Practice Matters

Physicians, like most other professionals, have life experiences that ebb and flow. At times, we dive into our professional responsibilities full throttle; other times, our personal responsibilities demand a reduction or pause in our work life. For those who have taken a break from the OB/GYN field, the process of re-entry can be daunting. This segment highlights the experience of one such physician.

I am 54 years old, board certified in Obstetrics & Gynecology and mother of three, "20 something year old" daughters. I come from a long line of physicians, mostly women. My maternal grandmother was a pediatrician who graduated from medical school 60 years before I did. She practiced in the UK. Two of my female cousins are physicians practicing in the UK, and my maternal uncle practiced Family Medicine in Canada. And finally, as I write this, my youngest daughter is studying for the MCAT. Striving to achieve work life balance as a female physician and raising daughters while taking care of women, has created a constant issue of re-evaluating and re-setting of my career compass since 1990. Now an empty nester, I continue to seek work life balance.I was fortunate to be spared excessive educational debt and was not the primary breadwinner for my family early in my career. Because of this, I could seek out as well as create flexible employment opportunities while my daughters were young. In fact, from 1993 through 2004, I worked part-time. Albeit, for much less income and benefits than I felt I deserved. But, my highest priority was being home as much as possible to raise my children while, at the same time, keeping my OB/GYN skills current and maintaining my board certification. In 2004, I made the decision to stop practicing obstetrics and joined the faculty of MD Anderson Cancer Center (MDA) as a benign gynecologist in a full-time position. I stayed at MDA until 2013 when I moved away from Houston and started my professional life all over again. I started a gynecology only private practice. Starting from scratch in a new community, I soon realized the resulting income deficit would need supplementation.
 
I have supplemented my gynecology only practice income through locum tenens and expert witness work. Unfortunately, this work is sporadic, and securing a permanent part-time position has been difficult. Many OB Hospitalist job opportunities exist, but potential employers are not keen on hiring someone like me, who hasn't delivered a baby in over ten years. In an attempt to re-enter the work force, I have offered to be "shadowed" by an existing OB hospitalist and to work for a reduced rate, until my skills meet the designated requirements. I have not found any employer willing to take on this proposal. In addition, I have researched "OB re-training" programs throughout the country but have not found one that is reasonably priced and that doesn't require substantial time away from my existing practice.
 
It is frustrating that I am unable to secure an opportunity to practice obstetrics, despite an inadequate supply of obstetricians currently in practice to meet the national demand for maternity care services (1). This not only places an unfair burden on the existing workforce, it also deprives the public of vital healthcare services.
 
I have discovered that this pause in my professional practice has amounted to a forced retirement from obstetrics. In addition, I recognize that female obstetricians are more likely to be impacted by this practice since we are the ones more likely to take this professional break.
 
I am disappointed that our national governing bodies such as ACOG & ABOG choose to remain quiet on this very important issue. Our field desperately needs guidance and direction for those seeking professional re-entry; guidance to the physicians, hospitals, potential employers and insurers. Currently, each hospital, employer and insurer make up their own rules and for most, the approach is to simply not hire or insure physicians who find themselves in this position.
 
I hope that by speaking out on this important issue, obstetrics re-training programs that are affordable and feasible may be developed. I also hope that ACOG, ABOG and other national organizations will develop standardized re-training curricula so that more physicians like myself may re-enter the obstetrics work force, practice the field we love and provide the service so desperately needed by our communities.
 
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