how much physicians work: Men and women are different
Dual physician households, at least non-white hetero-normative households, have been studied based on self-reported data.[3] In the dual-income, no kids (DINK) couples, we see that women physicians reported working on average 58 hours per week. However, in those couples with children, women reported between 38.1 to 41.9 hours. The male counterparts in the studies always worked more hours than the women. Male physicians in DINK couples reported working on average 60.7 hours per week, while those with kids reported between 53.2-55.0 hours per week.
The authors of this study, writing from Harvard Medical School’s Department of Health Care Policy, posit two reasons for this discrepancy. First, they wonder if societal expectation leads to women shouldering a greater burden of childcare, even within dual physician households. Second, they note that they were unable to control for physician specialty, therefore could not test the hypothesis that women within certain medical specialties may choose to have fewer children and/or work fewer hours.
Let’s approach this thoughtfully. While any inequity between men and women is troubling, do women regret working less and spending more time at home with their children? In particular, the time spent at leisure with children reading stories and throwing balls feels very different when you have a long list of chores left to do.
What I am alluding to is that in addition to long hours at work, physician mothers certainly partake in the so-called second shift phenomenon, first described in the book written more than twenty years ago by Berkeley professor Arlie Hochschild. Dr. Hochschild raises the issue of the domestic burden shouldered by women at home (cooking, cleaning, childcare, household management) and which continues to be shouldered by women AFTER their full-time job.
She writes,
The career woman pays a cost by entering a clockwork of careers that permits little time or emotional energy to raise a family. Her career permits so little of these because because it was originally designed to suit a traditional man whose wife raised his children. In this arrangement between career and family, the family was the welfare agency for the university and women were its social workers. Now women are working in such institutions without benefit of the social worker. As I repeatedly heard career women in this study say, “What I really need is a wife.” But maybe they don’t need “wives”; maybe they need careers basically redesigned to suit workers who also care for families. This redesign would be nothing short of a revolution, first in the home, and then at places of work—universities, corporations, banks, and factories.
Hochschild, Arlie. The Second Shift (p. xiv). Penguin Publishing Group. Kindle Edition
While many women are happy to shrug off the burden of daily cooking and cleaning, few are happy to unburden the lovely details of motherhood—bedtime stories, baking desserts, finger-painting escapades—to work, instead. I suspect there is a clear culprit for women’s higher rates of burnout, particularly in light of the reduced hours of medicine they practice compared to men.
First, the unpaid, less prestigious work of running a household is mundane and tedious. Second, the performance of this work is not at all rewarded with accolades; rather, maintaining a well-run household is expected of professionals. Households with children typically have complicated schedules and competing needs; this can be organization-heavy work with many moving parts. The work of feeding the family, keeping toilet paper in the closet, planning family celebrations, remembering bake sales, remains the domain of mom.
The fact is, forty-hours-per-week in the office careers were designed for single people and for the families of yesteryear, with wives at home raising children. That women have been so successful professionally rather speaks more of the creativity and perseverance of women than the flexibility and tolerance of the the American work day.
Consider the sixty hour work week of many physicians fathers and the 80+ hours performed by today’s resident physicians, with obligations switching from day to night call often in the same two week span. These schedules were not designed to suit the working mother, but working mothers contort their lives to make them work.
How do physician mothers accomplish childcare?
Today, physician mothers piece together a network, a patchwork, a village, for childcare. Most physician mothers[2] surveyed report working between 41-60 hours per week and have one child. Where do these moms turn for childcare?
*data taken from JAMA network article surveying 844 physician mothers (2019) regarding childcare solutions for their first child.
It turns out, most physician mothers use nannies or daycare. Looking at the primary data, there is clear overlap between mothers who use daycare and nannies as well. Twenty-seven percent of physician mothers report requiring additional support beyond standard childcare.
I could not find data reflecting the childcare choices of physician households, but I am curious to see whether there is any difference in choice of childcare solution.
Thanks for reading!
References
[1] Kane, Leslie. 2020. Medscape national physician burnout and suicide report 2020: the generational divide. < https://www.medscape.com/slideshow/2020-lifestyle-burnout-6012460#2>
[2] Juengst et al 2019. Family leave and return-to-work experiences of physician mothers. JAMA Net Open. 2019;2(10):e1913054. <https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2752815>
[3] Ly, D.P. et al 2017. Hours worked among US dual physician couples with children, 2000 to 2015. JAMA Intern Med. 2017 Oct;177(10) 1524-1525. < https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5820690/>
