Viewpoint
An All or Nothing Career?
After reading a thought- provoking and controversial op-ed in the New York Times, “Don’t Quit this Day Job,” by Dr. Karen S. Sibert, I decided to share it on Facebook. Wow, did I ever generate discussion. The premise of the article is that working “part time” (less than 60 hours per week) is a disservice to society because tax dollars subsidize part of medical school and postgraduate education. “I think it’s fine if journalists or chefs or lawyers choose to work part time or quit their jobs altogether,” Sibert writes. “But it’s different for doctors. Someone needs to take care of the patients.” She argues that with the projected physician shortage, only those who commit to full-time practice (more than 80 hours per week) should be admitted to medical school. She is especially harsh with women physicians, whom she says are “less productive” than their male counterparts.
Perhaps this article hit home for me because I was trained during the same era as Dr. Sibert. I fully bought into the “macho” model of medical practice. I missed weddings, recitals, and reunions because I did not feel free as a student or resident to ask for any special favors. I became the mother of three lovely children during my training years but tried hard to not let being a parent affect my ability to work because I did not want to appear to be a slacker or to inconvenience my fellow residents. When my children were still quite young, I started a practice and was on call nearly seven days a week. I had a busy clinic practice, an inpatient service, and saw obstetrical patients who delivered at all hours (mostly at night, it seemed). My children had the good sense to choose careers other than medicine. When they were in grade school, they frankly stated that they did not want to work the long hours their mother was working.
That style of practice left me feeling burned out. Fifteen years into my career, I began wondering if I could go the distance. I entered lotteries and sweepstakes, hoping to win enough to retire early. I fantasized about being a full-time gardener (my favorite hobby). In my practice, we had no experience with part-time practice or job sharing.
It took a crisis in the form of suicidal ideation for me to come to my senses, get help, and restructure my life. I know now that I made the right decision to cut back on some work hours and responsibilities. I’m a better doctor to my patients because of that; but still, I feel some shame about admitting that I could not live up to my image of the ideal, heroic doctor. Must medicine be an all-or-nothing career as Dr. Sibert implies? Must we give our lives completely to our profession, or can we have a life and a practice?
I suspect that the physician shortage will worsen if we tell prospective medical students that they must choose between medicine and self-care, family, or the other soul-feeding activities that make life joyful.