Enough Already!

I have stayed mostly quiet on the topic of the Macleans article that hit newsstands in January. It examined the doctor shortage across Canada, gave tips on how to find a family doctor, and looked in particular at the shortages in rural areas. Sprinkled liberally with anecdotes and horror stories, it was intended to sell magazines. It caught my attention, and the Bean and I took a trip to our local Chapters to peruse the article in question over a Starbucks Soy Chai (the Bean is sensitive to dairy). 

It was just another verse of the same song. I've complained about it before. And now other people are complaining about it too. The backlash from the article was heard across the country. Blaming female physicians for the doctor shortage is misguided. Now I know that the plural of anecdote isn't data, but I don't know of ANY female physician throwing it all away to spend more time with her children. But that might be because I don't know many female physicians who are married to male physicians. In the real world, income usually wins out over traditional gender roles. If Mom's income potential is $200K and Dad's income potential is $80K, if one of them is staying home with the kids it sure as hell isn't going to be the one who gave birth to them. Particularly not with med school debt to pay off.

I've said it before and I'll say it again... louder this time, for those of you in the back.

IT'S NOT A WOMAN THING.

Physicians just aren't like that anymore. Gone are the days of the kindly old doc who has a family practice, delivers babies, does shifts in the emerg, cares for his inpatients in the hospital, does house calls, visits the nursing home, and does coroner call on the weekends. You know the type... known to everyone in the community but a stranger to his own family? Men have wised up. That's not a life. No one ever lay on their deathbed and wished they'd spent more time at work. The popularity of 'lifestyle specialties' is a testament to this. For the past few years, there have been spots left over after the match in specialties like general surgery, orthopedic surgery... hell, even neurosurgery hasn't filled in the first round. At the same time, the popularity of anesthesia, radiology and emergency medicine have gone through the roof. It seems that the only surgical specialties that are still uber-competitive to get into are the ones that offer a reasonable lifestyle on top of the hefty paycheque-- like ENT and plastics. 

Family doctors as a whole are setting up sustainable practices. That means picking a practice structure (FHT or FHN) that lets you leave work behind at the end of the day. That means less call. That means building a practice that won't leave young physicians burned out in 10 years. That means having a life outside of medicine. Imagine the nerve of these young physicians, trying to have it all! Since more women are entering medicine, it MUST be their fault!

Ask any of the old-school docs nearing retirement. They'll back me up. It's not just women. It's ALL new doctors. We're soft. We didn't train as hard as they did-- we didn't have to live in the hospital, we were allowed to be married. We got days off. We're paid. Our residency is shorter. We are protected by a union that enforces the rules and keeps us from being used as slave labour. We aren't willing to be on call. We protect our leisure time with the ferocity of a rabid dog. We don't want to work more than 60 hours a week. How dare we.

Why complain about it? The evolution of medicine has been positive in many respects. We aren't paternalistic, and medical decisions are now made with the patient calling the shots. We listen. We consider more than just the illness (in family medicine, anyway) but the social context. We have lives outside of medicine, and protect the longevity of our careers by not working to the point of suicide or burnout. We make a decent living, but are more likely to choose a smaller paycheque in order to work fewer hours. And what's the harm to the system? Well, maybe we'll need a few more doctors. We've seen that coming for years. And those doctors will be better people for the choices they've made... none of which can be attributed solely to gender.