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	<title>Comments on: Physicians &#8220;opting out:&#8221;  gender and medical education as a privilege, not an entitlement</title>
	<atom:link href="http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/feed/" rel="self" type="application/rss+xml" />
	<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/</link>
	<description>History and sexual politics, 1492 to the present</description>
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		<title>By: shelley</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-2/#comment-1180442</link>
		<dc:creator>shelley</dc:creator>
		<pubDate>Fri, 30 Nov 2012 02:07:58 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-1180442</guid>
		<description>I couldn&#039;t have said it better myself.  &quot;you go girl, dr. sibert!&quot;

I&#039;ve been complaining for years that our society has been misleading women about the fairy tale of being able to have a &quot;power career&quot; (yeah, we&#039;re doctors, not secretaries, teachers, or nurses), be a great wife, and a great mother.  it just doesn&#039;t work that way with doctors. some aspect will invariably suffer.  

blah, blah, blah, the part-time doctors are part of a team or deserve a &quot;balanced&quot; life.  in my practice, the part-timers take the same amount of call as us &quot;full-timers&quot; lest they be seen as slackers.

sorry, but when it comes to medicine, women need to PULL UP THEIR BIG GIRL PANTS AND JUST BE DOCTORS.

S</description>
		<content:encoded><![CDATA[<p>I couldn&#8217;t have said it better myself.  &#8220;you go girl, dr. sibert!&#8221;</p>
<p>I&#8217;ve been complaining for years that our society has been misleading women about the fairy tale of being able to have a &#8220;power career&#8221; (yeah, we&#8217;re doctors, not secretaries, teachers, or nurses), be a great wife, and a great mother.  it just doesn&#8217;t work that way with doctors. some aspect will invariably suffer.  </p>
<p>blah, blah, blah, the part-time doctors are part of a team or deserve a &#8220;balanced&#8221; life.  in my practice, the part-timers take the same amount of call as us &#8220;full-timers&#8221; lest they be seen as slackers.</p>
<p>sorry, but when it comes to medicine, women need to PULL UP THEIR BIG GIRL PANTS AND JUST BE DOCTORS.</p>
<p>S</p>
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		<title>By: Jonathan Moy</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-2/#comment-878514</link>
		<dc:creator>Jonathan Moy</dc:creator>
		<pubDate>Mon, 26 Sep 2011 23:59:58 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-878514</guid>
		<description>I am a medical doctor who has left clinical medicine. 

Just because someone completes a medical degree does not mean that they are endebted to anyone to continue in the field.  Many factors influence people to study medicine, and factors change over peoples lives they give priority over career!  Career is not everything. Family and relationships have been shown to be more important than career in most studies. 

Their is no debt to society for having a medical degree anymore than a lawyer must practice law, or a political scientist must be a politian.</description>
		<content:encoded><![CDATA[<p>I am a medical doctor who has left clinical medicine. </p>
<p>Just because someone completes a medical degree does not mean that they are endebted to anyone to continue in the field.  Many factors influence people to study medicine, and factors change over peoples lives they give priority over career!  Career is not everything. Family and relationships have been shown to be more important than career in most studies. </p>
<p>Their is no debt to society for having a medical degree anymore than a lawyer must practice law, or a political scientist must be a politian.</p>
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		<title>By: Co history 1858</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-2/#comment-840499</link>
		<dc:creator>Co history 1858</dc:creator>
		<pubDate>Tue, 21 Jun 2011 03:58:49 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-840499</guid>
		<description>I&#039;m still scratching my head over this one. Do NO male doctors choose to be part-time when they have young fsmilies? is this because their partners give them a choice? Having never been part time for one second, I&#039;m just envious of people who do have that choice!</description>
		<content:encoded><![CDATA[<p>I&#8217;m still scratching my head over this one. Do NO male doctors choose to be part-time when they have young fsmilies? is this because their partners give them a choice? Having never been part time for one second, I&#8217;m just envious of people who do have that choice!</p>
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		<title>By: These&#8230; are the Links of our lives. &#171; Grumpy rumblings of the untenured</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-2/#comment-839450</link>
		<dc:creator>These&#8230; are the Links of our lives. &#171; Grumpy rumblings of the untenured</dc:creator>
		<pubDate>Sat, 18 Jun 2011 07:08:44 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-839450</guid>
		<description>[...] love.  In the mean time, pop over there and see what she&#8217;s written.  Start with this one on female physicians opting out.  Related:  Wandering scientist comments on the same article, as does Dr. Isis.  This last [...]</description>
		<content:encoded><![CDATA[<p>[...] love.  In the mean time, pop over there and see what she&#8217;s written.  Start with this one on female physicians opting out.  Related:  Wandering scientist comments on the same article, as does Dr. Isis.  This last [...]</p>
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		<title>By: That's Grantastic!</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-2/#comment-839242</link>
		<dc:creator>That's Grantastic!</dc:creator>
		<pubDate>Fri, 17 Jun 2011 20:01:55 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-839242</guid>
		<description>In other news, by combining this topic &amp; the Barnard speech, I think this guy is totally ripping off Historiann&#039;s blog!

http://onpoint.wbur.org/2011/06/16/should-doctors-work-more</description>
		<content:encoded><![CDATA[<p>In other news, by combining this topic &amp; the Barnard speech, I think this guy is totally ripping off Historiann&#8217;s blog!</p>
<p><a href="http://onpoint.wbur.org/2011/06/16/should-doctors-work-more" rel="nofollow">http://onpoint.wbur.org/2011/06/16/should-doctors-work-more</a></p>
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		<title>By: That's Grantastic!</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-2/#comment-839241</link>
		<dc:creator>That's Grantastic!</dc:creator>
		<pubDate>Fri, 17 Jun 2011 19:59:51 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-839241</guid>
		<description>Nicoleandmaggie, you&#039;re conflating hours of experience with years in practice, when the entire point is that they are not the same. 

Sure, doctors who are up on modern technology are better than those who aren&#039;t.  Fine, recent med school grads have advantages over doctors who don&#039;t resolutely stay on top of advances, in that respect.

The question is that *within each cohort* who do you prefer, those who work more or those who work less?

Recent grad who has 1 year post-residency at 20 hrs/week, 40 hrs/week, 60 hrs/week, or 80 hrs/week? That&#039;s the question.

You say that because babies don&#039;t remain babies forever, this is a short-term decision women are making.  Of course that&#039;s true for some.  But the &quot;short-term&quot; (how many years is short-term?) aspect of this decision is certainly not true for MANY women who opt out, including those who originally intend for the arrangement to be short-term but find out later that opting back in isn&#039;t as simple as they assumed. 

I&#039;m all for making it simple.  But I think it&#039;s a joke to pretend that it IS already, or to assume that there&#039;s no substantive difference between working a full time paid job and...NOT.  The mommy track is the mommy track.</description>
		<content:encoded><![CDATA[<p>Nicoleandmaggie, you&#8217;re conflating hours of experience with years in practice, when the entire point is that they are not the same. </p>
<p>Sure, doctors who are up on modern technology are better than those who aren&#8217;t.  Fine, recent med school grads have advantages over doctors who don&#8217;t resolutely stay on top of advances, in that respect.</p>
<p>The question is that *within each cohort* who do you prefer, those who work more or those who work less?</p>
<p>Recent grad who has 1 year post-residency at 20 hrs/week, 40 hrs/week, 60 hrs/week, or 80 hrs/week? That&#8217;s the question.</p>
<p>You say that because babies don&#8217;t remain babies forever, this is a short-term decision women are making.  Of course that&#8217;s true for some.  But the &#8220;short-term&#8221; (how many years is short-term?) aspect of this decision is certainly not true for MANY women who opt out, including those who originally intend for the arrangement to be short-term but find out later that opting back in isn&#8217;t as simple as they assumed. </p>
<p>I&#8217;m all for making it simple.  But I think it&#8217;s a joke to pretend that it IS already, or to assume that there&#8217;s no substantive difference between working a full time paid job and&#8230;NOT.  The mommy track is the mommy track.</p>
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		<title>By: Nicoleandmaggie</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-1/#comment-839232</link>
		<dc:creator>Nicoleandmaggie</dc:creator>
		<pubDate>Fri, 17 Jun 2011 19:36:07 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-839232</guid>
		<description>@Historiann-- how steep the experience profile is for different specialties is an empirical question.  Babies don&#039;t stay babies forever, and often happen after a residency.  If women go part-time for a few years, how is that a big deal in the grand scheme of things?  That&#039;s like the argument to not lengthen tenure clocks for academic women who have babies.

And there&#039;s TONS of research showing that sleep-deprived medical personnel make mistakes.  If they&#039;re working too many hours, that is just as much a problem as less experience.  There&#039;s a sweet-spot for hours/week worked, and that probably not at 80 hours/week.  That&#039;s why there&#039;s recent legislation on not allowing residents to work too many hours/week.  Again, where that sweet spot is is an empirical question and no doubt differs dramatically depending on what the doctor is actually doing with his or her time.  (Cloud&#039;s post suggests somewhere between 45 and 60.)  Again, paperwork has zero value added to diagnostics and is what most doctors spend a large chunk of their time doing.  And it&#039;s something that many of these women in large group practices working part time do not spend their time doing... the majority of their time is face time seeing patients. 

Paperwork is also why a childless doctor I know decided to drop out of medical practice entirely (for shame!).  If your main concern is lack of doctor-patient time causing lack of experience, that is where you are going to get first-order gains in terms of professional satisfaction, increases in patient care, and increases in face time.  You&#039;ll probably even be able to drop reimbursement costs because most doctors did not go to medical school in order to fill out insurance forms.

And actually, the best doctors I have had have not been the most experienced.  They&#039;ve been younger doctors who actually read up on recent research in their areas.  The doctor who tried to force my son&#039;s foreskin was very experienced.  The one who actually knew why that was bad had her first baby (a daughter) about two weeks after she delivered mine.  The OB/GYN who had no idea what to do with my infertility problems, highly experienced, the RE who knew what she was talking about including all the most recent research on metformin&#039;s safety during pregnancy, in her 30s.  

One of the known problems with experience and doctors (known in both my research field area and my husband&#039;s very different research field area) is that doctors tend to do what they were trained to do at their hospital of residency.  That&#039;s one of the reasons that so much of the country is on flat-of-the curve medicine -- some parts of the country do not keep up with new technologies so they end up using more expensive technology that is worse for the patient.  This is especially true of heart attacks (there&#039;s a long series of papers on this topic out of the Dartmouth Atlas project).  Experience is not everything.</description>
		<content:encoded><![CDATA[<p>@Historiann&#8211; how steep the experience profile is for different specialties is an empirical question.  Babies don&#8217;t stay babies forever, and often happen after a residency.  If women go part-time for a few years, how is that a big deal in the grand scheme of things?  That&#8217;s like the argument to not lengthen tenure clocks for academic women who have babies.</p>
<p>And there&#8217;s TONS of research showing that sleep-deprived medical personnel make mistakes.  If they&#8217;re working too many hours, that is just as much a problem as less experience.  There&#8217;s a sweet-spot for hours/week worked, and that probably not at 80 hours/week.  That&#8217;s why there&#8217;s recent legislation on not allowing residents to work too many hours/week.  Again, where that sweet spot is is an empirical question and no doubt differs dramatically depending on what the doctor is actually doing with his or her time.  (Cloud&#8217;s post suggests somewhere between 45 and 60.)  Again, paperwork has zero value added to diagnostics and is what most doctors spend a large chunk of their time doing.  And it&#8217;s something that many of these women in large group practices working part time do not spend their time doing&#8230; the majority of their time is face time seeing patients. </p>
<p>Paperwork is also why a childless doctor I know decided to drop out of medical practice entirely (for shame!).  If your main concern is lack of doctor-patient time causing lack of experience, that is where you are going to get first-order gains in terms of professional satisfaction, increases in patient care, and increases in face time.  You&#8217;ll probably even be able to drop reimbursement costs because most doctors did not go to medical school in order to fill out insurance forms.</p>
<p>And actually, the best doctors I have had have not been the most experienced.  They&#8217;ve been younger doctors who actually read up on recent research in their areas.  The doctor who tried to force my son&#8217;s foreskin was very experienced.  The one who actually knew why that was bad had her first baby (a daughter) about two weeks after she delivered mine.  The OB/GYN who had no idea what to do with my infertility problems, highly experienced, the RE who knew what she was talking about including all the most recent research on metformin&#8217;s safety during pregnancy, in her 30s.  </p>
<p>One of the known problems with experience and doctors (known in both my research field area and my husband&#8217;s very different research field area) is that doctors tend to do what they were trained to do at their hospital of residency.  That&#8217;s one of the reasons that so much of the country is on flat-of-the curve medicine &#8212; some parts of the country do not keep up with new technologies so they end up using more expensive technology that is worse for the patient.  This is especially true of heart attacks (there&#8217;s a long series of papers on this topic out of the Dartmouth Atlas project).  Experience is not everything.</p>
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		<title>By: That's Grantastic!</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-1/#comment-839190</link>
		<dc:creator>That's Grantastic!</dc:creator>
		<pubDate>Fri, 17 Jun 2011 17:24:06 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-839190</guid>
		<description>Though I suppose opting out to work PT does leave one more time for buying yogurt to eat in a gray hoodie, perhaps the only real economic engine this country has left.

http://current.com/shows/infomania/88941392_sarah-haskins-in-target-women-yogurt-edition.htm</description>
		<content:encoded><![CDATA[<p>Though I suppose opting out to work PT does leave one more time for buying yogurt to eat in a gray hoodie, perhaps the only real economic engine this country has left.</p>
<p><a href="http://current.com/shows/infomania/88941392_sarah-haskins-in-target-women-yogurt-edition.htm" rel="nofollow">http://current.com/shows/infomania/88941392_sarah-haskins-in-target-women-yogurt-edition.htm</a></p>
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		<title>By: That's Grantastic!</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-1/#comment-839187</link>
		<dc:creator>That's Grantastic!</dc:creator>
		<pubDate>Fri, 17 Jun 2011 17:12:32 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-839187</guid>
		<description>Unions frequently base seniority for PT employees based on number of hours worked.  

I don&#039;t know why being a &quot;professional&quot; would exempt somebody from fair-minded and fairly logical ideas about effort --&gt; experience --&gt; expertise.</description>
		<content:encoded><![CDATA[<p>Unions frequently base seniority for PT employees based on number of hours worked.  </p>
<p>I don&#8217;t know why being a &#8220;professional&#8221; would exempt somebody from fair-minded and fairly logical ideas about effort &#8211;&gt; experience &#8211;&gt; expertise.</p>
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		<title>By: Historiann</title>
		<link>http://www.historiann.com/2011/06/12/physicians-opting-out-gender-and-medical-education-as-a-privilege-not-an-entitlement/comment-page-1/#comment-839125</link>
		<dc:creator>Historiann</dc:creator>
		<pubDate>Fri, 17 Jun 2011 12:28:27 +0000</pubDate>
		<guid isPermaLink="false">http://www.historiann.com/?p=15555#comment-839125</guid>
		<description>I suppose it&#039;s all a matter of personal comfort, but if I ever get an abnormal pap smear or a hinky mammogram, I&#039;m going to feel more confident about the judgment of the more experienced, harder-working person.

Why do you think the experience curve of new residents is pretty steep?  They&#039;re in the hospital 60-80 hours a week, that&#039;s why.  They take overnight call in the hospital.  There are things that hard work and experience can teach that no amount of reflection ever can.</description>
		<content:encoded><![CDATA[<p>I suppose it&#8217;s all a matter of personal comfort, but if I ever get an abnormal pap smear or a hinky mammogram, I&#8217;m going to feel more confident about the judgment of the more experienced, harder-working person.</p>
<p>Why do you think the experience curve of new residents is pretty steep?  They&#8217;re in the hospital 60-80 hours a week, that&#8217;s why.  They take overnight call in the hospital.  There are things that hard work and experience can teach that no amount of reflection ever can.</p>
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