September is Women in Medicine Month, and I have loved seeing all the promotions.  I have created some myself and shared them.  Many women’s physician wellness conferences are set in September to honor and amplify this.  It is a time for celebration and for awareness of the benefits and challenges of being  #WomeninMedicine.

PROS: The statistics show that in many medical school classes, women have overtaken men. In my national society, the American College of Physicians, women make up approximately one-third of the membership list.  I honestly never counted how many men vs. women were in my medical school class or my residency.  It seemed about half and half. I do remember in the early 2000s being aware that many of the OB-GYN residents were women, and there was a true transition in that field.  As I got into practice as a primary care physician, it seemed that women wanted to see women doctors, so my patient panel was about two-thirds female.  

PROS: I read studies that said women took more time with patients and had better patient outcomes, possibly because of this.  Patients wanted to see me, and I never asked why specifically. Personally, most of my physicians are female. 

PROS: Working as a physician is meaningful and fulfilling when congruent with your values.  Dr. Kerri Palamara says it well in a recent Internist Weekly article. When asked about statistics showing doctors having high levels of career satisfaction despite high levels of burnout, she remarked that “well-being and burnout are not necessarily opposite ends of the spectrum and that you can have both. … I can love what I do, but not love the way I’m being asked to do it.” 

It is a conundrum.

CONS: I know that approximately 50% of physicians experience burnout and that women physicians die by suicide at almost 2.3 times the rate of the total female population.

CONS: I read studies that women physicians made less money than male physicians.  I practiced in an environment where pay was transparent, and there was no discrimination based on sex that I could identify.  I wanted to see fewer patients in a day, so I expected to be paid less in a productivity / RVU model.  This is not the same for everyone.

CONS: I read that we spend so much additional documenting and taking care of patients outside of the exam room that it adds up to 3 weeks more per year than male physicians.  Charting outside of work hours is a significant negative for physicians in general and a driver of burnout.

CONS: Women are leaving the medical workforce in higher amounts due to many factors, according to the #GiveHerAReasonToStay campaign introduced by Julie Silver MD, AMWA, and ELAM. We know that women are trying to give their all at work and home, and many are having to make choices between the two.  Campaign literature reports that the pandemic is exacerbating this and setting back the progress women had made in the US workforce to the level it was 25 years ago.  Compared to male colleagues, women in medicine are encouraged to take on unpaid volunteer duties and are not promoted in an equal manner to their male colleagues.

What can be done to turn this tide and increase the benefits of a career as a woman in medicine?

I think it comes down to support, in its many faces: Facilitate financial support. Create opportunities for sponsorship and promotion. Encourage time for personal and family self-care. Build a network of other women physicians to be both a sounding board and a safe haven.  Say thank you privately and publicly to women in white coats.  Provide an inviting work environment.

I recently interviewed a physician who built an amazing multi-faceted career while also creating a wonderful family and being an authentic mentor to her residents.   In hindsight, she supposed that the reason she stayed at one institution most of her career was due to the flexibility it provided and the support it gave for her priorities and her interests.  She knew her “why,” and she was able to live by it in her career and her home life.  Harmony was the word she used to describe it.

In homage to her story, I wish all the #WomeninMedicine, during this celebratory month of September (and beyond), a chance to live by your “why” in a flexible, supportive environment so that you can experience a successful harmony of passions.  Is that not what all women are after?

Marion Mull McCrary MD FACP is a practicing primary care general internist in North Carolina and a national board-certified health and wellness coach. She is also a Women in White Coats Writers Fellow and Podcast Co-Host. Her website is http://www.marion-wellness.com, and she can be followed on Instagram and Facebook at marionmccrarywellness

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