May 2022 • DALLAS MEDICAL JOURNAL | 9
ABOUT THE AUTHORS
An experienced dealmaker and strategic advisor for a
cal physician workforce shortage. It is critical
that we normalize wellness initiatives, such as
days off for health maintenance and doctor’s
appointments, including pregnancy, with an
equitable approach for coverage of workplace
responsibilities in the event that an employee is
unwell or away for a medical condition.
2. Normalizing Caregiving
Because of gendered expectations of
caregiving, women often see caregiving as an
extension of well-being. This frequently translates
into substantial physical, cognitive, and
emotional labor devoted to teaching, training,
and other activities in the workplace. These expectations
are on top of an already disproportionate
burden of caregiving at home, including
caring for sick family members, virtual school for
children, and other homemaking activities.
Hospital systems can be a driving force in
altering cultural expectations about caregiving
responsibilities. One method for doing so is by
normalizing male physicians to take the time
needed for caregiving, such as for paternity
leave or sick days for self and dependents. This
would not only serve to upend gender-related
biases about caregiving, but also support
the retention and advancement of women in
medicine.
3. Family-Friendly Policies
Organizations can bring about a culture
change by creating and maintaining sustainable,
long-term shifts toward supporting
mothers in the workplace. This may include
paid maternity and paternity leave; subsidizing
childcare options; protected private spaces
for breastfeeding or pumping; and support for
fertility treatments, adoption, etc.
Women physicians bear an unequal brunt of
pressures about fertility, especially as many of
their childbearing years are spent meeting the
physically, emotionally, and financially challenging
demands of medical school and residency.
Since female physicians tend to delay pregnancy
until after residency, nearly one in four
are diagnosed with infertility when they try to
conceive, which is twice the rate of the general
public. Furthermore, female physicians are also
much more likely to experience pregnancy loss
and other pregnancy-related complications
due to their rigorous work schedules and lack of
time for self-care and medical appointments.
Furthermore, taking time off during pregnancy
and child rearing is a driving factor in
unequal promotion opportunities. The perceived
power differential between trainees and training
institutions is a significant barrier impacting
self-advocacy; therefore, residency and fellowship
programs, in particular, need to be proactive
in designing systems that normalize and
standardize maternity and paternity. Supportive
and nonpunitive systems should also be in place
to support the time needed to address pregnancy
complications, childcare issues, fertility
treatments, and flexibility in training to accommodate
the needs of physician mothers.
4. Flexibility
Our current systems are designed such that
physicians have to opt in to request case-bycase
opportunities for flexibility, whether it is
clinical schedule, part-time work from home, or
parental/family medical leave.
Organizations that want to retain female
physicians must offer flexibility in all the aforementioned
areas as well as access to backup
childcare. Further, the physician mother may
further benefit from lactation rooms that are
readily available.
The integration of a flexible work environment
can provide benefits in normalizing well-being
and making the workplace parent-friendly, as
mentioned above. Moreover, flexibility can be
a sustainable approach over singular interventions
such as for physician retention, satisfaction,
and work-life balance.
5. Equitable Achievement Determinants
Current determinants for measuring the
success and level of achievement of physicians
are largely subject to gender biases. Take, for
example, the Press Ganey scores, which have
been shown to favor male physicians over female
physicians in some settings through higher
patient ratings for the same work input. These
determinants do not necessarily measure the
unique strengths and achievements in ways that
are equitable to female physicians.
The compensation and career advancement
models in place in medicine do not consider the
emotional labor of female physicians and their
contributions to the healthcare system, including
teaching, curriculum development, work on
committees, quality improvement, and organization
services, which are neither compensated
nor considered in career advancement. In academic
settings, for example, scientific publications
are often key determinants for tenure and
promotion decisions. As such, weighing publications
with other equally important contributions
can help balance the scales in this regard.
6. Career Advancement Opportunities
Because of all the aforementioned barriers
to advancements in the workplace, women
physicians especially need intentional mentorship,
allyship, sponsorship, and targeted funding
for advancement. If the promotion of women is
considered an institutional priority, the frame