Is the Problem Women Doctors, or the Way Doctors Work?

(Click here to check out this week’s Fast Company post “Work+Life Flex as Retention-Retirement Strategy? Yes, Say More Retirees and Companies“)

A British medical journal, a Canadian magazine and the medical blogosphere have ignited a controversial debate around the following premise:

There are too many women doctors who want to work part-time, which is contributing to a lack of capacity in the medical system. Therefore, we should reconsider the amount of resources devoted to the education of women doctors and focus more of them on men.

This debate was the subject of a interesting post a couple of weeks ago, “Women Doctors: Waste of Money?” in BusinessWeek’s Working Parents blog. Not surprisingly it resulted in many emotional comments on both sides of the issue.

I asked a 40-something, male doctor I know to weigh in, and he brought up an another angle: “Certainly my anecdotal experience is that more women work part time and those that work full time take more time off for family reasons. But, many MEN entering medicine are not willing to work the way men did 30 years ago. And this is commonly called a “poor work ethic.”

This got me thinking. Is the problem simply about more women than men wanting to work a reduced schedule? Or is it also about doctors resisting fundamentally rethinking some of the ways they do their jobs so there is more work+life flexibility for everyone, not just women?

I recently met a doctor who had tried to innovate the way medicine was practiced in his specialty to give people more work+life flexibility and failed.

He was motivated to rethink the way his hospital scheduled elective surgery when he began to notice that many of the younger doctors (and he was quick to add that these were male and female doctors) weren’t as interested as he had been at their age to work 24/7. Of course, they were all willing to be on call and do emergency surgery when necessary, but they openly questioned the need to schedule non-emergency surgery 24/7.

He did an analysis of the financial impact of having all of the operating rooms open all the time, and realized the cost of having doctors on site, as well as the lab, pharmacy, and nurses on duty “just in case” was prohibitive, and unnecessary.

Everyone supported the new system except a small group of older doctors, who found they weren’t making as much money because they couldn’t schedule the same volume of operations. 24/7 was how they’d always done it, and it’s how they believed “real doctors” in their specialty operated. Not surprisingly, the new system was scraped, and they went back to the 24/7 model, even though initial evaluations of the change indicated patient care actually improved with the new system. Doctors weren’t as tired and made fewer errors.

As the doctor who championed the innovation put it, “This was a matter of a small group of doctors putting their desires and old-school thinking ahead of everyone and everything else.”

The facts do seem to suggest that women doctors are more likely to work a reduced schedule. But how much more work+life flexibility would both male and female doctors achieve if the medical community was more open to innovation and to rethinking the way they delivered high-quality patient care?

Let me reiterate–I understand this is a complex issue. But I can’t help wondering if the question “Are Women Doctors Worth the Money?” distracts medicine from having to answer the harder question, “Can we provide high-quality care more flexibly for everyone?”

(For more on doctors and work+life fit check out this article from the 4/29/08 Wall Street Journal, “As Doctors Get a Life, Strain Shows”)

What do you think?