Feminization of Medicine?

[drusso]

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I think this is a great trend. But, many economic studies show that as women enter into a field, there is negative salary pressure because women tend to be more willing to work part-time and/or desire time away from work for childcare. What are people's thoughts on the long-term impact of this trend? How will healthcare adjust to more women in the workplace?


Women Lead Applications to U.S. Medical Schools


WASHINGTON (Reuters) Nov 05 - More people are applying to medical schools in the United States, and women outnumber men for the first time, according to a report issued on Tuesday.

Nearly 35,000 people applied to attend medical school in the 2003-2004 school year, a 3.4% increase over last year, according to the Association of American Medical Colleges.

"The main reason for the increase was the number of women applicants, 17,672, an almost 7% rise over last year's total," the AAMC said in a statement.

The number of applicants to medical school peaked in 1996 at 47,000 and then steadily fell until last year, the AAMC, which represents 126 medical schools, said.

"While the total number of black applicants (2736) rose almost 5% due to a 10% increase in black women applicants (1904), the number of blacks who were accepted and then went on to attend medical school (1056) declined by 6%," it added.

"The total number of Hispanic applicants (2483) increased by less than 2% since last year, while Hispanic attendees declined by almost 4% (to 1089)."

AAMC President Dr. Jordan Cohen said the report showed that schools need to work harder to attract minority students.

"At the same time, the increase in total and first-time applicants is a reaffirming sign that the current generation of young people recognizes the attractiveness of medicine as a profession," he said.

 

[fourthyear]

Yes, those who choose to work part time will be paid less. But that won't affect those who choose to work more. Generally, you can find many practice opportunities which will reward you for productivity if you choose to work a lot. Having part-time physicians in your specialty just leaves more work (and more potential income) for those who want it.

I doubt that women increasing numbers in medicine will do anything to affect our future salaries. The insurance, managed care, and malpractice problems will continue to drag our salaries down, not the demographics of those within our profession.

 

[BellKicker]

If we're anything to go by, then the female:male ratior will continue to rise in the US. We have 2:1 here in Scandinavia.

Women applicants have been rising for many years but I believe it's leveling off now. From what older doctors tell me, it's made medicine a more pleasant field.

It has also influenced which specialties are most popular. You invariably need a PhD or more to get peds or OB/GYN here (Seriously). Rads or surgery are open throughout the year, presumably because they don't appeal to women (don't ask me why).

 

[ckent]

From an economic standpoint (and by economic, I mean doctor's salary and job security), I would actually think that having more and more females join the field of medicine would actually increase the demand for doctor's services and thereby increase overall salaries because if most female physicians are seeing fewer patients then male physicians on average (for whatever reason), then that means that previous doctor to patient ratios are no longer applicable since you actually need more doctors to see the same number of patients. Then again, I'm no economist, so I don't fully understand how any of this supply/demand stuff works. It's definitely not a simple bar graph when you are talking about health care and have to factor in things like governmental regulations and fee determining rates made by insurance companies. Of course with medicare decreasing physician/hospital payments by 4.5% this year, and this trend being expected to continue or worsen with the addition of a prescription drug benefit and increasing governmental deficit (none of which effects lawmaker's salary of course, which went up again this year), who knows what doctors salaries and job security will be like in 10 yrs. The only constant I think will be that the current trend in malpractice will continue since everybody feels entitled/wants something for nothing (eg ferry boat passengers who sue for 200 million for emotional trauma of being on the ferry boat with lawyers advertising, looking for "victims") and lawmakers are lawyers and lawyers are corrupt.

 

[DrMom]

Originally posted by ckent
lawmakers are lawyers and lawyers are corrupt.

maybe the answer is to stop providing healthcare to lawyers. with their high stress levels and type-A personalities, they'll all keel over from MIs. then, maybe, we can make some progress.

😉

**DISCLAIMER**

please note that DrMom does not actually advocate withholding care from attorneys, no matter how tempting.

 

[drusso]

Interesting comment from POL...

"People don't like to admit it, but one reason for the increase in "time controlled" specialties is the increased percentage of women in medicine. When you figure that 50% of grads are women - mostly in their upper 20's, then looking at 3-4 years residency. That takes them into their 30s. Those that are married have the bio clocks ticking. Many aren't married which may even create more anxiety. You don't find many women willing to bust their "balls" to attain partnership status in pri practice groups, and many find salaried positions (which ultimately weakens doctors' positions as we yield to corporate medicine). I don't mean to be sexist or judgmental, but we can't fight demographics and biology. I really respect those women who are able to balance professional and family lives but the examples in surgery, busy IM practice, etc. are rare. We've been taught that you can have it all, but in reality life is about choices. If my daughters want to go into medicine, I'd recommend they find a guy who is not in medicine and willing to take on the Mr. Mom role"

 

[Mirror Form]

My uncle has been a school teacher for several decades. He says that over the past couple decades, whenever the teachers want to try and negotiate for higher salaries, it's always the female teachers who are the fastest to give and end the strike/negotiations. This could be b/c women are more likely to have a spouse who makes more money then they do, and as a result tend to be richer then their male counter parts. Whatever the reason, he (and several other from his district) pretty much view it as a fact that having lots of women in a field will tend to drive down the average salary. I hope this doesn't hold true for medicine, but who knows.

 

[Voxel]

I think that some women will choose part-time, salaried, or non-partnership tracks and this will lead to a decrease in the relative supply. It's hard to have it all, especially in dual career families.

I also think there will be a significant number of unmarried and childless women physicians, unless they find a Mr. Mom/partner.

 

[roja]

Originally posted by drusso
Interesting comment from POL...

"People don't like to admit it, but one reason for the increase in "time controlled" specialties is the increased percentage of women in medicine. When you figure that 50% of grads are women - mostly in their upper 20's, then looking at 3-4 years residency. That takes them into their 30s. Those that are married have the bio clocks ticking. Many aren't married which may even create more anxiety. You don't find many women willing to bust their "balls" to attain partnership status in pri practice groups, and many find salaried positions (which ultimately weakens doctors' positions as we yield to corporate medicine). I don't mean to be sexist or judgmental, but we can't fight demographics and biology. I really respect those women who are able to balance professional and family lives but the examples in surgery, busy IM practice, etc. are rare. We've been taught that you can have it all, but in reality life is about choices. If my daughters want to go into medicine, I'd recommend they find a guy who is not in medicine and willing to take on the Mr. Mom role"

An interesting quote. I think like many things there is some validity to it. But I knew many a woman who would trounce the men for positions etc. They had adopted the more 'traditional' roles of competitive medicine and had no problem sacrificing it all for their careers. And instead of marrying mr.moms, many women just hire nannies.

I, personally, don't ascribe to the 'live, eat, breath sleep your medical career', and I think its unhealthy for anyone to sacrifice thier entire being to medicine. But that's me... and I admit to being a freak. *g*

 

[Supadupafly]

The comment on increased presence of women lowering wages is incorrect, at least for working class jobs. While jobs that have traditionally been dominated by men (dock loading, longshore, ect.) do pay more, times are changing.

Women are more likely to unionize and form more representative and democratic unions. Have a look at salaries in nursing and other paraprofessional fields. Pay and recognition comes with organization.

We must realize that it is not our own divisions, but managerialist manipulation, causing wage losses. We must respond in a well organized manner in the interests of our class.

Bringing more women into medicine could only be good. It will benefit quality of care & public health, bring about the end of paternalistic medical practice, and draw us towards unity as a profession.

And I'm a man.

 

[Foxxy Cleopatra]

I think it is backwards to make blanket assumptions about all women, as if we live our lives on some schedule of having to get married by age X, have 2.5 kids, etc. There's nothing wrong with those things, but personally I have seen that life usually doesn't fit into a plan and am not particularly interested in that.

What is the solution then- to admit less women into medical school? Though, (and I hate to break it to the wide-eyed pre-meds) medicine isn't all that great a career and (by doing that) it may be doing us a favor. Alluding that women entering professional fields is going to drive salaries down for men implies that women should be kept out of fields that are highly paid based on motivation. And for that to happen, the issue would have to go much deeper.

Women get too many mixed signals the way things are now, from childhood in the 80's when we were pushed to be little overachievers/go-getters then to have the tables turned in our young adulthood at a time where society is placing more of an emphasis on family. Though I personally am not one of the women who is looking to enter part-time work to raise a family, I can see how many other women find themselves in that position. I imagine that it would be hard for someone with many years of education and the debt to go with it to just drop everything and be a stay-at-home mom.

 

[Voxel]

I'm not sure about the nanny part. I would want at least one of the parents there at least part time to raise the children especially in the early formative years. I guess you can drop them off at day care or with the nanny after 6-8months until they go to kindergarden, but personally I don't think I would want that for my children if I could afford not to do that. I'm not saying there is something objectively wrong with nannies and day care but given the choice I probably would not let my children be raised that way. I can think of plenty of people that turned out ok that way.

I think it's a harder road for most women as they have to juggle full time careers, children and husband.

 

[SunnyS81]

I don't think the wage issue will become a factor, but demand will.

And I am about to stereotype.

Most female doctors I know (including many faculty members) don't work 5 days a week as physicians. From what I've seen they seem to take one or two more days off per week than their male counterparts (especially when they have young kids).

I have no problem with that. Medicine is nice because you are given the autonomy in many situations to make your schedule.

However, with the predicted increase in demand for healthcare with the baby-boomers and so forth, and increasing number of women in medicine, you are essentially creating an increase in demand while decreasing the supply (since women work less from my observation above). For example, a group of five women worked 4 days a week, only 4 men would be needed to provide the same supply. By maintaining the number of seats in med schools, this will eventually lead to a net decrease in labor hours per year from physicians.

In theory, this would lead to an increase in pay (an incentive for all women to work equally). However, since doctors get paid by reinbursements (which are unlikely to go up), and they are limited by time, their salary is limited by the number of patients they can see, so doctors who are already extremely busy won't see any increase in pay, while those with struggling practices might.

Just my observations and thoughts..........

 

[nuclearrabbit77]

if the man-docs get trophy wives....i say that the woman-docs get trophy hubbies.

now the question is...what would make a good trophy-hubby?

 

[Museless]

For starters, he's gotta stay home and take care of the kids. 🙂

 

[chillin]

I think all ugly women should become physicians. That way they can concentrate on their career. At the same time, not only will this help boost the number of hot stay at home moms, but we'll breed out all the uglies in our society.

 

[Skip Intro]

I think all ugly women should become physicians. That way they can concentrate on their career. At the same time, not only will this help boost the number of hot stay at home moms, but we'll breed out all the uglies in our society.

Ummm... I think you're forgetting where the other 50% of the genes come from, dude. You might luck-up and marry some Cindy Crawford lookalike, but I'd bet good money your kids would still look like Opie.

-Skip

 

[LADoc00]

I brought up the fact that the number of women in medicine is directly proportional to the lawsuit fervor when I was a med student. Lawyers look for "marks", they are like birds of prey when they see weakness in one field or company they descend on it and devour it.

Government is no different, as the number of women increases, pencil pushers will drop compensation with the justification that since most docs are women, they have a 2-income home and dont need medicare payments to make em even richer.

Yep, I try to focus on medicine like it was say in 1975-1985 the real "Golden Era" because this is all down hill from here!

Wooohoooooo

 

[docB]

Women are more likely to unionize and form more representative and democratic unions. Have a look at salaries in nursing and other paraprofessional fields. Pay and recognition comes with organization.

True but I'm always reading and hearing about how all the highest paying jobs in nursing and the majority of admin and managerial jobs are held by men despite the fact that the field is mostly populated by women. I'd say the reasons are the same as those expressed on this thread, kids, time off, etc.

Another thing, and I'm not saying this is god or bad, just a fact, is that as more people of either gender take part time positions in primary care the chances that any given patient will be able to see their PMD on an urgent basis or to have them as primary in the hospital goes down. Regardless of whether that makes a difference or not pts see it as a negative.

 

[Ross434]

Women are more likely to work less. This has been proven. Thus, supply decreases, bigger paychecks.

 

[f_w]

This thread is goood !

> I brought up the fact that the number of women in medicine is
> directly proportional to the lawsuit fervor when I was a med
> student. Lawyers look for "marks", they are like birds of prey when
> they see weakness in one field or company they descend on it and
> devour it.

On the contrary. A study on lawsuits in radiology recently prooved an observation many had made in the past:
Female radiologists are far less likely to get sued over mammograpy reports than male ones. As 95% of the mammo lawsuits are patently bogus, they make a good model. The way how malpractice suits are fought, key is to have a sympathetic poor victim (suffering patient), and an 'evil cold perpetrator' (doc). And in that respect, a self assured male makes a far better mark for the shysters than a female.

(Can blame women for a couple of things, but surely not for bringing the malpactice crisis upon us.)

> This could be b/c women are more likely to have a spouse who
> makes more money then they do, and as a result tend to be
> richer then their male counter parts. Whatever the reason, he
> (and several other from his district) pretty much view it as a
> fact that having lots of women in a field will tend to drive
> down the average salary.

Wow, and where did you get this pearl of wisdom from ? It is surely not supported by labor market or census data. (or could it be that the women in this district cave earlier during a strike bc they depend on their regular paycheck more then men ?)

 

[dr_almondjoy_do]

Wow. SDN never ceases to amaze me.

Has it ever occured to anyone that a woman might want to work less and make more money in order to be successful and raise a family? And do you all realize that raising a family is only a part of a family's time in the scheme of things?

I would say that, based on my opinion only, it would take a woman 10-15 years tops to work part time and raise a family if she chose to. And part time for a physician is still 30-40hrs. After the kids are all in school and off to college, then she can take up her full time role again (60hrs including saturday).

And call me sexist, but I feel that it's a woman's place to make sure the family is well managed. Be it via nanny, grandparents, private chef, housekeeping, husband... she still has to have the upper hand, no matter what her profession is.

 

[EctopicFetus]

I think that one of the basic tenets of economics is being sort of missed here. There is a thought that if there isnt someone who is willing to do a job if you pay more then people will go and do that work.

So for the sake of our discussion lets look into a field like ER. Lets say an ED requires 300 hours per week of coverage. Lets then assume that an average EM Doc makes $125 per hour. Lets then say that all the full-time docs are working 200 of those hours and the other 100 hours are left over for 4 doctors. Each of these only want to work 20 hours per week leaving 20 hours uncovered. Now no one wants to work for the $125 per hour but if you were to pay them (just an example and certainly not a fact) $1,000 per hour. Do you think those 20 hours would be gobbled up. Of course they would.

This is what happens in the end. In reality instead of $1,000 the number might be to increase all pay to $150 or $175. The solution is not to pay the doctors less because then even fewer people would want to work.

I hope everyone understood this process. I know it gets complicated with reimbursement etc, but as soon as there is a true lack of supply then wages will increase to compensate.

There is a reason why rural docs are reimbursed at a higher rate... to encourage people to practice there.. thats the reason.

Personally, I dont think it is a bad thing for women to go into medicine. In my opinion there are possibly too many FMGs in training. While many of these are very very smart they lack communication skills with inner city patients. This is something I have noticed throughout my 3rd yr. Wondering what the thoughts are on this.

It appears that FMGs are taking over many primary care spots mostly because US medical grads dont want them (i.e. Family, Medicine, and OB). They see more patients than other docs and many lack the ability to communicate effectively with patients. As I mentioned before it isnt a question of intelligence (cause they are very often much smarter than their US counterparts). I know many have been attendings in other places... This is not meant to be a flame but rather a concern I have seen.

 

[f_w]

> I hope everyone understood this process. I know it gets complicated
> with reimbursement etc, but as soon as there is a true lack of supply
> then wages will increase to compensate.

This would be true if medicine was driven by market forces, but it is not. US medicine is one of the last vestiges of soviet style planning buerocracy. Reimbursements are the result of political clout of the respective specialty college, not a result of any market mechanism.

> There is a reason why rural docs are reimbursed at a higher
> rate... to encourage people to practice there.. thats the reason.

LoL.
One of the key problems of the medicare payment formula is that it acts to the disadvantage of rural areas. Some of the senators from rural states are trying to fight this, but currently the exact opposite of your statement is true.

 

[Ross434]

> I hope everyone understood this process. I know it gets complicated
> with reimbursement etc, but as soon as there is a true lack of supply
> then wages will increase to compensate.

This would be true if medicine was driven by market forces, but it is not. US medicine is one of the last vestiges of soviet style planning buerocracy. Reimbursements are the result of political clout of the respective specialty college, not a result of any market mechanism.

> There is a reason why rural docs are reimbursed at a higher
> rate... to encourage people to practice there.. thats the reason.

LoL.
One of the key problems of the medicare payment formula is that it acts to the disadvantage of rural areas. Some of the senators from rural states are trying to fight this, but currently the exact opposite of your statement is true.

Its true the specialty boards are really the major forces - but - a lot of times their main tool is a market force - restricting supply - by being stingy about accreditation.

 

[U4iA]

And call me sexist, but I feel that it's a woman's place to make sure the family is well managed. Be it via nanny, grandparents, private chef, housekeeping, husband... she still has to have the upper hand, no matter what her profession is.

sexist.....

 

[Winged Scapula]

> This could be b/c women are more likely to have a spouse who
> makes more money then they do, and as a result tend to be
> richer then their male counter parts. Whatever the reason, he
> (and several other from his district) pretty much view it as a
> fact that having lots of women in a field will tend to drive
> down the average salary.

Wow, and where did you get this pearl of wisdom from ? It is surely not supported by labor market or census data. (or could it be that the women in this district cave earlier during a strike bc they depend on their regular paycheck more then men ?)

This was actually a traditional reason used in the argument why employers paid their female employees less than their male counterparts. It was assumed that the female's salary was "extra", and she was not supporting a family with it, hence she didn't need as much money (for her hats, shoes and other girl things) as the man who was supporting the wife and 2.3 children.

Trouble with that argument (and you can find lots of literature on this practice, especially during the 70s) was that often SINGLE male employees were also paid more than their female counterparts, even though they didn't have a family to support. Perhaps it was assumed that male "extras" (ie, cigars, beer, gambling debts) were more expensive than the females! 😉

 

[MD'05]

In my opinion there are possibly too many FMGs in training. While many of these are very very smart they lack communication skills with inner city patients. This is something I have noticed throughout my 3rd yr. Wondering what the thoughts are on this.

It appears that FMGs are taking over many primary care spots mostly because US medical grads dont want them (i.e. Family, Medicine, and OB). They see more patients than other docs and many lack the ability to communicate effectively with patients. As I mentioned before it isnt a question of intelligence (cause they are very often much smarter than their US counterparts). I know many have been attendings in other places... This is not meant to be a flame but rather a concern I have seen.

I've seen the same thing. It really depends on the FMG. I've seen a few that are empathetic towards inner city patients, but the majority provide suboptimal treatment of disease in most inner city populations. The FMGs seem to not understand how people can be so f*cked up in the land of plenty and have absolutely no empathy towards these populations.

 

[Furrball]

maybe the answer is to stop providing healthcare to lawyers. with their high stress levels and type-A personalities, they'll all keel over from MIs. then, maybe, we can make some progress.

😉

**DISCLAIMER**

please note that DrMom does not actually advocate withholding care from attorneys, no matter how tempting.

Wouldn't work, we'd get nailed by IMTALA; so we would have to provide care. At least they wouldn't have to chase the ambulance

 

[Furrball]

>
One of the key problems of the medicare payment formula is that it acts to the disadvantage of rural areas. Some of the senators from rural states are trying to fight this, but currently the exact opposite of your statement is true.

And don't forget that states that are more efficient with their healthcare dollars end up getting less than states that are wasteful. States actually get hurt in the Fed health-dollar lottery if they are more responsible.

 

[Furrball]

e on this practice, especially during the 70s) was that often SINGLE male employees were also paid more than their female counterparts, even though they didn't have a family to support. Perhaps it was assumed that male "extras" (ie, cigars, beer, gambling debts) were more expensive than the females! 😉

And your point is? It's tricky to type when one hand is holding onto a beer 😀 If I smoked cigars I would need a voice activated computer. I shall talk to the financial aid department immediately!