I was sent an article published in Time magazine about a new study showing that female physicians have a shortened lifespan.
A terrifying finding.
It hits me hard not only as a female physician, but as someone who is really interested in longevity particularly for females. For those of us in this space, are we exhausting ourselves to prolong the lifespan and healthspan of women and in doing so, meeting our own demise?
The study was published in Jama Network. It looked at over 3 million women ages 25 to 74 by occupation. They found lower mortality for females in non-healthcare professions compared to males. There was also lower mortality for most healthcare workers, but not female physicians specifically.
There’s something about the healthcare system that is particularly crushing to female physicians. Female physicians have a higher divorce rate and suicide rate than male counterparts and female surgeons have a higher infertility rate than other professions. The ultimate poor outcome, death, is also higher among female physicians than males and other professions.
What the actual fuck.
This means that even high-income females who are not physicians retain their longevity, suggesting it’s not necessarily the “boss babe” mentality and performance that’s harmful.
Are we paying attention to this? Clearly not enough.
I don’t mean paying attention with a cursory “wellness” session. This is what residency programs and hospitals now use as a metric to combat physician burnout.
“Resident wellness” became a buzz term when I was in residency, I even led a yoga session for co-residents during one of the sessions. I love yoga. It was nice to lead the session. Did it help the long-term burnout of any of the physicians, particularly females? I doubt it.
Scheduling more wellness is literally the opposite of wellness. It’s more obligation. It’s more shit to do. It’s another meeting.
What makes me feel most fulfilled, whole, and well is being away from work physically and mentally. A lot of what I do at home is still work: gardening, baking from scratch, exercise, animal care, and of course, kids. Work, or labor, is not the dissatisfying factor.
At the same time, I can be doing absolutely nothing with my family and feel better than when I’m carrying two phones answering calls, texts, electronic medical record chat messages and emails.
What this study does not tell us is why this is happening. There isn’t data on whether the female physicians were W2 employees, self-employed, entrepreneurs, had families or not.
The unprecedented and unparalleled access to me is a stark contrast to not all that long ago when my mom, who was a career mom, worked before the time of cell phones and smart phones. She could leave work and actually leave work. She was compartmentalizing by default. In today’s world, we have to force ourselves to compartmentalize. This is harder than it sounds, especially for females who tend to give endlessly.
As a resident, I was told “you’re a resident before you’re a girlfriend, wife, mother” (or the analogous male roles). I took that to heart. I owned it. I was proud of it. I was given a hard time when I took a long weekend off to attend a wedding because it fell during my first Obstetrics month of my intern year. I was being conditioned and outright instructed to sacrifice myself for the system, and once I had a family, to sacrifice them too.
Women need more sleep than men. That means this other-worldly sleep deprivation, which I frequently experience, may affect us more. Even if we feel like we recover, our lifespan being cut short is evidence that we didn’t.
Healthcare is increasingly lacking fulfillment for its professionals, both emotionally and financially. Doctors are reduced to task completion rather than compassion and healing. While there are measures of poor outcomes and quality control, there are very few celebrations of healing or helping. While doctors make salaries higher than the American median, there is a pervasive undervaluing of physicians, particularly females. We see this in contract negotiations with low-ball salary offers. We see this in lower reimbursement rates for surgeries performed on female anatomy, frequently by female surgeons. The anatomy is worth less, therefore so are we.
I think these statistics about female physicians lend supporting data to what many of us internally know, but maybe haven’t been willing to admit and certainly we weren’t told. That is, we can’t give 100% of ourselves to the healthcare system and still have enough or anything left for what truly matters to us, which will be different for each person.
Statistically the mental health, physical health, and relationships suffer more for female physicians. Whether women can “have it all” or “do it all” is a continual subject of debate. In my opinion and personal experience, the answer is yes, but something is always sacrificed.
We were told we could be doctors.
We were told we could have families.
We were not told how that would crush us.
There are many female physicians with impressive resumes and many with wonderful families, and sometimes both. This is not to suggest that anyone is failing in any realm, but rather that women are being failed.
While it seems like an easy next step to regret this career, that’s a very slippery slope I’m not willing to go down. The remedy is instead of fitting into the box that medicine expects us to fit into, which was never designed for women or mothers, we have to make it fit us.
I’m very proud my career and my accomplishments. I still plan to achieve and do more. The difference is my future plans will prioritize my family and my own health, two things that medical training and the healthcare system continue to ignore, despite frightening statistics of the female physician population.
Resources:
https://hms.harvard.edu/news/doctors-divorce
https://hsph.harvard.edu/news/female-physicians-continue-to-face-elevated-risk-of-suicide/
https://jamanetwork.com/journals/jamasurgery/fullarticle/2782357
https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2830179