Are women wasting valuable med school and residency spots?

[FIREitUP]

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Michelle au with the rebuttal

http://www.psychologytoday.com/blog/wont-hurt-bit/201106/the-mommy-wars-medical-edition

"Maybe you could work part-time eventually," my husband Joe suggested.
"Or maybe you could work part-time eventually." I countered.


My cue to leave...By the way, I actually wouldn't mind working part time to raise my kids (as a male). But going into medicine with this intent is not ideal IMO, and I can imagine many people just not going back into medicine after staying home with their kids for a brief period of time.

 

[Grom]

"increasing numbers of doctors — mostly women — decide to work part time or leave the pofession."

"But their (women) productivity doesn't match that of men."

"The American Academy of Pediatrics estimates that 71 percent of female pediatricians take extended leave at some point — five times higher than the percentage for male pediatricians." (Gee... I wonder why women would need an extended leave that men wouldnt...?)

"With a growing shortage of doctors in America, we can no longer afford to continue training doctors who don't spend their careers in the full-time practice of medicine."

Sorry but these quotes are pretty explicit that she believes many women are wasting medical training/money... Her thinking is draconian.

That didn't address RogueUnicorn's argument at all.

Less than optimal use is not synonymous with wasting, and the author never stated that women should be excluded from medicine, only that changes should be made to facilitate full-time work for physicians and that premeds shouldn't enter the profession with the intention of working part-time. Keep in mind that I am not suggesting that RogueUnicorn would agree with my points.

 

[eli20]

"Maybe you could work part-time eventually," my husband Joe suggested.
"Or maybe you could work part-time eventually." I countered.


My cue to leave...

I don't see why this suggestion is so ridiculous?

 

[PostHaste]

Sidebar - things the government spends a similar amount of money on as they do
on GME (residency):

GME: $9 billion
Anti-drug programs: $12 billion
Space programs: $6.7 billion
Anti-missile defense system: $10 billion
Annual operating expense of the IRS: $10.3 billion
Military aid to Egypt: $1.3 billion
Pell grants: $12.4 billion
NSA/NRO/CIA/FBI: $7/7/5/5 billion

Doctors are worth more than the space shuttle but less than the IRS. Interesting...

 

[eli20]

That didn't address RogueUnicorn's argument at all.

Less than optimal use is not synonymous with wasting, and the author never stated that women should be excluded from medicine, only that changes should be made to facilitate full-time work for physicians and that premeds shouldn't enter the profession with the intention of working part-time

Well actually yes it did... I'm sorry but if you want to say that "less than optimal use of a limited resource" isn't the same thing as wasting, especially with her characterization, then you want to have an argument in semantics that I'm not willing to engage in. Her suggestion is that women who want both a family and to be a physician should pick one or the other...

 

[Geekchick921]

Michelle au with the rebuttal

http://www.psychologytoday.com/blog/wont-hurt-bit/201106/the-mommy-wars-medical-edition

I have been lurking in this thread, trying to avoid responding because this is obviously a touchy subject for me but I really like this rebuttal article. Dr. Au and I seem to share a lot of opinions, particularly on what Dr. Silbert had to say.

Also, I'm very thankful my husband's career is becoming more and more conducive to my having a very demanding career and having children. I know most women aren't in the same boat (I'd call myself fortunate but I'm sure plenty of other women don't care), and I'd guess that's a large part of the reason so many more doctor-moms are cutting back their hours compared to doctor-dads.

 

[startswithb]

Agreed that it's worth discussion, but I have to disagree with your second conclusion - the article is strongly suggesting that people should work a certain amount of time or not be in the profession... its sort of the point of the entire article... One of her solutions is that family-oriented people ("especially" women) shouldn't go to medical school because they don't have an output "worthy" of the money spent training them.

Her suggestions are retrogressive, sexist and out-dated.

http://www.psychologytoday.com/blog/...edical-edition
Good read 🙂

Thanks for posting this article. I love the ending where she encourages us young women in medicine to find our mentors and pick them well. 🙂 BRB buying Michelle Au's book.

 

[Narmerguy]

I don't like that the direction that this debate, especially with Au's response, is going into a gender discussion when it doesn't have to be. This issue is much bigger than some sexist quarrel.

The facts are that we have a severe shortage of doctors approaching and training doctors is expensive. If we want to meet that shortage without basically promoting every mid-level willing, we either A) Increase the number of doctors we train B) Import more doctors C) Force doctors to work more.

Regardless of how Dr. Sibert presented the issue and how many are obviously reacting to it, let's clear a lot of that out and simply address the reality of those three points above. Something must be done, so which is it? The rules should--and would--be the same regardless of who the doctors are. Obviously any system that downgrades women by virtue of their sex alone will never be enacted.

 

[Grom]

I'm saying that you were misinterpreting Rogue's argument because of this, your argument's with him.

Well actually yes it did... I'm sorry but if you want to say that "less than optimal use of a limited resource" isn't the same thing as wasting, especially with her characterization, then you want to have an argument in semantics that I'm not willing to engage in.

Only by the way you have chosen to interpret it

 

[eli20]

I don't like that the direction that this debate, especially with Au's response, is going into a gender discussion when it doesn't have to be. This issue is much bigger than some sexist quarrel.

The facts are that we have a severe shortage of doctors approaching and training doctors is expensive. If we want to meet that shortage without basically promoting every mid-level willing, we either A) Increase the number of doctors we train B) Import more doctors C) Force doctors to work more.

I think Dr. Au's response is entirely appropriate considering how Dr. Sibert framed her argument, and all the blame for leading a real discussion into the mires of gender discussion rest on Sibert's shoulders.

But moving on - In that case the answer to the question is pretty simple and has already been stated - train more doctors. Option B is predatory and Option C is authoritarian, retrogressive and impractical.

 

[eli20]

I'm saying that you were misinterpreting Rogue's argument because of this, your argument's with him.

Only by the way you have chosen to interpret it

I'm not misinterpreting his argument, I'm disagreeing with him because we have entirely different readings of the article - obviously both based on our own interpretations. 🙄

 

[Grom]

I'm not misinterpreting his argument, I'm disagreeing with him because we have entirely different readings of the article - obviously both based on our own interpretations. 🙄

So you do want to argue with me? Interpretations of his argument or the article? You seem to suggest the latter, I am suggesting the former

 

[235009]

Michelle au with the rebuttal

http://www.psychologytoday.com/blog/wont-hurt-bit/201106/the-mommy-wars-medical-edition

to the person who said i misrepresented the article in this thread's title...apparently i'm not the only one who interpreted that way

from the above-quoted article....

it laments the national shortfall in the physician workforce, and places the blame squarely on the shoulders of female physicians, who because of their proclivity to bear and raise children, are "less productive" than their male counterparts.

 

[eli20]

So you do want to argue with me? Interpretations of his argument or the article? You seem to suggest the latter, I am suggesting the former

Ok... Let's take a look at what I disagreed with:

except that the word 'waste' or any of its variations are never used in the article. if one were to examine this article calmly, it is easy to see that it is an article that points out a problem, justifies/explains the problem, brings up reasons why it exists, and suggests some solutions. in no part of this article do i find, implicit or explicit, that the women of medicine should be pushed out in favor of men, or that women shouldn't take up these spots.

I agree - the word waste isn't used. It's just implied in the extreme - so much so that I would say it's explicit. This waste is then tied to women over and over again, with her concluding that they should be specifically questioned about their family goals before being admitted and encouraging anyone who wants both a family and to be a doctor to pick one or the other.

 

[Grom]

Ok... Let's take a look at what I disagreed with:



I agree - the word waste isn't used. It's just implied in the extreme - so much so that I would say it's explicit. This waste is then tied to women over and over again, with her concluding that they should be specifically questioned about their family goals before being admitted and encouraging anyone who wants both a family and to be a doctor to pick one or the other.

Okay 😉

 

[eli20]

Okay 😉

Your disaffected sarcasm and lack of any substantial argument of your own is so refreshing and new. 😉

 

[Grom]

Your disaffected sarcasm and lack of any substantial argument of your own is so refreshing and new. 😉

You didn't bring up any new arguments, so I didn't either 🙄

 

[eli20]

You didn't bring up any new arguments, so I didn't either 🙄

You still haven't explained how you think I misinterpreted his argument, so I didn't have much to respond to 🙄.

 

[phltz]

premeds shouldn't enter the profession with the intention of working part-time

This is what it comes down to for me. I don't think doctors should be forced to work a certain number of hours, or a certain number of years. I think medicine benefits from having a well-balanced mix of men and women, parents and non-parents. Sometimes the unexpected happens in life, and plans change - medicine should be prepared to accommodate that in the lives of its workers.

The number of residency spots is highly constrained. If I was a member of congress, I'd vote to fund more residency spots. Given that I'm not in congress, if I was a residency director, and I was trying to choose between a candidate who says she intends to work full-time as a doctor and a candidate who says she intends to work part-time as a doctor, I'd probably take the full-time planner. Given that I'm not a residency director, I'll just post on student doctor and I won't have any impact on anything.

Dr. Sibert doesn't seem to be arguing that doctors should be in any way forced to work full time. She doesn't seem to be arguing that female doctors should be discouraged from having children. She's making an argument about expectations and norms. Instead of encouraging aspiring doctors to think of part-time work as a normal choice, she seems to think they should be encouraged to work full time. That's all. Honestly, I think most of the people who are offended are reading way too much into this.

 

[startswithb]

This is what it comes down to for me. I don't think doctors should be forced to work a certain number of hours, or a certain number of years. I think medicine benefits from having a well-balanced mix of men and women, parents and non-parents. Sometimes the unexpected happens in life, and plans change - medicine should be prepared to accommodate that in the lives of its workers.

The number of residency spots is highly constrained. If I was a member of congress, I'd vote to fund more residency spots. Given that I'm not in congress, if I was a residency director, and I was trying to choose between a candidate who says she intends to work full-time as a doctor and a candidate who says she intends to work part-time as a doctor, I'd probably take the full-time planner. Given that I'm not a residency director, I'll just post on student doctor and I won't have any impact on anything.

Dr. Sibert doesn't seem to be arguing that doctors should be in any way forced to work full time. She doesn't seem to be arguing that female doctors should be discouraged from having children. She's making an argument about expectations and norms. Instead of encouraging aspiring doctors to think of part-time work as a normal choice, she seems to think they should be encouraged to work full time. That's all. Honestly, I think most of the people who are offended are reading way too much into this.

Ok, I actually agree with this. I also do not find the article that offensive. I wanted a demanding career and I chose medicine. If I wanted to carpool I would not have. I don't think anyone, male or female, should enter medicine with the expectation that they should be able to work part-time. It is a professional career. Like I mentioned earlier, there are other professions more suitable for this. I fully expect that if/when I decide to have children I will be needing help from nannies or family members to do much of the daytime childcare. I would never once consider that I needed to either quit or drop down to part-time in order to care for my child. I am ok with this decision because my own parents always worked full-time. Someone who thinks they need to bake cupcakes and drive their children to dance lessons, soccer games, and playdates should probably consider a less demanding field. I don't see what's wrong with that.

 

[Suncrusher]

Dr. Au's so-called rebuttal completely ignores Dr. Sibert's point that physicians who take up valuable, taxpayer-subsidized medical training slots and then only work part-time afterwards constitute yet another important inefficiency in our country's healthcare spending. It may be a warm and fuzzy response but it is hardly skillful or complete. In debates, omission equals admission...and Dr. Au just gracefully admitted that Dr. Sibert's main point is an unfortunate reality.

I agree that more residency slots would make this whole debate moot, but until that time, this is a financial problem that should be discussed--not ignored while Dr. Au puts a band-aid of humanism over it or Dr. Sibert's utilitarianism in the face of a critical scarcity of resources is slandered as "sexist" or "draconian."

I agree with Dr. Au that our society, like most contemporary societies on earth, puts far too much pressure on women to take an oversized responsibility for childrearing. But that societal pressure that is responsible for mostly women working part-time is not Dr. Sibert's fault. If that societal pressure were removed and men felt just as pressured to be at home caring for children as women currently do, then Dr. Sibert's argument against the inefficiency of training part-time physicians would be equally applicable to male and female physicians. Her argument is not sexist; our societal status quo is. Realize the difference and stop ignoring a valid argument because of it.

 

[startswithb]

If the number of doctors leaving the profession or retiring early was ballooning in size, it'd be a cause for concern, and it would absolutely be worth talking about.

No one is suggesting that doctors should somehow be required to work a certain amount. No one seems to be suggesting that women should be admitted to medical schools in lower numbers. Mostly, people seem to think that this is something that should be talked about.

The article lays out the following facts. 1) A shortage of physicians is being projected for the coming years. 2) A rapidly growing fraction of physicians are working part time or taking extended leaves, which would be expected to make this shortage considerably worse. 3) The largest driver of part-timing and leave-taking seems to be women juggling their families and their careers.

Do you think these facts are in error? Or do you object to how they are being interpreted? You're doing an excellent job of conveying shock and outrage, but it's not clear that you have any substantive criticism of the article other than that you don't like it.

I think you're lumping me in with others' interpretations. I am not outraged at the author. My post was expressing my frustration that women are being targeted as being a drain on the system while ignoring others who also contribute less (time) as physicians. But you're right, women make up the higher percentage. I do not want to be grouped in with the women physicians who want to work part-time; I do not want to have to fight that battle. "No! I really actually care about my work even though I have ovaries!!"

 

[eli20]

Too many circles for me 🙂/Unsubscribed.

Edit: I feel like I've clearly outlined my opinion and have nothing else to contribute, if you feel the need to respond to me then I've probably already answered what I think earlier in the thread...

 

[Suncrusher]

Too many circles for me 🙂/Unsubscribed.

dodge?

 

[PostHaste]

Dr. Au's so-called rebuttal completely ignores Dr. Sibert's point that physicians who take up valuable, taxpayer-subsidized medical training slots and then only work part-time afterwards constitute yet another important inefficiency in our country's healthcare spending. It may be a warm and fuzzy response but it is hardly skillful or complete. In debates, omission equals admission...and Dr. Au just gracefully admitted that Dr. Sibert's main point is an unfortunate reality.

I agree that more residency slots would make this whole debate moot, but until that time, this is a financial problem that should be discussed--not ignored while Dr. Au puts a band-aid of humanism over it.

You're right in this assertion, that the financial piece must be addressed as much as the humanistic piece. The problem is that there's no metric. As the rebuttal and comments to those articles show, the definition of part-time and full-time isn't even spelled out. Dr. Au is working 56 hours a week "part time." 😕 Until (the royal) you define at what point a physician "earns his keep," there can be no more discussion on the waste/efficiency/taxpayer pillaging.

What is being proposed by Dr. Sibert and everyone else who says we must have a solution while waiting for more residency slots is essentially forced labor. Sure, you're paid well, but your hours are mandated and you're not allowed to leave the field until you've put in what you "owe society" for taking a) a valuable residency spot and b) taxpayer money*. Even the military doesn't (usually) expect you to stay on indefinitely.

*How long do you think it takes a physician to pay back their $600k residency expense in taxes?

 

[Suncrusher]

No one is advocating for forced labor, or that it can be quantified at what point a physician has "earned his keep." All that is being said is that it is very inefficient to give a highly competitive and valuable taxpayer-subsidized medical training position to someone who isn't going to provide the taxpayer with as much healthcare as someone else who is willing to work more could provide to those same taxpayers.

Yes, such an inefficiency is hard to fix in practice. That is why Dr. Sibert merely calls for serious introspection among everyone ("especially women," due to the current data on part-time physicians, but everyone) who is thinking about taking up one of these competitive and valuable taxpayer-subsidized medical training positions.

 

[Avoidthetiger]

You're right in this assertion, that the financial piece must be addressed as much as the humanistic piece. The problem is that there's no metric. As the rebuttal and comments to those articles show, the definition of part-time and full-time isn't even spelled out. Dr. Au is working 56 hours a week "part time." 😕 Until (the royal) you define at what point a physician "earns his keep," there can be no more discussion on the waste/efficiency/taxpayer pillaging.

I'm finding it impossible to figure out what part-time means for a doc... consider reports range from 30-50 hours a week. Considering that approximately 20-30% of physicians work 65+ hours a week("over-time"), and about 20-30% work "part-time." I think the number of hours a physician should be expected to work has been "balanced" out, aka no "decrease in productivity". If there is still a physician shortage, we need to get more residency spots.

EDIT: My best guess is that "over-time" is 65+ hours a week, "full-time" is 40-65, and part-time is less than 40 hours (based on a 2000 article). Honestly though, is just hitting 40-hours is considered 'part-time', I might aim to be one of those unproductive woman talked about above. I don't want my life to be just being a physician, and I really don't see an issue about working as much as a government employee (40 hours a week).

 

[Quizlet04]

No one is advocating for forced labor, or that it can be quantified at what point a physician has "earned his keep." All that is being said is that it is very inefficient to give a highly competitive and valuable taxpayer-subsidized medical training position to someone who isn't going to provide the taxpayer with as much healthcare as someone else who is willing to work more could provide to those same taxpayers.

Yes, such an inefficiency is hard to fix in practice. That is why Dr. Sibert merely calls for serious introspection among everyone ("especially women," due to the current data on part-time physicians, but everyone) who is thinking about taking up one of these competitive and valuable taxpayer-subsidized medical training positions.

Mind going to the previous page and addressing what I said there? I (and the rest of the non-trads, I'll wager) would like to know what your cutoff is even though there is, by your own admission, no good way to quantify a reasonable contribution to society by a doctor.

 

[Gigantron]

She's probably infertile or a lesbian. Either way that's okay, but what a trader!

That's a pretty catty statement for someone who seems to have not even read the beginning of the article, mighty mom.

 

[Ursa]

My fiance (despite having a competitive GPA, EC's, and MCAT) decided not to apply to med school because of the conflict in lifestyle that she imagines having once we have kids. I think it's cool that she was real with herself and gave her spot at a med school to someone who wants to work full time.

But I also know many docs who work less than full time, and it seems nice. I would love to be part time for the last couple years of my career before I retire.

In short: I don't have an opinion on this! lol

 

[PostHaste]

No one is advocating for forced labor, or that it can be quantified at what point a physician has "earned his keep."

You're going to make my engineering brain explode!

(The royal) you cannot argue for change if you can't define where you are or what your goal is. You can't deride somone (or 40% of a category of someones 🙄) for not living up to your expectation if you can't clearly state that expectation.

 

[Wolfman89]

lol More people need to go into primary care and work more..says the anesthesiologist

Isn't that like the pot calling the kettle black?

 

[Ursa]

Isn't that like the pot calling the kettle black?

Yep. Someone beat you to it about 50 posts ago.

 

[Suncrusher]

Mind going to the previous page and addressing what I said there? I (and the rest of the non-trads, I'll wager) would like to know what your cutoff is even though there is, by your own admission, no good way to quantify a reasonable contribution to society by a doctor.

Why does there have to be a cutoff? The definition of part-time vs full-time varies greatly among specialties, practice type, and location. The important point is that each physician's job with it's own definition of full-time and part-time can either be filled in a cost-efficient way by a physician who has used up a taxpayer-subsidized training slot and works full-time afterward or a cost-inefficient way by a physician who has used up a taxpayer-subsidized training slot and then works part-time afterward...whether "part-time" means 60 hours a week for a rural primary care physician or only two 12-hours shifts per week instead of three for EM.

 

[Wolfman89]

Yep. Someone beat you to it about 50 posts ago.

Opps didn't read through all the posts.

 

[PostHaste]

Why does there have to be a cutoff? The definition of part-time vs full-time varies greatly among specialties, practice type, and location. The important point is that each physician's job with it's own definition of full-time and part-time can either be filled by a physician who has used up a taxpayer-subsidized training slot and works full-time afterward or a physician who has used up a taxpayer-subsidized training slot and then works part-time afterward...whether "part-time" means 60 hours a week for a rural primary care physician or only two 12-hours shifts per week instead of three for EM.

Whaaa? If the argument is that people aren't working enough to be efficient, shouldn't the EM doc be working just as much as the FM doc?

Or are you just saying that to make this right all the women who want to spend time with their families can work in whatever specialty has the lowest "full-time" hours and Dr. Sibert will stop picking on them? Riiiight.

Anyway, even your statement above implies that there is some definition of full- vs. part-time, even if it is specialty-specific. I'm just saying you can't shouldn't go publishing some wildly controversial op-ed in the NYT based on floozy numbers. There's clearly a definition somewhere, otherwise how would she know that 40% of women are part-timers?

 

[Suncrusher]

Whaaa? If the argument is that people aren't working enough to be efficient, shouldn't the EM doc be working just as much as the FM doc?

"Whaaa?" No. Different specialties require different time commitments.

Or are you just saying that to make this right all the women who want to spend time with their families can work in whatever specialty has the lowest "full-time" hours and Dr. Sibert will stop picking on them? Riiiight.

Yes, Dr. Sibert's criticisms would not apply to them if they did that. Because then they are meeting the expected time-commitment for their job, providing the expected amount of healthcare that our system needs their specialty to provide, and aren't using up a taxpayer-subsidized medical training slot that could have been given to someone willing to work more than them. "Right."

Anyway, even your statement above implies that there is some definition of full- vs. part-time, even if it is specialty-specific. I'm just saying you can't go publishing some wildly controversial op-ed in the NYT based on floozy numbers. There's clearly a definition somewhere, otherwise how would she know that 40% of women are part-timers?

Because it is extremely easy to look at employer-kept stats on how many employees are full-time and how many are part-time, even though, as I've said, each employer's unique definition will vary greatly based on the specialty they are hiring for, the location of the practice, and the type of practice. Duh. Her numbers on part-time and full-time aren't suspect just because they don't have an exact cut-off associated with them; in fact, if she artificially instated some sort of cut-off across the board for all specialties, practice types, and locations--such as <36 hours for part-time--then her numbers actually would be suspect.

 

[eli20]

Nvm... I keep getting sucked back into this idiotic thread...

 

[Avoidthetiger]

"Because it is extremely easy to look at employer-kept stats on how many employees are full-time and how many are part-time, even though, as I've said, each employer's unique definition will vary greatly based on the specialty they are hiring for, the location of the practice, and the type of practice. Duh. Her numbers on part-time and full-time aren't suspect just because they don't have an exact cut-off associated with them; in fact, if she artificially instated some sort of cut-off across the board for all specialties, practice types, and locations--such as <36 hours for part-time--then her numbers actually would be suspect.

My issue with that is people outside of medicine who will read this article and find it horrible that physicians are working"part-time", don't understand what "part-time" or "full-time" is to a physician. If you are working parttime, but that is actually 40 hours a week in your specialty, the public will be able to understand why there is a need for more residency spots and more physicians... as people really shouldn't be expected to work more than 40-50 hours a week. But, if the general public thinks part-time means approx. 20 hours a week, they view the physician as a slacker... who isn't working as hard as the general public and won't be able to understand why physicians are having such a hard time balancing work and family.

 

[Narmerguy]

I think Dr. Au's response is entirely appropriate considering how Dr. Sibert framed her argument, and all the blame for leading a real discussion into the mires of gender discussion rest on Sibert's shoulders.

But moving on - In that case the answer to the question is pretty simple and has already been stated - train more doctors. Option B is predatory and Option C is authoritarian, retrogressive and impractical.

That's like saying the solution to the lack of students going into primary care is simple--pay them more. Your proposal costs money and for better or worse, our society is most certainly in the mood for cutting healthcare costs, not augmenting them.

I agree with Dr. Au that our society, like most contemporary societies on earth, puts far too much pressure on women to take an oversized responsibility for childrearing. But that societal pressure that is responsible for mostly women working part-time is not Dr. Sibert's fault. If that societal pressure were removed and men felt just as pressured to be at home caring for children as women currently do, then Dr. Sibert's argument against the inefficiency of training part-time physicians would be equally applicable to male and female physicians. Her argument is not sexist; our societal status quo is. Realize the difference and stop ignoring a valid argument because of it.

I think this is the main point that is being lost. Dr. Silbert is pushing for less part-time physician training. Period. Whether that happens to affect women more than men is not a product of her proposal, and is illustrative of some of the greater problems with how our society views child-rearing.

However, ignoring the reality that this is a difficult task for parents to currently meet, instead of throwing out the entire argument, better progress could be made creating stronger resources to help physician parents with young children (office supported daycares, etc).

No one is advocating for forced labor, or that it can be quantified at what point a physician has "earned his keep." All that is being said is that it is very inefficient to give a highly competitive and valuable taxpayer-subsidized medical training position to someone who isn't going to provide the taxpayer with as much healthcare as someone else who is willing to work more could provide to those same taxpayers.

Yes, such an inefficiency is hard to fix in practice. That is why Dr. Sibert merely calls for serious introspection among everyone ("especially women," due to the current data on part-time physicians, but everyone) who is thinking about taking up one of these competitive and valuable taxpayer-subsidized medical training positions.

+1 I think what's being advocated, at this stage, is that people examine it and think about it.

You're going to make my engineering brain explode!

(The royal) you cannot argue for change if you can't define where you are or what your goal is. You can't deride somone (or 40% of a category of someones 🙄) for not living up to your expectation if you can't clearly state that expectation.

My physics brain had no problem with it. I don't think suncrusher or I is advocating for some number, if for nothing else than it is neither our job nor our expertise to make such a precise measurement. Nonetheless, one can view that the present system is unsustainable and the direction in which it must move without being able to nail the exact inflection point--surely an engineer isn't unaware of such concepts.

 

[Suncrusher]

At first I was at least following your arguments even if I disagreed - but this is just "dwhat?" 😕

sorry you couldn't keep up.

 

[eli20]

sorry you couldn't keep up.

🙄

 

[MonicaMelquiade]

People keep trying to make the point that "it's not sexist" because "it's just the facts" - while I agree that it's relevant that women have been more likely to work part-time than men, I disagree with the way the article interprets and presents that information, and believe that the real reason for that gender difference lies in societal pressures and patterns that we should look into. (Kiwifruit and Eli had started taking us in this direction a long time ago, I think.) I've gathered that Dr. Au's article makes this point rather clearly, so I won't elaborate on that, but I think we should think about what these kinds of statistics actually mean.

More women work part-time because women are expected to bear the brunt of childcare. (I'm pretty sure almost everybody wishes that there were a little more equality on that front - when I have children, I intend to be sure that my partner does as much of the childcare work as I do, if practical and possible.) This disparity is induced by societal norms (that are hopefully shifting). In other words, the reason that one disparity (more women work part-time) exists is due to other gender disparities (women are expected to do most of the child-rearing work). This means that any information the statistic gives us is necessarily circular. It's saying, "More women choose to work part-time because society dictates that they are the ones that must work part-time" and then later trying to use the fact that more women work part-time as some sort of interesting piece of information - it's not, since if the world weren't sexist that disparity wouldn't exist. So part of the way to stop being sexist is to stop quoting these kinds of statistics. Hope that makes sense. Point is, I think it's irresponsible to bring up statistics like this, even though the author of the article didn't seem to be making any real point with them. (Why bring up the gender disparities in the first place?)

And as for the point that the author of the article would have made much less offensively if she hadn't brought up gender differences at all: Economically and pragmatically, there's a doctor shortage, and taxpayer money would theoretically be spent more efficiently if fewer doctors worked part-time. I think this problem has to be solved pragmatically, though, and not by saying, "Doctors - you're supposed to be selfless! Stop stealing our money! Why aren't you contributing enough to society?" If we were really concerned about the good of society, we would be a little less short-sighted - aren't we invested in the care of a subsequent productive generation? I think that there should be more resources to facilitate balancing careers and family, for both men and women, in general. I also think that working doctors to the bone might produce burnt-out, cynical doctors that aren't as happy to do what they do, which (wouldn't you agree?) might make a worse doctor for the patients they're treating.

 

[Narmerguy]

sorry you couldn't keep up.

🙄

Comeon guys. Let's not spoil a thoughtful discussion.

 

[NickNaylor]

People keep trying to make the point that "it's not sexist" because "it's just the facts" - while I agree that it's relevant that women have been more likely to work part-time than men, I disagree with the way the article interprets and presents that information, and believe that the real reason for that gender difference lies in societal pressures and patterns that we should look into. (Kiwifruit and Eli had started taking us in this direction a long time ago, I think.) I've gathered that Dr. Au's article makes this point rather clearly, so I won't elaborate on that, but I think we should think about what these kinds of statistics actually mean.

More women work part-time because women are expected to bear the brunt of childcare. (I'm pretty sure almost everybody wishes that there were a little more equality on that front - when I have children, I intend to be sure that my partner does as much of the childcare work as I do, if practical and possible.) This disparity is induced by societal norms (that are hopefully shifting). In other words, the reason that one disparity (more women work part-time) exists is due to other gender disparities (women are expected to do most of the child-rearing work). This means that any information the statistic gives us is necessarily circular. It's saying, "More women choose to work part-time because society dictates that they are the ones that must work part-time" and then later trying to use the fact that more women work part-time as some sort of interesting piece of information - it's not, since if the world weren't sexist that disparity wouldn't exist. So part of the way to stop being sexist is to stop quoting these kinds of statistics. Hope that makes sense. Point is, I think it's irresponsible to bring up statistics like this, even though the author of the article didn't seem to be making any real point with them. (Why bring up the gender disparities in the first place?)

And as for the point that the author of the article would have made much less offensively if she hadn't brought up gender differences at all: Economically and pragmatically, there's a doctor shortage, and taxpayer money would theoretically be spent more efficiently if fewer doctors worked part-time. I think this problem has to be solved pragmatically, though, and not by saying, "Doctors - you're supposed to be selfless! Stop stealing our money! Why aren't you contributing enough to society?" If we were really concerned about the good of society, we would be a little less short-sighted - aren't we invested in the care of a subsequent productive generation? I think that there should be more resources to facilitate balancing careers and family, for both men and women, in general. I also think that working doctors to the bone might produce burnt-out, cynical doctors that aren't as happy to do what they do, which (wouldn't you agree?) might make a worse doctor for the patients they're treating.

 

[Narmerguy]

People keep trying to make the point that "it's not sexist" because "it's just the facts" - while I agree that it's relevant that women have been more likely to work part-time than men, I disagree with the way the article interprets and presents that information, and believe that the real reason for that gender difference lies in societal pressures and patterns that we should look into. (Kiwifruit and Eli had started taking us in this direction a long time ago, I think.) I've gathered that Dr. Au's article makes this point rather clearly, so I won't elaborate on that, but I think we should think about what these kinds of statistics actually mean.

More women work part-time because women are expected to bear the brunt of childcare. (I'm pretty sure almost everybody wishes that there were a little more equality on that front - when I have children, I intend to be sure that my partner does as much of the childcare work as I do, if practical and possible.) This disparity is induced by societal norms (that are hopefully shifting). In other words, the reason that one disparity (more women work part-time) exists is due to other gender disparities (women are expected to do most of the child-rearing work). This means that any information the statistic gives us is necessarily circular. It's saying, "More women choose to work part-time because society dictates that they are the ones that must work part-time" and then later trying to use the fact that more women work part-time as some sort of interesting piece of information - it's not, since if the world weren't sexist that disparity wouldn't exist. So part of the way to stop being sexist is to stop quoting these kinds of statistics. Hope that makes sense. Point is, I think it's irresponsible to bring up statistics like this, even though the author of the article didn't seem to be making any real point with them. (Why bring up the gender disparities in the first place?)

Well, that societal pressures is the reason that women take part-time more than men is not something I think anyone, including the author, would argue. In fact, contrary to what you were saying, I think the entire point of bringing up the child-rearing point was the author's way to bring to the fray the point that women are not somehow inherently less prone to work but instead commonly fulfill an obligation that they perceive takes more time than they full-time allows.

Gender disparities were brought up because the major source of the "excessive" part-time work can be traced to something that disproportionately affects one group. I think people's response to this article being simply "Well, women are pressured more by society to take time off!" is completely unproductive. Clearly that is true, but unless we are to lampoon the Dr. Sibert for not instead advocating for a societal cultural shift, it is not going to help us address this problem.

Let us not forget that many women work demanding hours in other fields and that this is made possible by different structures and systems in place provided by the company. Why not argue for these sorts of things instead of pointing out obvious social trends? Similarly, why should we not examine whether it is practical or perhaps financially irresponsible to continue to give full funding to all doctors when there is no expectation that they will work fulltime.

Sure if money were limitless we could simply call for opening up more spots. But not only is clearly not the case but our government is moving in the opposite direction. We have to be realistic.

 

[mauberley]

My physics brain had no problem with it. I don't think suncrusher or I is advocating for some number, if for nothing else than it is neither our job nor our expertise to make such a precise measurement. Nonetheless, one can view that the present system is unsustainable and the direction in which it must move without being able to nail the exact inflection point--surely an engineer isn't unaware of such concepts.

PH wasn't saying that a precise measurement has to be made, but there must be some measurable quantity (whether it is precise or not, whether it is a direct or indirect value) by which progress can be assessed.

(also an engineer)

 

[Narmerguy]

PH wasn't saying that a precise measurement has to be made, but there must be some measurable quantity (whether it is precise or not, whether it is a direct or indirect value) by which progress can be assessed.

(also an engineer)

Time is not measurable? 😕

I imagine it would very much involve time or some ratio comparing time to some output.

 

[Suncrusher]

There is a status of either full-time or part-time which is determined by a measurable quantity of hours that varies greatly depending on specialty, practice type, and location. As I said before, a part-time physician is not meeting the expected time-commitment for their specialty, not providing the expected amount of healthcare that our system needs their specialty to provide, and is using up a taxpayer-subsidized medical training slot that could have been given to someone willing to work more than them.

 

[eli20]

There is a status of either full-time or part-time which is determined by a measurable quantity of hours that varies greatly depending on specialty, practice type, and location. Yawn...

I think the vast amounts of variability is what some of us have an issue with when people start calling for the sorts of changes people here seem to be interested in.

Having such blatant labels for something that varies so much is counterproductive and just leads to further issues in parity between specialties/fields.

Under your definition it would be better to start eliminating less necessary residency positions to use that money to fund gp slots.