I belong to Physician Mom’s Group, a robust closed Facebook group with more than 62,000 female physician-mothers like me as members. Recently, a 30-something obstetrician/gynecologist announced on the site that she was retiring from practicing medicine.
Thousands of “likes” and comments congratulating her on the career move populated her post. Many of the women in the group viewed her early retirement from clinical practice as a success; many others said they wished they had the courage to follow the same path.
But why would a successful, smart woman leave a career in medicine?
For one thing, the hours are grueling. In a good week, I work between 60 and 70 hours. The physical and mental demands of the profession are also significant. To successfully complete an OB/GYN residency you need to have drive, determination and stamina — which can also lead to burnout.
Burnout is a prevalent issue. In fact, a study conducted by the American Medical Association and the Mayo Clinic reported that more than half of U.S. physicians experience burnout, and that can cause them to leave the profession.
What’s interesting, though, is that female physicians are most susceptible to burnout. The AMA study showed that women are 1.6 times more likely to report burnout than men. Approximately 400 physicians commit suicide in the United States each year, and the suicide rate for female physicians is 2.5 to 4 times higher than that of the general population.
One of the main causes of physician burnout is a lack of work-life balance. In obstetrics and other specialties, institutions’ emphasis on patient satisfaction surveys, such as those administered by Press-Ganey, have transformed patients into consumers. The increasing requirements for maintaining certification and the astronomically high cost of malpractice insurance further add to the growing pressure on physicians.
The intense demands of the medical field combined with the lack of support for work-life balance tips the scales in favor of attrition.
I’m guessing the empathetic support this physician received from hundreds of Facebook group members relates to burnout. But for women in particular, biology also plays a role; women who struggle with work-life imbalance are also possibly facing a narrowing window of fertility, and greater reproductive challenges.
One study of women in Hungary showed that female physicians had increased chances of infertility, with an 18.4 percent rate for physicians, compared with 9.8 percent of the general population. The study also showed higher rates of miscarriage for female physicians, at 20.8 percent, compared with 14.6 percent in the general population.
I don’t know what brought on these physicians’ social media support for the woman who decided to hang up her medical career, but I do know that work-life imbalance plays into the reproductive decisions of many of my patients. Burnout is not just a physician problem; it affects high-achieving women in many careers.
I’m a reproductive endocrinology and infertility specialist and a mother of three children, and I counsel single women in their 20s and 30s on fertility preservation. The closest we can come to maintaining our potential fertility is through oocyte vitrification, or “egg freezing.”
Women are attracted to the idea of egg freezing because it can allow them to wait and find the right partner, or to delay motherhood while they build their careers. Peak fertility coincides with the peak career-building years, and the pressure of racing against a biological clock to accomplish both at the same time may exacerbate feelings of burnout.
Peak fertility for women happens when they are in their 20s, and it begins to decline before age 30. There is a second decline in fertility around age 35, and a steeper decline after age 40. The intent of egg freezing is to allow women more control over the timing of motherhood.
One cycle of IVF costs roughly $15,000, and egg freezing costs about $10,000-$12,000, including annual storage fees. A new poll released recently by FertilityIQ, a start-up that collects patient feedback about fertility clinics, showed that technology companies such as Google, Intel, Spotify, Facebook, Microsoft, Amazon and Wayfair offer insurance plans that cover fertility procedures such as in vitro fertilization and egg freezing. Intel has noted an increase in its retention of female employees since 2015, although it is unclear whether the expanded fertility benefits were a direct cause.
More women are having babies later in life. This is due, in part, to increased utilization and success of fertility treatments such as IVF.
But IVF cannot overcome all of the barriers of age, and the success rate of IVF after age 40 is less than 10 percent. Freezing your eggs during your most fertile years, and returning to use them if needed, increases the overall likelihood of being able to have a baby at an older age.
Both the biological clock and the enormous demands of their careers may drive women to leave jobs in medicine to find work-life balance. Taking the biological clock partly out of the equation with egg freezing may help chill the burnout trend, allowing more women to stay in the medical field and continue practicing what they trained so hard to do.
Eve C. Feinberg is an assistant professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine and founder of the Kevin J. Lederer Life Foundation. She is an NU Public Voices Fellow through The OpEd Project. Find her on Twitter @DrEveFeinberg.
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