Maternity Leave Takes Higher Toll on Physicians in Procedural Specialties

By Rita Buckley

March 23, 2017

NEW YORK (Reuters Health) - Female physicians lose significant income during maternity leave and report high rates of career dissatisfaction, particularly in procedural specialties, say researchers.

Dr. Nelya Melnitchouk from Brigham and Women’s Hospital in Boston and colleagues conducted a national cohort survey of physician mothers to define the personal and financial impact of maternity leave, and its relationship to career satisfaction for those in procedural and nonprocedural specialties.

A 45-question anonymous, secure, online questionnaire on the impact of pregnancy and childbearing was posted on the Physician and Moms Group, a Facebook group established in 2014 and exclusive to female physicians. Membership is voluntary and self-selected, but acceptance depends on direct referral from another physician mother within the group.

At the time of the survey, the Physicians and Moms Group had 14,518 members. The researchers posted a link to the survey on the Facebook page. It was active for four weeks.

The final cohort included 1,541 female physicians from all 50 states and the District of Columbia who were in practice during their most recent pregnancy, including 393 women (25.5%) who practiced in procedural fields.

The most common procedural fields were OB/GYN (12.8% of the total cohort), surgery and surgical subspecialties (7.1%), and anesthesia (4.2%).

The most common nonprocedural specialties were pediatrics (23.8% of the cohort), internal medicine (23.8%), and family medicine (11.0%).

Overall, 35.7% were in private practice, 33.4% in academic medicine, and 26.8% in community-based practice, the authors reported online March 7 in Annals of Surgery.

Female physicians in procedural fields trended toward slightly older age than their nonprocedural colleagues at the time of first pregnancy, but the difference wasn’t statistically significant.

Roughly half the respondents - 609, or 52.9% - reported losing over $10,000 in income during maternity leave, with no significant difference between procedural and nonprocedural fields.

Maternity leave was included in the most recent contracts of 28.9% of the female physicians.

Procedural specialists were more likely to report that maternity leave had a negative impact on referrals (odds ratio 1.78, p=0.001). They were also more likely to report requirements to complete missed shifts (OR 3.04, p<0.001) and owing money to their practice (OR 2.71, p<0.006).

Procedural specialists were also more likely to report a desire to have chosen a less demanding specialty (OR 2.33, p<0.001).

“Despite the increasing number of women entering medicine, their numbers in senior positions remains disproportionately small,” said co-author Dr. Jennifer Davis from the University of Massachusetts Medical School in Worcester.

She noted in email to Reuters Health that despite some improvement, it’s still critically important to identify the barriers that face female physicians as they advance in their careers.

In email to Reuters Health, Dr. Melnitchouk emphasized that more than two-thirds of the female physicians reported that maternity leave wasn’t included in their most recent contract. For more than half, maternity leave had resulted in a loss of more than $10,000 in income. Furthermore, she continued, women in procedural fields were significantly more likely to have shorter leaves, be required to make up shifts, owe money to their practices, and report career dissatisfaction.

Both Dr. Melnitchouk and Dr. Davis hope their findings will help inform hospital-level policy to create a more nuanced approach with more flexibility in scheduling, productivity goals, and organizational values that address the issues of female physician career satisfaction and burnout.

“These findings are a good first step,” said Dr. Melnitchouk. “Our next step is to build on this work and begin to develop policies and interventions to address the issues that we’ve identified.”


Ann Surg 2017.