President's Perspective August 2012

Michelle ButterworthToday's Foot and Ankle Surgeon: A Working Mother's Perspective
By Michelle L. Butterworth, DPM, FACFAS, President

 
It’s 5 am and the alarm is buzzing; it’s time to welcome another day. I enjoy the quietness of the house to do some work — emails, charts, letters and bills. A quick sip of coffee and I’m off for a run. I enjoy this peacefulness as I know the rat race is just minutes away. I return home and the chaos begins. Breakfast is fixed, lunches are made, backpacks are loaded, shoes are found and we rush out the door making it to school just before the bell rings.
 
I walk into my office and my day begins. Dr.Smith needs this patient seen today. Return patient calls. Finish patient records. Refill prescriptions. Dr. Jones needs me for a consult. I take a drink of coffee, smile and see my first patient.
 
My mind wanders as I work: What’s for dinner? Pick up milk. Did Ryan pass his spelling test? I don’t have time to see that drug rep. Did I feed the fish? I hope that infection doesn’t need surgery today. Will I make it to Ryan’s baseball game?
 
Surgery, a base hit, pizza, homework, laundry, a fish funeral, bath and finally everyone is in bed. My day is complete.
 
This is a typical scenario for many physicians, not just parents. And while I don’t mean to begrudge working fathers, all this usually comes down on mom. So it’s not surprising then that four times as many female physicians in the US work fewer than 20 hours/week, in contrast to their male colleagues. This probably explains why, in our recent ACFAS practice/salary survey, male respondents made on average $70,500 more per year than female participants. The difference is even larger in other medical specialties, where male compensation is $86,000 higher than female physicians.
 
More women are practicing medicine in theU.S. than ever before and they are entering medical schools in record numbers. In 2010- 2011 women accounted for 47 percent of all first year medical school students and 48 percent of all MD degrees awarded. The statistics are similar in podiatric medical schools with women accounting for 41 percent of all first year podiatric medical school students and 44 percent of all DPM degrees awarded.
 
In 1970, fewer than 8 percent of physicians in the US were women, by 2011 this number increased to 33.8 percent. While there has been an increase in women residents, currently 45 percent, in all specialties over the past ten years, there has been minimal change in the percentage of women choosing particular specialties. Women currently make up only 15 percent of the surgical workforce and only 5 percent of female medical students choose a surgical specialty. Instead, women tend to gravitate to non-surgical specialties and primary care, such as internal medicine, pediatrics, family practice, and OB-GYN. Currently 74 percent of OB-GYN residents are women; whereas, less than 10 percent of orthopaedic surgical residents are women, the lowest percentage among all residency programs.
 
Surgery has been known to have longer, irregular irregular hours and studies show that female surgeons are more likely to be single or divorced. They are also more likely to postpone having children or having none at all. With these facts, it is not hard to understand why most female physicians prefer non-surgical specialties. What is the future then for surgical specialties with the increasing numbers of female physicians? If surgical specialties are not attractive to half of the medical school student population, the people applying to these programs are limited and may not be the best and brightest.
 
Will this affect the podiatric profession since every graduating resident now has at least three years of surgical training? Surgery will no longer be an option for our profession, but a mandated path for every podiatric medical school graduate. Since most female physicians pursue non-surgical specialties, will the numbers of female podiatric medical students decrease? Time will tell and I hope this won’t be the outcome, because as crazy as my day seems, I love being a foot and ankle surgeon, a wife, and a mom and I look forward to tomorrow so I can do it all again.
 
Questions for Dr. Butterworth? Write her at president@acfas.org.

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