Categories: Health

Didn't we say this 17 months ago?

A new study affirms that our female doctors are overworked, and patients are suffering

by macleans.ca on Wednesday, May 20, 2009 10:55am - 17 Comments

“Female docs hurt productivity” is on the front page of the National Post today.

Maclean’s featured a groundbreaking report about this issue in January 2008. Journalists Cathy Gulli and Kate Lunau examined how professional, personal and domestic demands create a perfect storm for many female physicians, who cope by working fewer hours, taking on fewer patients or leaving medicine altogether. They also reported on the premium care provided by many of these doctors, which has made them more sought-after by patients and, paradoxically, more overwhelmed and susceptible to burnout.

Leading experts called for various solutions such a increased medical school enrollment, Canadian accreditation of foreign medical schools, and benefit packages for physicians. No one blamed female doctors or recommended curbing their numbers.

Maclean’s was lambasted by a good number of medical workers, and even accused of sexism in an editorial published by the Canadian Medical Association Journal. In a new study, one of their own—Dr. Mark Baerlocher, a radiology resident at the University of Toronto—is saying the same thing as Maclean’s reported 17 months ago. Dr. Diane Kelsall, deputy editor, clinical practice at the CMAJ, calls it “a good study,” yet backs their editorial from last year, insisting the doctor shortage shouldn’t be seen as “a gender thing.”

Dr. Baerlocher makes an essential point: “You can’t simply ignore it because it’s a sensitive issue.”

Tags: Canadian Medical Association Journal, CMAJ, female doctor shortage

Tom Blackwell

Actually, the National Post first tackled this issue, with a front-page, 1,300-word feature story on the effects of the feminization of medicine, in September 2005, almost three years before your “groundbreaking” piece … What’s new here is a study that quantified what the different work habits of female physicians would mean once their numbers reach parity with those of men.
Kyle Bailey

This is arguably a very meaning of ‘productive.’ Since when do we define productivity as number of hours worked/degree granted?

If one was considering another profession, such as lawyer/doctor, I highly doubt this standard would be employed. For example, take an engineering company wher engineer Fred works 35 hours/week and engineer John works 30 hours/week….but gets more work done than Fred. I don’t think there are many HR departments that would consider Fred as more productive, given that he is punching in for more time and doing less work.

In this case, many of the indicators seem to point to female docs being more productive ‘premium care,’ better communication, and most importantly, preventitive care that surely acts as a multplier effect.
A more accurate headline would be “Will Female Doctors increased productivty outweigh their lesser hours worked?”
Of course….that would probably sell less newspapers!

This whole kerfuffle reminds me of an American and Frenchman arguing about productivty:
American: I work 54 hour work weeks and almost never take vacations- I’m much more productive than those lazy Frenchman!
Frenchman: I work 35 hours/week, take long vacations, and still get almost as much work done as those inefficeint Americans- I’m much more productive!

Craig O.

The problem is that there is no indication that female workers are more productive than their male counterparts. Premium care means better work, but quality of care is far less of a concern these days than quantity of care, since line-ups and wait times are Canada’s biggest health care problems. The article mentions not only fewer hours but fewers patients as well. Productivity may not mean more hours worked, but the implication here is not just that the average female doctor works fewer hours, but cares for fewer patients as well, and that is an issue of productivity.

Kyle Bailey

Craig.
Yes definately there problem is of quantity of care. However, the point of my spiel is that when one uses productivity in the context of people working- it is generally understood to be ‘labour productivty,’ and measured in output/time.

Here is a Conference Board of Canada blurb that is illuminating:
“Many people confuse the concept of productivity with that of work intensity. But improving productivity is not about working longer or harder, it’s about working smarter. It’s about finding more efficient and effective ways to produce goods and services so that more can be produced with the same amount of effort. It’s also about producing higher-value-added products and services that are worth more in the marketplace.”
http://www.conferenceboard.ca/HCP/Details/Economy/measuring-productivity-canada.aspx#Labour_context

So, in this context, the headline ‘female docs hurt productivity’ will be parsed by many as female doctors produce less output/time. Of course, they actually mean a definition of productivity that is based on number of patient-hours/degree granted- which is certainly counter-intuitive, but I will agree is one form of productivity- one that provides a confusing (and I would say, quite misleading) headline, albeit one much more likely to catch the eye.

I think you’re standing on shaky ground when you say “quality of care is far less of a concern these days than quantity of care, since line-ups and wait times are Canada’s biggest health care problems”…since a) Some of those people wouldn’t be waiting in line-ups/lists if they had more preventitive care, and b) I don’t think anyone thinks that a huge amount of low-quality, but highly available care is the direction we should be moving.

You mention number of patients consulted….
The fact that female doctors have less patients/hour since they produce more satisfied patients may well be a good example of (labour) productivity, since the gains in better care may outweigh the decrease in patients/hour. It would be really interesting to see how often the patients who get longer consults with their doctor feel the need to go see said doctor…perhaps they go to the doctor 20% less, or are 20% healther…or there isn’t a signficant benifit…who knows?. No hard evidence around though- maybe someone will do some really groundbreaking research, so we can know whether it adds or subtracts from (labour productivy).

Mo

I agree that there are many ways by which to measure ‘productivity’; however, I think the point was quite clear – women docs work fewer hours, so they need to take this into account.

I find it a bit ironic when people argue that female physicians provide a ‘higher quality’ of care. Would we ever even consider saying the reverse? Unlikely.

Again, I think the point is very simple and very clear – women docs work fewer hours, and they need to take this into account. I think it’s unfair to simply infer this is sexist in any way and consequently dismiss it.

Re: measuring the impact of spending more time with patients, etc – that would be extremely difficult to objectively measure, at least from an outcomes perspective.

Bill Simpson

It seems to me that this only matters because we appear to have a rationed number of doctors available. if supply was allowed to meet demand, both through accrediting foreign trained doctors and widening the availability of medical schools, then this is pretty uninteresting. If a woman wants to be a doctor, then she should have that opportunity, and if she wants to work part-time or take sabbaticals, then this should not be a negative, since another doctor will appear to take her place.

http://www.jackmitchell.ca Jack Mitchell

Hear hear. Professions should not be allowed to regulate themselves.

http://parentalalienationcanada.blogspot.com Mike Murphy

When you give a monopoly to any group or organization they have not got the right stimulation (in the private sector competition) to redress what customers are telling them. If the RCOPS is behind the shortage and not government policy they need to be removed from any form of recruitment in med schools.

The study proves that females have different work habits, work fewer hours, take more time off for family reasons. There is nothing wrong with this and it is their choice. Those of us men who have been stay-at-homes for periods to raise children understand it completely. More men are doing the same thing and much more involved in the nurturing and rearing of children.

This pattern, as found in this study, is not new but may have just been discovered in medicine. Feminists like to promulgate the myth of women making 71 cents on the dollar as compared to men. The reasons why this is so are also evident in this study. They make less money because of the factors shown in this study and it is by choice not the patriarchy as victim feminists like Antonia Zerbisias, over at the Toronto Red Star, like to spin.

The Victim Feminist talking points will be the female Doctors earn less money than men and it will be true!. But it will be for reasons of choice as it is most every where else not because of that nebulous and evil patriarchy. Now that we have that out of our system we learn to deal with it. We need more Doctors enrolled in med school whether they be men or women. Life goes on. If the victim feminists start to spin this as further victimization of women – mow them down with facts.

If restricting entries into med school is artificial then it needs to be changed by the government regulators and the money found to support it. Tax and spend McQuinty can juggle his allotments and find it easily instead of buying our votes with our own tax dollars.

theragingranter

I just wanted to say, that’s the coolest goddam mask I’ve ever seen. I’m going to have nightmares, it’s that cool.

theragingranter

Of course, I was talking about Bill Simpson’s avatar, not Jack Mitchell’s. Just wanted to clarify that, lest there be a misunderstanding.

bl2345

I just saw the reply to the article in the Post:

http://www.nationalpost.com/opinion/story.html?id=1629753

That seems like a ridiculous response! They totally ignore the point. They also suggest or imply that the original paper and article entirely blamed women for the doctor shortage, while total BS – it was made pretty clear that no-one felt that anyone should be blamed; only that it was one factor that should be taken into account.

Knee-jerk reactions like that letter are pretty transparent.

If the reverse situation was true – men made up the minority of doctors, but would soon become the majority, and worked 50% of women doctors – would people not feel that this should the be studied? Obviously. So here the difference is smaller than 50%, and it’s women not men. It should still be studied and taken into account.

I can understand if 2 medical students would write something like that; but I find it hard to believe that 2 deans would have the short-sightedness to write that kind of a response.

Finally, if they really don’t think that we need more doctors, with the Ontario government’s May 21 announcement that they’ll increase the number of medical student spots and associated funding by 100 and 35 million dollars, I wonder if the deans will ‘decline’ the funding.

This is so disappointing – people in such a position can’t see things for what they are without mixing in the politics.
Gaunilon

I love how if you suggest that there might be any downside to having more women in a given profession, you’re automatically bigoted. Even if you sugarcoat it by pointing out how much more sought-after those women are because of the ‘premium care’ they provide, you’re clearly a misogynist.

Let’s just imagine, for a moment, what sort of reaction there’d be if someone suggested that men are more ‘sought after’ because of their ‘premium’ performance in some profession. Sorry, sorry, it was inadvertant heresy. I recant! I promise! Please don’t burn me!

Raj

Here is a link of the discussion between the study’s author, the dean of the University of Western Ontario, and a health politician on CBC radio:
http://www.cbc.ca/thecurrent/2009/200905/20090529.html

http://www.kegelaid.com kristengager

This come to no suprise to me it is well documented in Hr case study that i have gone over in business school. Women reality and men reality are not the same considering that women have maternity leave and in general wants to see there kids grow up it is more then normal that if they have the chance ,they will work less. It is just a matter of priority and not a question of sexism i think.
http://fulldiziizle.biz dizi izle

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Jane

One of the great upsides of more female doctors is that they tend to be more open to working on salary rather than on a per case basis. That makes them less expensive to the system – even if we have to have more of them to see the same number of patients.

I also wonder about the definition of productivity. I have a feeling a lot of the extra counselling female doctors do pre-empts a lot of extra visits and expensive surgical interventions.
Jennifer

Jane:

Younger MDs in general are more likely to prefer salary/AFPs vs FFS. However, there was a paper published that showed that MDs who work for salary or AFP see less patients than those working FFS (on average, it was something like 50% in the same time period). So it won't save money overall…in fact, quite the opposite (since the salaries are not 50% of the FFS incomes!).