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Enlightened Physicians and Healthcare Workplaces Will Reject that Women Physicians are Responsible for the Expected Physician Shortage

Expediting The Inevitable is an organization dedicated to changing the way the healthcare marketplace and women physicians engage to achieve business growth and clinical excellence without sacrificing quality of patient care. But every time we begin a conversation about this new and dynamic paradigm, the same old harangue turns up again and again. After 5 different ETI members brought forth an interesting but inflammatory post by Darrell White, MD on MedPage Today’s, we had no choice but to put this baby to bed.

Citing “statistics” such as 50% of newly trained physicians are women, “many of them do not practice full-time,” and women physicians do not work the same number of hours as men, Dr. White concludes that physician “manpower” is suffering. He is categorically wrong when he says, “When we look at the economics of physician resources, the more important statistic is not the number of physicians working, but the number of physician-hours that are worked.” Here’s why.

First, no definition of physician productivity exists–and certainly none that cuts across specialties would be appropriate. Is the surgeon who works 10 hours in the OR and does 10 hernia repairs in one day, but has a 20% recurrence rate, more productive than the surgeon who works 6 hours in the OR and has 2% recurrence rate? Outcomes count. Studies have shown that women physicians have better outcomes in treating congestive heart failure .

Second, no study has been done that actually measures how much time over a career women and men work. In fact, women appear to be more productive towards the ends of their careers as men slow down. Do men have more medical leaves for injuries and cardiac events?

Third, in informal polling, only 7% of doctors cited numbers of hours worked or patients seen as a measure of productivity.  RVUs, outcomes, patient complexity, patient satisfaction and other measures accounted for 65% of responses.
(To access this survey you must be a physician on SERMO.)

Finally, and most importantly, medicine is not practiced the same way it was 20-30 years ago. Teaming with highly trained medical personnel such as nurse practitioners and physician assistants and the use of technology to manage medical records and patient care, for example, have physicians working in new ways. Recognizing that the structure and function of the healthcare workplace need to better align with the emerging healthcare workforce is essential, and should be at the heart of the discussion.

For more than a century, women physicians have found ways to be incredibly productive. Their strategies of integrating work and life are only just now being recognized as needing institutionalization in the workplace because the women are not the only ones who see the benefits of such change. It’s time to stop the finger pointing and blame game. It’s time to re-engineer the healthcare workplace so that all doctors can contribute to their fullest abilities. At ETI we are committed to this process so we can better engage all physicians in the modern healthcare workplace.


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