august 2007 | Welcome to Finding Balance eNews.

Women in Medicine
Ok, I am a guy, but I am married to a women physician, so I feel like a second hand expert. Let’s take a brief look at issues for women physicians.

Women physicians have more complex lives than their male colleagues. Historically, medicine has not been a warm fuzzy place for women. While this is likely to change over the coming years as more women enter the medical workplace (greater than half of medical school enrollees over the past 10 years have been women) it is still not the happiest place for women today. Many women physicians are still looked down upon for taking time with their families or working part time. They are often seen as, or feel ‘less’ than men in this regard. This is changing. Part time medicine is on the rise for both men and women and in most environments, it is usual.

In primary care settings, women physicians tend to see more women patients with complex psychosocial problems, while seeing patients with the same numbers of complex medical problems. This is because a patient with complex medical or social problems believes that a women physician will be a better listener. This is especially stressful for these physicians as every patient seems to want to “talk their ear off”. Thus women are seeing more challenging patients than their male colleagues. On average, women physicians reported needing 36% more time than allotted to provide quality care for new patients or consultations, compared with 21% more time needed by men. This is probably due to the complexity of the patients. This is additionally stressful for women physicians who are being compared to their colleagues on a patient volume basis.

Because of societal roles set for women, they often do more than their share of work in the house, with the children and with community activities. Women may feel that they have tried to please everyone, and end up feeling they have pleased no one. With all of the above responsibilities, women physicians find that their personal needs are last and often lost. They put their personal and emotional needs at the bottom of the list of priorities. There is no time to consistently take care of themselves, even the basics such as exercising, eating well, getting enough sleep, and spending time alone or with friends.

“I feel like I have to justify every minute I spend not taking care of some one else” — T. K-H, MD, Family Physician and mother of five children

How does this effect women physicians’ mental health and attitudes? Women had 1.6 times the odds of reporting burnout compared with men. The odds of burnout for women increase by 12% to 15% for each additional 5 hours worked per week over 40 hours. The odds of burnout were 40% less for women when the support of colleagues, a spouse, or significant other was present for balancing work and home issues.

I strongly suggest beginning to take care of your selves. Don’t sacrifice yourself for the good of others. Burnout and fatigue are likely to be the result and then you can serve no one! And there is hope, over the next generations there will be more women practicing medicine in the US than men!

So, how to manage the stress of all this? Two of the most de-stressing events, for a women are coming home to a clean house and talking with friends, so some suggestions:

• Get a massage – you deserve it!
• “Out-source” your house cleaning – this is one place not to ‘cheap out’
• Find time with your friends to talk

References:
Career Satisfaction of US Women Physicians; Results From The Women Physicians’ Health Study E Frank et al. Archives of Int. Med., July 12, 1999, v.159, n. 13

The work lives of women physicians’ results from the physician work life study. The SGIM Career Satisfaction Study Group. McMurray JE; Linzer M; Konrad TR; Douglas J; Shugerman R; Nelson K J Gen Intern Med 2000 Jun;15(6):372-80

Women in medicine: stresses and solutions, Mamta Gautam, MD,West J Med 2001;174:37-41

Biobehavioral responses to stress in females: Tend-and-befriend, not fight-or-flight. Taylor, Shelley E.; Klein, Laura Cousino; Lewis, Brian P.; Gruenewald, Tara L.; Gurung, Regan A. R.; Updegraff, John A., Psychological Review. 107(3), Jul 2000, 411-429.

Fun stuff for this month:
If you’ve not yet seen the movie “What Dreams May Come” with Robin Williams and Cuba Gooding Jr., I highly recommend it. While it is a few years old, it certainly is one of my favorite movies of all time. It explores the possibilities of soul mates. (if this does not fit your belief structure – don’t bother) It is also a visual masterpiece.

For you and your patient:
A great way to manage stress is guided imagery. For learning this, I highly recommend Marty Rossman, MD’s “Stress Relief through Guided Imagery”. This is a simple and great set of imageries that will work well for you or you patient.