and the obligation that goes along with them. And when they get trained, maybe they ought to give some serious thought to their obligation to give back from that training for which others have paid.

    Nobody actually addressed that directly, although someone indirectly attacked the idea of a physician working 110 hours per week. (Another straw man: Nobody in his or her right mind [n.b.] advocates such hours and expects quality of care.)

    What I saw was mostly along the lines of “Why should not a woman be able to have it all?” While I think that most of us, even many republicans, wish that women could have it all, just as we would wish that men could have it all; however, in most walks of life, for all people, regardless of gender, one cannot have it all. Life isn’t fair, but it is what it is, and we can’t change the fact that we only have so much resource, only so many hours in the day. We make choices, and we live with them. The writer suggests that people not regard their medical training casually, as if no one else is impacted. I think she has a point.

    Another matter unaddressed which troubles me greatly: the part-time physician is in the office for a significantly (dramatically) shorter period of time per week. They see fewer consumers/patients/subjects/clients/payees. What effect does this have on their retention of older learning and the opportunity to learn new things? I have limited health insurance, and I do not have much choice in care-givers, but I would not want to be cared for by a part-timer. I don’t give a hoot about the person’s gender, but I do care about their commitment to the knowledge of medicine.

    Can a part-timer give as good quality of care when it’s a dicey life-or-death situation? Perhaps, but I doubt it.

    Balancing life issues can indeed be a daunting task, and, yes, it’s damned unfair. But before all else comes quality of care.

    Like it or not, life isn’t fair. That’s not going to change. People who expect to be able to do the balancing act and have it all are very possibly setting themselves up for a fall. Let’s just hope some innocent doesn’t die or become permanently disabled in the process.

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