Physician mothers are in crisis – but hospitals won’t disclose the information needed to address the problem.
If things were bad for physician women in 2018, when a BMJ study found “insidious, persistent and sometimes blatant” discrimination – from pay inequities to limited advancement opportunities to lack of support during and after pregnancy – the last two years have only exacerbated the issue. Disproportionately burdened by domestic responsibilities amid the pandemic, physician mothers and female doctors writ large are leaving the profession in droves.
This has far-reaching consequences: women doctors – an estimated 80% of whom are or will become mothers – are proven to deliver better patient outcomes in two recent studies, and make up a third of all physicians in our country’s increasingly beleaguered health care system.
Parental leave policies and institutional support for physician mothers can help. But we can’t address the problem without understanding its scope. “Show us the data” is the standard rallying cry in academics, yet while several recent studies have addressed parental leave policies at top hospitals in the U.S., there is a lack of extensive data on many other issues affecting physician mothers. This includes support for infertility workup and management, breastfeeding/lactation, and hospital-provided childcare options, as well as how family leave and other time off related to family-building is accounted for in women physicians’ financial compensation and career advancement (e.g., effect on RVU targets, time clocks for academic promotion, etc).
So we knew we had to take matters into our own hands. Our plan was to contact the HR departments of each institution listed in the top 20 US News and World Report “Best Hospitals” to review the parental support policies listed above. What we found – or rather what we were unable to find – was staggering.
Of the 20 hospitals contacted, 6 (30%) required a written request after initial contact with HR and 0 of these 6 responded to the written request once sent. Five hospitals (25%) did not answer the phone and did not return a call after a message was left, and 5 (25%) refused to speak to non-employees regarding benefit policies. One hospital (5%) denied the request to speak without reason, and one (5%) stated that their employees could not participate in research studies, even though the callers described the project as a quality initiative rather than a research study. Only two hospitals (10%) were able to provide any data on parental leave at all, and in both cases the data provided was partial rather than complete.
Our inability to gather this important information speaks volumes. If we hope to change the workplace to better support physician mothers, we must first be able to gather the baseline data to benchmark our starting line, delineate the areas that are most in need of change, and develop open policies and discussions about what benefits are available to their employees. Moreover, when such data becomes publicly available, we will be able to identify “champion” institutions that offer supportive policies that can serve as models for other institutions hoping to make positive changes for their physician mothers. The medical field in general loves a good rankings competition, and a race to the top for good parental health policies would benefit everyone.
For too long, women doctors have heard the phrases, “You should just stay home and be a mom,” or “Your husband makes enough money; why do you work?” For too long, we’ve had our contracts modified or terminated during or after our pregnancies. For too long, we’ve been passed over for leadership positions or denied salary increases because of maternity leave, breastfeeding, and other demands of motherhood.
Change is desperately needed, but we cannot be effective advocates for change without first understanding what needs to be changed where. That’s why we challenge all medical institutions to make their parental health policies publicly available for review and comment. If we are to believe that institutions want the best for their physicians, this is one way to prove it. Show us your data. We are waiting for it.
Drs. Marshall and Jain are members of the nonprofits Marshall Plan for Moms and Women in Medicine.
Image: Red Vector / Shutterstock