Work-Life Balance Dwarfs Pay in Female Doctors' Top Concerns

Marcia Frellick

July 15, 2020

Work-life balance was the top concern for female physicians who responded to a new Medscape survey, far outpacing concerns about pay.

A psychiatrist who responded to the survey commented, "I've been trying to use all my vacation to spend time with my spouse. I'm always apologizing for being late, not being able to go to an event due to my work schedule, and missing out on life with my husband."

Nearly two thirds (64%) said the balance was their top concern whereas 43% put pay at the top.

Medscape surveyed more than 3000 women physicians about how they deal with parenthood, work pressures, and relationships in Women Physicians 2020: The Issues They Care About.

Almost All Are Making Personal Tradeoffs

An overwhelming percentage (94%) said they have had to make personal tradeoffs for work obligations.

"Women are more likely to make work compromises to benefit their families," a cardiologist responded. "I won't/can't take a position that would disrupt my husband's community ties, my children's schooling, and relationships with family."

More than one third of women (36%) said that being a woman had a negative or very negative impact on their compensation. Only 4% said their gender had a positive or very positive impact on pay and 59% said gender had no effect.

The Medscape Physician Compensation Report 2020 showed male specialists made 31% more than their female counterparts and male primary care physicians earned 25% more.

Some factors may help explain some of the difference, but others remain unclear.

Poor negotiating skills have long been cited as a reason women get paid less; in this survey 39% said they were unskilled or very unskilled in salary negotiations compared with 28% who said they were skilled or very skilled in the talks.

Katie Donovan, founder of Equal Pay Negotiations, reports that only 30% of women negotiate pay at all, compared with 46% of men.

Additionally, women tend to gravitate in specialties that don't pay as well.

They are poorly represented in some of the highest-paying specialties: orthopedics (9%), urology (12%), and cardiology (14%).

"Society's view of women as caretaker is powerful," a radiologist commented. "Women feel like they need to choose specialties where they can work part-time or flexible time in order to be the primary caretaker at home."

Confidence High in Leadership Abilities

The survey asked women about their confidence in taking a leadership role and 90% answered that they were confident about taking such a role.

However, only half said they had a leadership or supervisory role.

According to the American Medical Association, women make up 3% of healthcare chief medical officers, 6% of department chairs, and 9% of division leaders.

Asked whether women have experienced gender inequity in the workplace, respondents were almost evenly split, but hospital-based physicians at 61% were more likely to report inequity than were 42% of office-based physicians.

A family physician responded, "I have experienced gender inequality more from administrators than from my male colleagues. I think it's coming from corporate more than from medical professionals."

In this survey, 3% said their male colleagues were unsupportive of gender equality in the workplace.

The survey responses indicate most women physicians who have children are also conflicted as parents regarding their careers. Almost two thirds (64%) said they were always or often conflicted with these dueling priorities; only 8% said they sometimes or rarely are.

Those conflicts start even before having children. More than half in this survey (52%) said their career influenced the number of children they have.

A family physician said, "I delayed starting a family because of my career. That affected my fertility and made it hard to complete [in-vitro fertilization]."

Family Responsibilities Meet Stigma

Half of the respondents said women physicians are stigmatized for taking a full maternity leave (6 weeks or longer). An even higher percentage (65%) said women are stigmatized for taking more flexible or fewer hours to accommodate family responsibilities.

A 2019 survey of 844 physician mothers found that physicians who took maternity leave received lower peer evaluation scores, lost potential income, and reported experiencing discrimination. One quarter of the participants (25.8%) reported experiencing discrimination related to breastfeeding or breast milk pumping upon their return to work.

Burnout at work puts stress on primary relationships, 63% of respondents said, although 24% said it did not strain those relationships. Thirteen percent of women gave the response "not applicable."

"I try to be present when I'm home, but to be honest, I don't deal with it very well," a family physician commented.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune and and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick

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