When we were young, especially if our parents were immigrants, the idea of a male neurosurgeon coming home to cook, clean, and give the kids a bath was hilariously ridiculous. Most male doctors came home, had a warm meal served to them, and had some time to unwind and watch TV while other family members took care of the children. 

Today, many women are neurosurgeons, cardiologists, and nephrologists. But unlike their male counterparts, once they arrive home, they have to manage a huge part of the child and home care. 

This phenomenon of additional, unpaid at-home work is referred to as the “second shift.” It can include time taking care of elderly parents, home upkeep, meal preparation, kids’ homework, and more. Sound familiar? A report by the United Nations shows that women do 2.6 times more domestic work than men. Along those same lines, a report from the U.S. Bureau of Labor Statistics shows that men spend more time exercising and enjoying leisure activities than women. Furthermore, according to the Organization for Economic Co-operation and Development, men in the U.S. spend 17.5 hours a week in unpaid labor, compared with 28.4 hours for women.

Needless to say, all of this work, from early morning until often late at night, can definitely impact working women physicians, especially where finances are concerned. Here are four additional ways our finances are impacted from daily double shifts:

1. Women forgo the executive route

Though some women physicians have a partner who also brings in income for the family, this is often not the case. A recent study found that, "while 43% of women who share responsibilities evenly with their partner aspire to become top executives, only 34% of women who do a majority of housework and child care have the same aspiration." 

According to Forbes, women have outpaced men in terms of college attendance and degrees for the past 20 years, and 49% of working women in the U.S. are the breadwinners in their families. Yet even if women have a greater potential for increased income compared with their partner, many choose not to go the executive route. This is possibly due to the “second shift” they have to manage after their paid jobs have finished, resulting in reduced likelihood for promotion and year-over-year salary increases.

2. Women enter lower-earning specialties

In 2013, the U.S. Census Bureau found that women physicians received an annual median income of $140,036, compared with $202,533 for men. In addition to this income disparity, women often choose lower-paying specialties because their second-shift responsibilities do not afford them the luxury of signing up for time-consuming higher-paying specialties. 

Higher-paying specialties typically demand greater time commitment and involve erratic on-call schedules, making it even more difficult to combine motherhood (especially second-shift work) and professional work. Of course, many women physicians pursue both and do a stellar job. However, the second shift certainly adds to their labor. And if a woman physician is the sole breadwinner in the family, working in a lower-paying specialty definitely decreases the family’s overall income.

3. Women have less retirement security

Not only can a second shift adversely affect physicians’ day-to-day and year-to-year income potential (which also affects things like emergency savings, home purchases, college savings, etc.), but also their retirement savings. A 2016 report, which assessed median annual earnings for full-time workers, found a 21-cent pay gap between men and women. 

If you do the math, that 21-cent pay gap amounts to $10,800 per year, close to half a million dollars over the course of a typical career, and a total of $1.8 million if that amount is invested annually in the market. This lower wage also affects Social Security benefits as well as 401(k) retirement accounts and other investments.

4. Women face ‘invisible labor’ tasks at work

The term “invisible labor” consists of household tasks that traditionally fall to women even in the workplace. These tasks are often subtly carried over into the workplace and can cloud how people understand their roles and tasks in the office, regardless of their role or profession.

Invisible labor can include tasks that are usually not included in a job description: mentoring, training, comforting, soothing egos, remembering birthdays and other important dates, keeping things civil between fellow employees, refilling the coffee pot, and so on. 

How can invisible labor affect their income? When women have to spend time on those tasks, they are spending less time performing actual job responsibilities that might otherwise help increase their net worth.

Here are some measures women physicians can take to turn the tide and increase their income potential:

• Work to change income disparity policies in your workplace. Ask for that promotion, ask for feedback from peers — both men and women. Band together with other women physicians to negotiate your salary and workplace benefits to improve both your income and your post-workday quality of life. Think outside of the box to make things more equitable financially.
• Ask for help at home, or outsource. There is no law stating that women have to do all of the second-shift tasks. So work with your partner or others to help better share and balance the division of those tasks. You can outsource to a professional cleaner, cook, travel planner, etc. to help you navigate the daily tasks.
• Stick to the essentials. Oftentimes, and this has been brutally apparent in our recently COVID-afflicted world, a lot of what we think is important really could be eliminated or scaled back. This would not only relieve some unwanted second-shift tasks, but also make room for women to go after career-enhancing — and income-enhancing — pursuits.
• Be wary of volunteer activities. When asked to do invisible labor in the workplace, make sure to rotate with people of other genders, or say no to things that fall outside of your responsibilities.
• Don't be afraid of change. If you’re not happy with your current income and/or workplace benefits, look for other opportunities. The best time to find a new job is while you have one. There are many forums and websites that help physicians find their ideal job. There are also a myriad of pharmacy tech, startup tech, coaching, and side-hustle opportunities available.
• Above all, take care of your personal finances. Make sure you have three to six months of emergency funds, term-life and disability insurance, maxed out tax-advantaged retirement accounts (e.g., 401(k), Roth individual retirement account), and then invest in taxable accounts with broad-based index funds for the long-term.

Though it can be frustrating to be caught in the second-shift trap, it is possible to have the at-home life you want and still make the income you deserve as a woman physician. It’s likely a safe bet that the reasons you became a physician and the reasons you excel in the important aspects of your second-shift life are similar — love and dedication. Keep your magical touch, but don’t be afraid to think outside the box to find ways to make both of your daily shifts as profitable — both monetarily and personally — as possible.

What's your take on the challenges of "second-shift" labor? Share your thoughts in the comment section below.

Dewan Farhana, DO, is the founder and CEO of Betternest, a tech startup that connects people to professional home and office organizers that declutter, tidy-up, and make spaces functional for productivity. She blogs about personal finance and wealth at Doctor Finances.