November 2010 - Program Notes by Bob Bondurant

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November 2010 - Program Notes by Bob Bondurant

We are pleased to present an excellent report authored by the task force on the Accommodation of the Pregnant Physician, published by the Physician Health Program of British Columbia called Medicine and Motherhood: Can We Talk? This study has many implications for the health care delivery system in this country, and includes specific recommendations on addressing the issues involved.

The physician to population ratio in the US is in decline, while at the same time there is a concomitant increase in demand due to the growth and aging of the US population, as well as a growth in public expectations. “The growing proportion of physicians who are female is having a profound impact on the physician workforce and delivery of care.... During the past 3 decades the proportion of physicians who are female has risen from 8% to nearly one in four physicians. Recent trends suggest that within the next 2 decades women will constitute nearly half the physician workforce.” (1) Additionally, in 2005, nearly half of all US medical students were female.

“The rising proportion of women in medicine and the higher propensity of female physicians to practice in metropolitan areas could hinder the national goal of improving physician supply in rural areas.... There is considerable evidence to show that female physicians are less likely to practice in non-metropolitan areas compared to their male colleagues. Ellsbury, (2002) describe reasons why female physicians may be more hesitant to practice in nonmetropolitan areas compared to male physicians” (1) due to concerns including the availability of flexible hours, availability of child care and opportunities for part-time employment. “Physicians in nonmetropolitan areas work longer hours and work in smaller practices, on average, compared to physicians in metropolitan areas. These factors possibly have a greater disincentive effect on female physicians who tend to have greater preferences for flexibility in hours to bear children and raise families....” (1)

As the report authors state, “pregnancy is a short period of time in a medical career that should span 30 or more years. It is imperative

that employers, medical organizations, educators and other stakeholders work together to develop policies that accommodate this aspect of physicians’ lives.” Although this study discusses the Canadian labor force, the same trends are evident in the states, and the discussion is certainly pertinent, as our medical care system is increasingly being challenged.

As the female practitioner and her associates wrestle with some of the issues presented in this article, Missouri Physicians Health Program stands ready to consult and provide assistance.

1. The Physician Workforce: Projections and Research into Current Issues Affecting Supply and Demand, US Department of Health & Human Services, Dec. 2008.