Give Doctors a Break

In a heartless op-ed in yesterday’s paper, an anesthesiologist argues that medicine shouldn’t be a part-time endeavor. Dr. Sibert makes a firm introduction: “I’m a doctor and a mother of four, and I’ve always practiced medicine full time,” she boasts. “When I took my board exams in 1987, female doctors were still uncommon, and we were determined to work as hard as any of the men.”

Her premise:

With a growing shortage of doctors in America, we can no longer afford to continue training doctors who don’t spend their careers in the full-time practice of medicine.

She’s half-right, I think; the costs of medical education are too great for doctors to be pulling back on normal work hours or quitting their work entirely, willy-nilly. Besides, perhaps a tougher or more persevering group of would-be physicians might have used their coveted med school slots to better end and, ultimately, helped greater numbers of people.

The problem is this: What happens when a doctor gets sick? Or her child? Or partner or spouse? Most of us who’ve gone to med school, men and women both, do or should plan for coping with the inevitable decline of our parents and older family members. But there are some unfortunate circumstances that can make full-time work a challenge for months or even years.

I suspect the author has been fortunate in her career and health.

When a doctor or a dependent becomes seriously ill, she needs a supportive environment. She needs a workplace that allows her to take time off completely, or to work part-time for a while and possibly for a period of years, in a way that doesn’t engender resentment among her colleagues.

In a system without slack, doctors may feel pressured to work under too much duress, when they themselves are facing serious health or family problems. As things stand, I’ve witnessed doctors who’ve abused alcohol, been unkind to colleagues and disrespectful toward patients, and cut clinical corners as ways of coping with too much work, too little free time, and too little sleep.

Sometimes, the reasons why a doctor needs to cut back on her hours or work may not be evident to her colleagues. She may keep her good reasons to herself. With patients, explaining the details of one’s own illness, or a child’s, seems unprofessional, in general, although I do think that when a doctor becomes so fragile that she may not be able to return to work, her patients have the right to know that much, if they depend on her.

As for me, what I’ll say here is this: The day I stopped practicing medicine, nearly five years ago, was one of the saddest days of my life.

Medicine still is a macho field, as Dr. Sibert reveals in her op-ed. This is a shame, because the physicians’ shortage is real. In the long run, the system – which amounts to doctors in supervisory positions, like division and department chiefs – should soften up.

A flexible, more realistic system would allow doctors, in whom the system has invested so much, and who have invested so much of themselves, to take time off when they need it, and flexibility in their schedules, so they can continue in their careers after prolonged illness.

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  • Elaine,

    When I read a statement like Dr. Sibert’s sarcasm bubbles right right out of my mouth as in — “aren’t YOU special?” Imagine, being brilliant, well compensated, able to induce comatose states in patients, breathe for them, wake them up, then go home to competently herd a brood of four similarly competent children.

    This struck a nerve – obviously – for two reasons: time I’ve lost from work from cancer (tho I’m quite sure Dr. Sibert would have managed chemo w/nary a puke) and the fact that my oh, so fabulous female internist had to retire to care for her children, who were reaching middle-school age. What a loss to no longer have this wonderful physician practicing in the community. I’d support whatever measures are necessary to keep women in medicine — the loss of them is collective.

    Life happens. Perfection doesn’t.

    Thanks for jump starting my brain this Monday morning.


  • Great post Elaine. When I think about how hard my oncologist works I wonder how he does it. He works full days, is on-call at the local hospital over weekends and after hours, and then he often calls me with test results etc in the evening after 8pm. But you’d never know it. He always make time for me, stops to chat about things other than cancer, and always always always greets me with a smile and puts me at ease. I have so much admiration for how hard medical professionals work, but burn-out must be a huge factor. It’s like running a marathon. So I think you make some very good points about the system could be a little more friendly. Just because something is, doesn’t mean it should be.

  • I think it’s not entirely fair to assume Dr. Sibert would not make an exception in the case of doctors who themselves are not of sound mind and body. I’m sure Dr. Sibert is referring only to the “duty to serve” of other MDs who have been as lucky as her, those who are not themselves ill or compelled to stay home by children with special needs. That would be callous and ridiculous to insist upon – which is why I think, as an interpretation of her opinion, it rings untrue.

    Doctors, like their patients, should seek treatment for psychological or physical problems before they effect their job performance – but I do think it’s fair to ask more fortunate MDs to shoulder some inflexibility if it means more experienced doctors who are abreast in the latest technologies and developments in their field. And, even though it’s heartless, as a patient, I want a thick-skinned doctor, who shies away neither from blood nor brusque colleagues.

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