Don't quit this day job. (part time mom docs)

[Michele]

http://www.nytimes.com/2011/06/12/opinion/12sibert.html

Discuss.

[Michele]

I tried to select, copy and paste the text of the article, but I can't from my iPhone.

[Vanquisher]

What a bitch! That's all I have to say about that. I think she is seriously wrong on many levels. I think that if you want to take on $200,000 of debt and work part time and can pay back your loans, you don't "owe" medicine anything. The fact that resident education is so expensive is mind boggling. Residents don't see nearly half of that money. Furthermore, I doubt with great furvor that it costs that much to train a resident given that they staff clinics and close up wounds in the O.R. so that the attendings can see a much greater volume of patients and bounce from O.R. to O.R. Residents make money for hospitals and universities in my estimation. Talk about your cheap labor! $8.50/hour for someone with a graduate degree sounds like a pretty big fucking steal to me.

If you want more men to go into primary care, make it pay more. Seriously. Women go there for the schedules. Men stay away because of the pay. Doctors don't need more dedication to medicine. I do agree with her that they need the medicare and medicaid cuts to stop. They do need tort reform. They need a stop to the insurance company beurocracy machine of bullshit that requires at least 30 minutes of paperwork per patient to meet quality assurance measures that may have little or nothing to do with your practice of medicine. My husband has to code for 10 medicare e-prescriptions by the end of June (I don't think he will make it) in order to not be docked 1% by medicare for everything that he sees. How is this not bullshit? He e-prescribes everything that he can, but when you aren't a primary care doc and mostly write for narcotics, or your patients on medicare generally come to you as an acute injury in the hospital and you can't e-prescribe to the hospital pharmacy, it puts a damper on things. Not only do the prescriptions have to be e-prescribed on medicare patients, but, they have to coincide with very few E&M code visits. Any post-operative medication doesn't count! It is so frustrating.

The average physician spends 3+ hours a week on administrative bullshit with insurance companies, trying to get their patients approved for their durable medical equipment or off-formulary drug, or referrals, authorizations, and eligibilities.

Screw that lady. She knows shit.

[SoonerTexan]

In short, She can shove it. I'm on my iPhone so I will post more later, but I'd like to see the stats that back up her argument.

[SoonerTexan]

Ha, cross posted with Vanquisher

[poky]

As is becoming traditional whenever a controversial mass media article about medicine comes up, I'm just going to link to Michelle Au's take on it. Worth reading after the article itself, I think.

http://www.psychologytoday.com/blog/...edical-edition

[SuzySunshine]

I think Michele Au responded very well and I agree with pretty much everything Heidi said.

If this lady is so worried about family practice being shorted by women who work part time why didn't she go into that specialty? Oh right because as she so aptly pointed out there isn't as much money in FP as anesthesia. What a tool!

[v-girl]

Can we start a Michelle Au fan club? DH and I both thought her rebuttal was very well written and she made very good points.

[ladymoreta]

Ugh, DH and I just finished reading that article (from v-girl's facebook), and we just wanted to smack her. What an idiot. Undergrad schools also get tons of federal funding, but she specifically said she didn't care if other professions went part time. Because everyone deserves to have doctors available to do their bidding whenever and wherever they want, for whatever they want (or don't want) to pay them. Sigh...

[GrayMatterWife]

I think she has a point. Don't suck up space in medical school if you aren't actually going to be a productive doctor.

I guess my take is: if you are going to be part-time, be a very productive part-timer. That seems to be the real issue: women have this degree and ability to be a productive doctor, then fail to be a productive doctor because they are stretched between their personal lives and their profession, hurting everyone from themselves, their families, their patients and other women who don't want to be presumed to be "mommy tracking." Find a way to make part-time work productive, constructive and cost-efficient, so that women in the medical field is not necessarily a depletion of available doctors. The answer cannot possibly be that the only truly productive doctors are the full-time doctors. There is a lot of wasted time in the business of medicine.

[Meenah]

I'm with you Heidi!!!!!!!!!!!!!!!!!! I do Primary Care, and I spent 75% of Friday filling out paperwork that is "required" but total BS. Between Medicare and the Insurance companies, they think I don't know how to prescrinbe the basics for hypertension or diabetes. Different medicare options changed all of the "approved" brands of diabetic glucometers, and I have to rewrite / reorder all of the patients diabetes equipment, even the ones I just renewed a few months ago. I could go on & on. I love what I do, but I barely clear enough to pay the office power bill. DH's income from ICU barely floats the office practice. My office nurse spent a couple of hours trying to get an MRI approved for one of my patients. I'll work when I want and how much I want, thank you very much.-

[Tenacious_D]

I think she has a point. Don't suck up space in medical school if you aren't actually going to be a productive doctor.

I guess my take is: if you are going to be part-time, be a very productive part-timer. That seems to be the real issue: women have this degree and ability to be a productive doctor, then fail to be a productive doctor because they are stretched between their personal lives and their profession, hurting everyone from themselves, their families, their patients and other women who don't want to be presumed to be "mommy tracking." Find a way to make part-time work productive, constructive and cost-efficient, so that women in the medical field is not necessarily a depletion of available doctors. The answer cannot possibly be that the only truly productive doctors are the full-time doctors. There is a lot of wasted time in the business of medicine.

I agree with this...I wish I had more time and energy to articulate my point but I think it affects doctor patient relationships. It can be rather confusing for the patient to have 3-4 people caring for them who don't interact. It is a personal decision but one that does affect others...I'll try to expand on this later.

[Tenacious_D]

I also think that choosing the right speciality for part time work is important. My husband chose radiology because of the work life balance and shift work associated with it. Ugh! I sometimes wish I could talk to y'all about my thoughts.

[PrincessFiona]

I sort of ... agree and disagree with her.

We have a huge problem with part-timers in primary care here. Huge. They all want to work mornings (from 8/9-11:30), none of them want to job/patient share, and they don't want to pick up their pagers/cell phones once they are at soccer with their kids, etc. That being said, they want to have the same voting rights/insurance/benefits as their full-time counterparts. The consequence of this is that patient care suffers. To top it off, they are opposed to mid-levels (who often come in and are twice as productive and frankly have more experience than they do actually seeing patients!) There is currently a waiting list for primary care at the clinic for over a year to be seen as a new patient. To be clear, these docs don't have to deal with the paperwork because they are employed by the hospital group here and their are coders etc who manage all of that.

There have been multiple occasion where Thomas has had to stay late and admit a patient who is not his because (for example) a part-timer ordered a CT, left, and didn't pick up her pager and the patient needed immediate medical care. He can't get the school vacations off or teacher inservice days because the part-timers get them off (even if their kids are highschoolers ... and hey ... it shouldn't matter. What about equality here?) The consequence of all of this is that a great deal of resentment has built up between the full-time men and WOMEN and the part-timers.

Going part-time has to be done right for it to work for patients and colleagues. There has to be a job/patient share and guidelines need to be established to make sure that colleagues aren't the ones stuck holding the ball (and missing their own child's recital while you are at ballet/karate/soccer). Any criticisms usually end up in an anti-women argument instead of being seen as what they are ... an attempt to make sure that patients are taken care of and that the colleagues are treated fairly.

This is definitely not a black/white issue.

Kri

[Meenah]

This is definitely not a black/white issue.

So true! Fortunately I work with DH, so anything we do affects both of us.