Physician Moms Are Often Subject to Workplace Discrimination

Workplace discrimination is common in medicine for women physicians who are also mothers, affecting as many as four out of five “doctor moms,” according to a new survey led by UC San Francisco.

Of the nearly 6,000 physician mothers in the survey, nearly 78 percent reported discrimination of any type. Forms of perceived discrimination ranged from disrespect and reduced pay to being overlooked for promotions or being held to higher performance standards.
 
To combat gender-based discrimination while retaining high-quality physicians, the researchers recommend that employers implement policies such as longer paid maternity leaves, backup child care, lactation support, and schedule flexibility.
 
The study will be published in JAMA Internal Medicine on May 8, 2017.
 
“Physician mothers treat patients, raise children, teach students and care for sick relatives and friends. But who looks after them?,” said corresponding author Eleni Linos, MD, DrPH, an assistant professor of medicine at UCSF.
 
“We need to make sure these women get fair and unbiased treatment at the workplace. The role of physician mothers is essential and we can’t afford to lose them to burnout,” said Linos, a UCSF Health physician in the Department of Dermatology who is also a member of the UCSF Helen Diller Family Comprehensive Cancer Center.
 
Previous research has shown that women physicians are typically paid lower salaries than male peers, are less likely to be promoted, and spend on average 8.5 more hours a week on household activities than male counterparts. The new research focused on how motherhood affects perceived discrimination among women physicians.
 
The Physician Moms Group (PMG), launched in 2014, is an online community with more than 60,000 physician members in the United States. Members are highly active, filing on average 415 posts daily and more than 7,400 comments.
 
The online, cross-sectional survey, conducted in 2016, queried PMG members about demographic and physical factors, perceived workplace maternal discrimination based on pregnancy, maternity leave, or breastfeeding, and desired workplace changes.
 
Altogether, 5,782 physician mothers completed the survey and provided responses that could be analyzed for the study, which adjusted for race or ethnicity, medical specialty and practice setting.
 
Of those, about 66 percent reported gender discrimination, while nearly 36 percent reported maternal discrimination. Approximately 32 percent reported discrimination based on pregnancy or maternity leave, and about 17 percent reported discrimination based on breastfeeding. Maternal discrimination was associated with higher burnout among the physician responders.
 
Overall, nearly 39 percent of the physicians experienced disrespectful treatment by nursing or other support staff. Among the 2,070 physicians reporting maternal discrimination, the most common forms were disrespectful treatment, not being included in administrative decision-making, and pay or benefits not being equivalent to male peers.
 
The physician mothers also listed numerous desired workplace changes including:

• More flexible weekday schedules
• Equal salaries to male colleagues
• Longer paid maternity leaves
• The option to work part time
• Child care on site
• Option to not work on weekends
• More sick days

Respondents included physicians in a variety of medical specialties, including anesthesia, dermatology, emergency medicine, family medicine, internal medicine, neurology, obstetrics-gynecology, ophthalmology, pathology, pediatrics, psychiatry, radiology and surgery. They worked in a variety of medical settings, among them academic medical centers, public hospitals, military and VA practices, and health maintenance organizations.
 
Some 68 percent of the physicians in the survey were between 31 and 40 years old. Nearly 76 percent had one or two children, while almost 18 percent reported having three children.
 
“It’s just good business sense,” said co-author Christina Mangurian, MD, MAS, vice chair for diversity in the UCSF Department of Psychiatry and associate professor of psychiatry at UCSF.
 
“In corporate America, it has been shown that family-friendly policies increase productivity,” she said. “It is so well known, in fact, that investors buy stocks when these policies are announced. We need to learn from our business colleagues. If we want to retain talented women physicians, we need more family-friendly policies.”
 
Co-authors are Taiwo Adesoye, MD, of the University of Texas at MD Anderson Cancer Center; Esther K. Choo, MD, MPH, of the Oregon Health & Science University; Christina Girgis of Loyola University Medical Center; and Hala Sabry-Elnaggar, DO, MBA, founder of the Physician Moms Group. Contributors to the article from UCSF are Adi Nosrati, MD, and Mary-Margaret Chren, MD.

UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises three top-ranked hospitals, UCSF Medical Center and UCSF Benioff Children’s Hospitals in San Francisco and Oakland, and other partner and affiliated hospitals and healthcare providers throughout the Bay Area.