Domestic tasks take harsher toll on proceduralist moms’ career satisfaction

Domestic responsibilities put a damper on career satisfaction for proceduralist mothers more than for physician mothers in nonprocedural specialties, suggests a study published April 10 in JAMA Surgery.

Specifically, proceduralist mothers who reported having sole responsibility for at least five of 11 domestic tasks were significantly more likely to want to change careers versus those with fewer household responsibilities (55% vs 42.1%). Nonproceduralist mothers were less likely to want to switch careers, regardless of whether they fell above or below that five-task cutoff—on both sides, they wanted to change fields about 32.5% of the time.

“For many physician mothers, career satisfaction is intertwined with work-life challenges, partially because of the competing burden of domestic responsibilities,” Heather G. Lyu, MD, with the division of surgery at Brigham and Women’s Hospital and Harvard Medical School in Boston, and colleagues wrote.

“Female surgeons are more likely than their male colleagues to be in dual-career relationships and are also more likely to have children at earlier phases of their career. These factors may result in a greater burden of domestic responsibilities that could hinder early academic productivity and advancement to leadership positions.”

Lyu et al. analyzed 1,712 online survey responses from attending physician mothers recruited from the Physician Moms Group, including 73% who were in nonprocedural specialties and 27% who were in procedural specialties. All surveys were completed in the spring of 2015.

Overall, the physician mothers reported having sole responsibility for more domestic tasks than their spouses or partners, including routine child care, backup or emergency childcare, cooking, grocery shopping, shopping for children’s clothing, helping with homework, vacation planning and laundry. On the other hand, their partners more often handled home repairs, finances and vehicle maintenance.

There were no significant differences in how domestic tasks were divided up when comparing proceduralist mothers versus nonproceduralist mothers, but the tasks appeared to be a greater hindrance to career satisfaction for those in surgical or procedural fields. In a multivariate analysis of the proceduralist group, primary responsibility for at least five tasks was independently associated with a 50% greater likelihood that a physician would want to change careers.

The authors noted these results are consistent with other reports and could factor into why many women gravitate to other specialties.

“Of all graduating medical students, only 14% of women apply to surgical residencies compared with 33% of men, and many female residents are concentrated in internal medicine, family medicine, and pediatrics,” they wrote. “Trainees with concerns regarding fertility and work-life balance are more likely to consider what they perceive to be more lifestyle-compatible fields.”

With the increasing numbers of mothers entering the medical workforce, Lyu and co-authors predicted there would be “a demand for more equitable distribution and/or outsourcing of domestic tasks.”

Extended child care services and scheduling flexibility could help healthcare systems offer the desired work-life balance to both male and female doctors, the researchers suggested.

“Particularly in the era of increasing dual-income households, parental leave should be emphasized rather than maternity leave,” Lyu et al. wrote. “Fathers should be given equal opportunity to take advantage of career and scheduling flexibility that allows them the time to equitably participate in domestic responsibilities. … Above all, a culture shift is needed in and out of the workplace to view parenting and domestic tasks as shared responsibilities, particularly for dual-career couples.”