Doctors are among the highest earners in the US, bringing in nearly $300,000 on average each year. Yet despite their elite status and years of professional training, more than a third of physicians who are also mothers said they face workplace discrimination simply because they have children, according to a 2017 survey published in a research letter in JAMA Internal Medicine.
To get to the root of how and why physician mothers are being discriminated against, the authors of the 2017 research analyzed comments from 947 of the nearly 6,000 respondents to the anonymous survey they posted to a Facebook group of US-based physician moms in 2016 for a new paper in the BMJ. “These are stories by physicians in their own words,” said Dr. Eleni Linos, a dermatologist and professor at University of California, San Francisco, who co-authored the study. “You really get to understand more deeply what’s really going on. The numbers can tell you the scale of the problem, but to really understand what’s going on you need to hear all the stories.”
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Double standards and fear of reporting discrimination
Among the recurring themes: gendered performance expectations, limited opportunities for advancement, lower salaries than their colleagues, and lack of support during and after their pregnancies. “What struck me the most was women’s stories related to limited opportunities for advancement,” said Dr. Linos. For example, one woman wrote: “My impression is that I’m not invited to some ‘extra’-type work things because it’s assumed that I’ll opt out because I have young children. Basically, someone else is opting out for me.” Another participant responded, “I have been ‘passed over’ for activities which could have helped me with promotion which were provided to male colleagues.”
The mothers’ comments also underscore the “stress, guilt, and fear of reporting discrimination,” Dr. Linos said. For example, one participant wrote, “I was very depressed after my first child because of the stress of going to work so quickly and trying to balance all demands of being a mom, work and fellowship.” Another commented, “I am tired of feeling like I am a bad mom when I am being a great doctor… and like a bad doctor when I am putting my children first.”
How workplace discrimination hurts patient care
Patients treated by women have lower mortality and readmission rates than those treated by male physicians, according to a 2017 JAMA Internal Medicine study. Nonetheless, the self-reported discrimination can adversely affect patient care. “I have been ignored in a code situation where I told a nurse to bag a patient slower because he was obstructing, and I have never been apologized to in any of these scenarios,” one participant wrote. Added another, “I resigned from that position after nearly four years due to significant burnout. I was unwilling to continue to compromise my patients’ safety.”
While this study focused on workplace discrimination for mothers who are doctors, other women physicians have publicly reported how discrimination has compromised patient care. In a widely reported incident in 2016, a black woman doctor, Tamika Cross, said that a Delta flight attendant initially turned down her offer to help a sick passenger on the plane on the grounds that she was not an “actual physician.” The airline later apologized to Cross and changed its policy to no longer require flight attendants to verify medical professionals’ credentials. Nonetheless, a similar incident occurred on a second Delta flight in 2018 when another black woman doctor began aiding a sick passenger.
How to reduce workplace discrimination for physician mothers
The biggest takeaway from the BMJ study, Linos said, is the need for initiatives that promote gender equity and support both women and parents, especially during their residencies, when they are expected to work longer shifts. Those who said they faced discrimination were more likely to say they want longer paid maternity leave, backup child care, and more support for breast milk pumping on the job.
An attitude change from their colleagues seems in order as well. “When I asked for a raise my Chair told me that my husband should get a job,” wrote one participant. Added another, “As a resident I was the golden child—until I got pregnant. Residency and fellowship director—both young men— both pretty blatant about not wanting to bring in more ‘ovaries’… There are no repercussions for these guys (they are still there 7 years later). I’ve never said anything—I’m afraid of being blackballed in a small specialty.”
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