In case you missed it, an op-ed published in the New York Times over the weekend, "Don't Quit This Day Job," by anesthesiologist Karen S. Sibert, MD, fired the first shot in a barrage of opinions that fellow anesthesiologist Michelle Au, MD, quickly dubbed as the "Mommy Wars: Medical Edition."
The debate centers around the growing prevalence and potential ramifications of part-time physicians. Although part-time work has gained some popularity among male doctors nearing retirement, the majority of part-timers are women, with 40 percent of female doctors between the ages of 35 and 44 reporting in 2010 that they worked part time.
To broadly summarize the two main sides--as I recommend reading both pieces in their entirety--Sibert's self-confessed ‘unfashionable' point of view is that physicians who work part time hold some direct responsibility for the physician shortages in the United States. In particular, she argues that because medical education and residencies are largely tax-funded, allowing physicians to reduce their time with patients in the name of work-life balance cheats taxpayers out of care. "With a growing shortage of doctors in America, we can no longer afford to continue training doctors who don't spend their careers in the full-time practice of medicine," she writes.
Perhaps most controversially, Sibert suggests that unlike other professionals, such as "journalists or chefs or lawyers" who may choose to work part time or leave the work force completely, doctors have a moral obligation to put medicine and their patients first. She concludes: "Patients need doctors to take care of them. Medicine shouldn't be a part-time interest to be set aside if it becomes inconvenient; it deserves to be a life's work."
In her response post in Psychology Today's This Won't Hurt a Bit blog, Au takes on Sibert's assertions point for point, making an equally passionate case. "Like Dr. Sibert, I am an anesthesiologist," she writes. "Also like Dr. Sibert, I have children and work full-time in a busy and high-acuity private practice. But as a woman in medicine, I find her views sexist, inflammatory, and frankly discouraging; and I can only hope she has not turned a crop of bright, young potential doctors away from the field entirely simply in her assessment that, to be truly worthy, a life of medicine must exist to the exclusion of all else. The face of medicine is changing, and the culture of medicine must change along with it."
Other physician bloggers, including Kevin Pho, MD, have weighed in on the debate. Pho's take: "Instead of pointing the finger at part-time doctors, it is our health system that needs to change and adapt to physicians who choose to place both medicine and their family on an equal pedestal."
But even among medical professionals who embrace the idea of work-life balance, misconceptions persist as to how it is achieved, I learned during a recent conversation with Atlanta-based physician coach Iris Grimm, creator of Master Performance Inc.'s Balanced Physician program. "Most physicians think that work-life balance has something to do with number of work hours versus personal time," she said. "In other words, [the thinking is that] if you don't work enough hours, you don't put enough time in your practice."
To the contrary, Grimm defines work-life balance as "a feeling of satisfaction with one's life--personal and professional." She continued, "Work-life balance is being at peace with where you are in your career and your personal life while still striving for advancements and promotions, being content in your relationships at work and at home, and dealing with a minimum amount of problems and challenges."
Because of all of the variables at play, reaching this equilibrium requires a different approach for every individual, Grimm pointed out. (Remember, both Drs. Sibert and Au indicated they were content practicing full time.)
The consequences of being out of balance, however, are more absolute.
"It is proven that tired, exhausted, overworked physicians make more medical errors and negatively impact patient care," Grimm said. And with issues, such as burnout, substance abuse, and suicide, plaguing physicians at a higher rate than the general population, Grimm contends that "work-life balance is not a ‘nice-to-have' condition but a ‘must-have' condition if the physician truly wants to be effective and successful."
The big question here, as Drs. Au and Pho point out, is whether the culture of medicine is ready to accept this mindset. I'm eager to hear what you think. - Deb