Sunday, June 26, 2011

Work, Life, and Education: What Promises Have You Made?

 NPR's recent Tell Me More interviewed four female doctors who are also mothers. The topic of discussion came from Dr. Karen Sibert's New York Times article, "Don't Quit This Day Job." In it, she argues that women who go to med school but then only work part-time or don't practice at all are hurting the profession and, ultimately, the patients because they are taking up limited slots in medical programs and residencies but not fulfilling their obligations to the field.

This, of course, sparked a lot of backlash. One of the other guests on Tell Me More was Dr. Michelle Au (also a full-time doctor with children), who wrote "The Mommy Wars, Medical Edition" in response. She found Dr. Sibert's views to be "a vast oversimplification of the issues it highlighted" and lamented that it might discourage talented young women from pursuing medical degrees (further affecting the doctor shortage) and that "when you start penalizing people for the desire or potential to reproduce, and from there it's a short step to discouraging women from becoming doctors at all."

There are a lot of interesting points in all three articles (Au's, Sibert's and the NPR broadcast), so if you're interested, I highly suggest taking a look. I'm particularly interested in this statement from Sibert:
 "It’s fair to ask them — women especially — to consider the conflicting demands that medicine and parenthood make before they accept (and deny to others) sought-after positions in medical school and residency. They must understand that medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve"
Why women especially? Au points this out in her response:
"male doctors have children too, don't they?  Obviously there are unavoidable biological underpinnings to the increased time commitment mothers face initially--men don't get pregnant, men don't require time to recover from labor and delivery, and men don't breastfeed--but after that first year of life, it seems that the time and commitment spent on raising a child should be about equal for the both parents."

And surely, I hope, no one is suggesting that doctors shouldn't be allowed to have children. So, really, what's at stake here is what is at stake in just about every work/life balance debate, no matter what flavor you're serving: if women are to be viewed as equal contributors in the workforce and society in general and if the human race is going to continue through procreation, gender roles in parenting need to bend from both sides. Fathers need to be held accountable for and socially allowed to provide childcare. Women need to be given the freedom to and accept the loss of "home sphere" power that comes with giving up some of those duties.

But what of the claim that subsidies for education obligate people to certain career paths? Sibert says "it’s fine if journalists or chefs or lawyers choose to work part time or quit their jobs altogether. But it’s different for doctors. Someone needs to take care of the patients." But really, that's kind of a silly argument. Those other degrees are often highly subsidized as well. While the importance of a doctor's profession is more highly dramatized and certainly more visible in life and death situations, can we really say that it's more important that a cosmetic surgeon be available for a patient than that a prosecutor be available for a crime victim? Is it really more important for the top dermatologist to remain true to her craft than for the top journalist to report on important current events? What about the top teachers? We're in an education crisis, aren't we? Doesn't just about everyone who goes to school do so with an implicit understanding that they will contribute to society through their career? Don't we need all of those different skills to keep things running?

So, if you take a Pell grant, for instance, are you guaranteeing that you won't change your mind about your field? Are you promising you'll work a minimum of 40 hours a week for the rest of your adult life in this field? Or even if you don't take direct government-funded aid, the school you attend probably does. Does every student they accept have an obligation to fulfill the tacit promise beneath the surface.

There's a lot wrong with this line of thinking, starting with the idea that human beings are capable of single-minded existences. Sibert tells a hopeful young woman seeking information on the work/life balance of an anesthesiologist, "If you want to be a doctor, be a doctor."

But even if you choose to be a doctor and not a mother, you are still not only a doctor. You are a friend, a sister, a daughter, a niece. You are a neighbor, a mentor, a student. You like to watch old movies late at night or take trips to Cancun. You shop for the cutest shoes and occasionally indulge in reality TV. You grocery shop and get your hair styled. You date or get married. You fight and get distracted. You cry sometimes. You laugh. You get insomnia and don't sleep well sometimes. You live.

Taken to its logical (perhaps extreme, but not far-fetched) end, Sibert's argument suggests that everyone who gets a degree is locked into putting that career ahead of every other role they fulfill.

I think that's discouraging not only for young women who might want to become doctors, but anyone, man or woman, young or old, who might want to be both a professional and a real, live person.


  1. I agree that this is ridiculous. I personally know of one guy who is a locum (ie, gets paid megabucks) and only works about half the time so he can go kayaking and do adventure sports the rest of the time. What about doctors who become hospital managers? Or doctors who become professors? Yup, that argument is pretty darn silly.

  2. Thank you!
    I am one of those women who Dr Sibert takes issue with. I am in the throes of trying to balance my life and my career, with a couple of kids in the mix (and hopefully more in the future) and for that I do not apologise. I feel this line of argument has transported us, time machine style, far far back in time.

    My patients and those of my female colleagues with children are very supportive of our choices and see many advantages in seeing a female doctor who has walked or is walking the path they are on.

    My skills as a Doctor often inform my parenting and vice versa.

    I totally agree with your questioning the Doctor centric thinking of this line of argument. I think teachers shape our future and their job is so very important, Police keep our streets safe, and artists give us a vibrant culture to enjoy. Of course the list could go on.

    Also, When I go home from work, there is not a huge Bekkles sized hole in my work place. There are in fact many other doctors to look after the patients in the 24 hour work place. Dr Siberts assertion that patient care is compromised is very debatable. In the context of hospitals being 24 hours/day 365 days a year some would argue that all Doctors are "part time"

    I was once told when working in an area of need in Aboriginal Australia, when you think the community needs you, it is time to leave. You are burnt out. Dr Siberts assertion that patients would die if she did not work so hard has a similar feel to thinking that a community cannot survive without you. Perhaps she is burnt out?