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  • Writer's pictureRebekah Bernard

No shortcuts in medicine: Women physicians speak out about scope of practice

One topic that gets women physicians fired up like no other is a discussion of gender issues in medicine. While medical school classes are currently made up of about 50% women, women physicians are still a significant minority in medical practice today, and women doctors face serious inequities due to their gender. One of the biggest challenges that women must face is the decision of if or when to have children, because of the intense and lengthy educational training process that doctors must complete.

A recent post from a nurse practitioner student who reported feeling guilty about being away from her children while on clinical rotations caused controversy among women physicians. Many women physicians noted that the number of clinical hours that the nurse practitioner student was complaining about was just a fraction of what they have had to go through while other women physicians argued that no woman clinician should have to feel guilt about balancing child-raising with education. Dr. Sonal Patel and Dr JouJou Hanna join us to discuss the nuances of this issue.


Rebekah Bernard MD 0:07

Welcome to 'patients at risk,' a discussion of the dangers that patients face when physicians are replaced with non physician practitioners. I'm your host, Dr. Rebekah Bernard and I am joined by my co host and the co author of the book, patients at risk the rise of the nurse practitioner and physician assistant in healthcare. Dr. Niran Al-Agba.

Niran Al-Agba MD

Good evening.

Rebekah Bernard MD

One topic that gets women physicians fired up like no other is a discussion of gender issues in medicine. While medical school classes are currently made up of about 50% women, women doctors are still a significant minority in medical practice today. And women doctors face serious inequities still due to our gender. One of the biggest challenges that women must face is a decision if or when to have children because of the intense and lengthy educational training processes that we go through.

So there was a recent post that a nurse practitioner put up that she reported that she was feeling really guilty because she was spending so much time away from her children while on clinical rotations. And this post created a lot of controversy among women physicians. Some of the women doctor said that the number of clinical hours the nurse practitioner student was complaining about was really just a fraction of what they had to go through. And then other women physician said, Well, hey, maybe no women, clinicians of any kind should have to feel guilty about balancing children and education. So we're here to talk about some of these nuances with my guests, Dr. Sonal Patel and Dr. JouJou Hanna, and welcome both of you. So let's start with you tell our audience a little bit about yourself.

Dr. Sonal Patel 2:42

Hi, well, first of all, thank you, this is amazing platform to discuss this. I am a product of two physicians. And so my mom and my dad - they were foreign medical graduates. So that means they had to actually they did their stuff in India. We actually traveled a lot when I was young. And so I moved here when I was 10. And then my mom, so we're gonna focus on my mom, my dad had to make those decisions too. But particularly my mom now who had a nine year old and a three year old had to redo all the at that point in time, they had to take like the TOEFL exam, and qualifying that they knew English and then USMLE and all of that lovely jazz. And so she actually had to make a choice. She's OB GYN trained, but the residency that was in Omaha, Nebraska, that's where I grew up, was only in family practice. And so her difficult choice was like, 'Okay, do I leave my kids to go to Columbia to do three years of OB or four years of OB, or do I stay in Omaha, Nebraska?' and she chose to stay in Omaha.

She did a family practice and through that, she was able to do some of her OB, but since she was an OB, an American OB doctor, when she had to do C sections and stuff like that she had to have another physician there. And so she had a lot of challenges that way. And she's she was most experienced one because you know, she's she's done it for so long.

My story was I knew I wanted to be a physician, despite the fact of all the hours I mean, I remember going to my parents were on service and going to the cafeteria, I thought it was like such a cool thing that I got to eat in the cafeteria. It's like my mom was on call, she'd come down but we'd eat at the cafeteria and that was like the highlight. I always knew I wanted to be a physician. I am raising four kids with my husband who is also a trauma orthopedic physician, and I'm a pediatrician, I did a NICU fellowship. And then fast forward, I really changed and pivoted and now I'm actually doing home health services. But I was a NICU doc for seven and a half years before I pivoted and there was a lot of balancing that happened. I had kids in residency, I had kids and fellowship.

Rebekah Bernard MD 4:49

You are definitely perfectly positioned to discuss these difficulties. What about you JouJou?

Dr. JouJou Hanna 4:57

Hi, yes, thank you for having me as Well, this is exciting. I've never done anything like this before. I am a little different. I'm first generation born here, the first doctor in my family, my parents came to this country. And it's like the true American dream. And I had no one helping me how to even go to med school. And so I had to figure it all out for myself, which was was really cool.

I wasn't one of those people that always thought I wanted to be a doctor, like I always, I'm a pediatrician as well. And I always knew I wanted to work with children. So I thought it'd be a teacher, like my mom or social work or something. But I was in this pretty bad car accident when I was 17. And I had the most amazing plastic surgeon who kind of encouraged me, it was a guy to be like, You should be a doctor. And I was like, 'Could I be a doctor?' you know. And so I always liked science. So I went that route, and of course, hard work, and became a physician.

I didn't settle down until I was older. And so when I was in residency, or med school and residency, I was it was on my own and I used to, I used to look at people in med school and go, I don't even understand how you're married, how do you have kids? I can't even do my laundry. I can't even feed my cat - like I didn't understand. And then as a resident, just seeing some of my awesome girl pediatr - Like they're pregnant, running down the hallways. And I was just like, this is this is awesome. And I always I always wanted to be a mom and have kids. But I didn't know if that would happen.

But I eventually got married, came back home and worked in the ER for a major hospital in Fort Worth. Eventually, I was not in a very good relationship. And I eventually had a kid and it was one of that dichotomy things were like, I'm working in the ER trying to save children's lives. And I'm worried about my own child at home. And little by little, I had to cut back hours. I was like, if I cut back hours, I can be there more home for him. Maybe that's this is my fault. And this and that. And everything I did was like, how do these moms have kids? Like, how do they support and who picks them up and who does this it's like, I feel like I'm working to pay for daycare. And I'm missing out on time. And every I went from er to urgent care to cut down hours. And then I just went to primary care. And I think it's worse. And so I mean, I don't I can't take my son to school. And now I'm a single mom. And I can't pick them up. And it's been horrible. And so I've finally actually just quit my job again. And going back to urgent care for more shiftwork. So where I can work, when my ex has my son. And in that those process I've seen other like, we can talk about nurse practitioners choose, like, I start with, like, all these doctors that's working with me, and then all of a sudden, it's me with like five nurse practitioners in the ER, and it's like little by little slowly that the pressure of my responsibility went like this, this, this and the stress at home this, this this. And it was awful. I couldn't handle it.

Rebekah Bernard MD 7:51

Oh, that is such a balance that you're going through and a really important perspective. So I want to get more into that before we do Niran talk about you. You also have four kids.

Niran Al-Agba MD 8:02

I do and what I was gonna say without even talking too much about myself because my story is very similar to both of the other pediatricians also who happen to be on this show with me. And I think it's I'm hearing that I think all of our parents were immigrants, is that correct? Yeah. So was was my dad, he was an FMG as well.

And for the those listening if they don't know about foreign medical graduates, they were educated six years doing basic science and anatomy and all these really, in fact, a lot of people that are foreign medical graduates, especially from India, the Middle East, and a lot of Asia come in with more education than we have here in the US. And so then they've also done the residency training, and they've been out in practice a lot of times.

So when they come here because they speak a different language or they're from a different country, as dumb as that sounds. To be uniform, though the United States requires them used to be one year of internship, that was my dad. And then he was a chief resident in New York after his one year. And then I'm not sure what Sonal you know, parents had to do, but they have to, like retrain. And so not only are they doing all the years, we did, but then they're retraining so that they can practice the United States and a lot of FMG physicians have to switch specialties as a result of that into a whole nother residency. So I wanted that one thing really clear there's extra training that they have to go through.

And then yeah, I mean, I think I was the same as far as waiting to have kids. You know, I got married at 32. And I had to bang out kids in four years, five years, essentially. And that's pretty much what we did. And so I had four kids, four and under at one point, I had a four-year-old, a three-year-old, an 18-month-old and then a newborn baby.

And so you know, I really - I love kids. I enjoy kids. I wanted to have kids, but you sort of postpone your childbearing years and I think what bothered a lot of us about that post was the person that was doing nurse practitioner school was complaining about doing children 40 hours in 14 weeks, and that breaks down to about 17 hours per week. I trained I know Rebekah- Dr. Bernard - also trained under the old residency hours, right? So we were in, you know, well over the there's no limitation we did 36 hour shifts, at least twice a week. And then you know, we would stay all day, there was no max on the hours, we can be there, oftentimes 36 hours plus or more in a shift. So, you know, she's complaining about half of what we would do in one day. And I'm sort of sitting here thinking, you have no idea what we had to go through. And the shame is, if we had to work 17 clinical hours, we can do a little setting, I think we've managed our kids just fine. So I think that's why it's set off so many women in our group.

Rebekah Bernard MD 10:36

I think you're right. And you know, I'll just share just briefly my story. I'm the only non pediatrician here. I'm a family physician, and also nonimmigrant parents, both my parents were nurses, actually registered nurses, I was really interested in medicine, because they would always talk about the things that they saw, my dad was an ER nurse, and my mom worked in a nursing home.

My situation is a little more similar to JouJou in that I got married at about 30. I didn't really know if I wanted to have kids. I'm the oldest of four siblings, and I did a lot of that child-rearing because my mom was unwell when I was a kid. And so I thought, 'Do I really even want to have kids?' And when I was about 35, and I just didn't get pregnant, I went to talk to the fertility doctor just to get some information. And I went in there and I said, 'Well, I'm not really sure if I want to have a baby. And I'm sure you hear that all the time.' And he looked at me and he said, 'No, I never hear that- people come here because they want to have a baby.' And I said, Okay, so I realized that fortunately, I didn't pursue that avenue because I ended up getting divorced, that was not the right person for me, either. I'm remarried. And I think, wow, I would have had a child with that person for the rest of my life. And that is as JouJou I think can attest it just another thing that we have to deal with. And I've talked to a lot of women doctors that are now single parents or you know, struggling with some marital things. Sonal, you have a supportive husband, who is also a physician. Do you have anyone else that helps you? Or how do you manage the child-rearing with your job as a physician?

Dr. Sonal Patel 12:10

Luckily for me right now, last year, we finally did not need a nanny, like it was like groundbreaking, because my kids now range from seven to 16. And I think that there's a shift in that. One of the things I learned early on was the fact that when I started the NICU, and my new job, a lot of nurses around me were getting a divorce. And I was like, Wait, why are you guys getting divorces? And they said that they kept putting themselves on the backburner. And the only advice they would have given me is to spend the money where I needed it in order to fulfill me, were two household income physicians.

Yes, we have loans, yes, we have all of that stuff. But everything is temporary. So having a nanny is temporary spending X amount of money is temporary. Because at the end of the day, I tried being a stay home mom, and I completely failed that. Not to say that, because I needed that structure for myself, to be a good mom to my kids. And I think realizing that and allowing myself to be like my identity is the fact that I'm a physician. And that is my identity. And I'm going to value that.

And so listening to them getting that piece of advice was amazing to be like, No, you know what, like, my husband has a very though he's a trauma ortho, he has a very kind of doable schedule. He's on-call Thursday nights, and he's on-call weekends that were known. We had to kind of rearrange it, but they were like, you know, what, if you need to go out Thursday night with your friends, and you wanted to do that, pay for it? I was like, that was a really good piece of advice that I got very early on.

Rebekah Bernard MD 13:49

Now, JouJou, what about you your situation is really unique and it sounds you know, particularly challenging. So have you learned anything that helped you make it easier?

Dr. JouJou Hanna 14:01

Just survival mode every day. I cry a lot sometimes. But it's kind of the same thing that Dr. Patel just said, it's like, I felt like I was I don't know if you can swear on the show or not like half doctor, half mom, like I wasn't like half that I felt like I was half-assing both of it but trying really hard at both of it right? Having a partner doing it I'm sure it's just as hard but doing it on my own is it's really really, really hard.

We kind of talked about, like my parents are not in the medical field at all. But my mom worked - she was a teacher. And all I can say is I always felt like a failure because my mom worked. She had a fresh dinner every single day. She made my lunch but she worked just like how the heck did my mom do that? And you know, serve like be the best mother in the world and I feel like a terrible mom.

And I know I'm doing the best that I can but it's gone in phases. I have had wonderful friends and family. But past like six months I've had to drop off my son in the morning at different people's houses every morning saying, 'Hey, can you take him to school.' And then I had a nanny for a while, which, which was wonderful. She was amazing. But she got pregnant and had a baby. But I was so happy she did. But at the same time, too, it's hard to trust people to come into my home and the interviewing process and all that. And I was like, I just and my son has gone through a lot of changes. And I just didn't want to keep introducing strangers to his life.

So I had to make the decision of, and I cannot be a stay-at-home mom, either. I was like, I didn't work this hard to just stay at home. And I have no and I think being a stay-at-home mom is probably the hardest job in the world. It's hard. But I want to do both. Like I want to be a good mom. And I want to work really hard, you know, I didn't get this degree for any reason. And I still have loans to pay off. And I still have this and kind of the same things like, like I'm paying for it as I pay for aftercare or I pay for daycare, but I'm a single mom, pediatrician, I don't make a lot of money. And I have a lot of things that I have to pay for. And so I can't just spend the money all the time, it doesn't work like that.

Yes, I might not have a social life because I'm going to be working the days that my son is with my ex. So I'm I will either be with my son, or I'll be working on nights like nights and weekends. So that post that I would like to bring is that I knew about nurse practitioners 20 years ago when I was 22 in med school, and I was one of the first members of PPP when there were like 100 of us because I was like this is gonna go out of control. And no one believed me. No, I know what I was talking about. We all got to work together and be a team. And they are team. But then I was like as a pediatrician, we're the first ones that they come in, and they think it's like, oh, it's just an ear infection, or it's just this I'm like, I didn't train 11 years, we make it look easy for a reason, right? Because they don't know. And so like when you're in the ER and you're working and all of a sudden these people are coming in thinking that like they can do what you can do. That's very frustrating. But that post, I was the first one that said, hey, look, there's a lot of things that I complain about. But I am number one a single mom right now, if she's having a hard time with whatever's on her plate, she couldn't handle that. Imagine what we go through, you know, and we just nobody ever talks about it, right? Because we have to be supermom, and super this and super that. And it's it's just trying to find that that balance. And it's day by day process. For me.

Niran Al-Agba MD 17:13

That's sort of what I wanted to ask both of you about essentially how the pandemic affected you. And the reason I'm asking is, this is not just in healthcare, right. So the pandemic pushed so many women back into the home, because we keep talking about balance. And I find it fascinating men balance like, you know, drinking, well, this is terrible drinking together on Thursday with their buddies, right with, like the football game with like, come home and eat dinner. And I know that's a stereotype. So I'm sort of doing that on purpose in a way. Because men really weren't pushed back into the home, they definitely did some more education, probably with their kids at home, there. But really, women were sort of broadsided by the pandemic, because we do always balance right. And then it sort of the pandemic unbalanced us. And so I guess what I'd like to hear from both of you is, how did you find a balance? Or if you didn't find a balance, you know, how have you kind of recovered or made it work during that time, because you know, all our kids were doing school at home.

Dr. Sonal Patel 18:05

I think for me, it's cultural. Also, there's always this cultural, the Indian and Asian culture, really promote that everything goes on the woman. So despite the fact that in residency, we were working the same hours, I have a fantastic spouse that super supports me. I mean, I could tell you guys incidences of like, Nimesh would take the baby carrier to rounding with him at 530 in the morning surgical rounds, and then would switch with me and I would take them to daycare because I'm, you know, but all that but at the end of the day, the pandemic was, for me as an Asian, all the responsibility at the end always came to me, regardless of when we were in training, it was easier to be like, Okay, I'm just gonna step in, because it's always been like that. And definitely he's done the, like, what he's done, like, I was never one of those moms, I learned early on that, you know, I cannot play on 36 hours when I'm on call. So here's baby by and he did a wonderful job of stepping up.

But when you get into the swing of things, you just kind of go back to your cultural aspect is like, well, we're just going to do it. I mean, honestly, again, I hired one of the teachers and I said Could I cannot handle this. And it was me, like I couldn't handle it, that pressure would had caused me to not be able to do my job properly. And then I was becoming resentful. But then she as a teacher, I was like, Okay, well that's gonna be maybe a third of my salary for and that's I want to do this because I need it for my sanity. So I think the pandemic kind of just was like, reinforcing the fact that I didn't work this hard for again, those many years to take a backseat with my career either. So we came together and we're like, we're gonna do this we're gonna hire this person to help us out.

Dr. JouJou Hanna 19:54

What happened with me. I ended up again I don't know if it's a blessing or God have it works for me, but I just happen to have a child that was at that age, he was not in public school yet. And he was in still daycare. And so he was in a Montessori daycare. And it's a lovely, yes, I paid for it. But they were so amazing. They never shut down during the pandemic. And they actually, in the very beginning, stayed open for essential workers. So I was the person that was leaving my house at 630 in the morning, taking him to the daycare, drive an hour to work every day, I work full time primary care, get off at five drove an hour, get to pick him up at 630 and then still have to feed him bath time during this and I do it every now and then I still have like 30 charts to do like every day, right? If that Montessori school wasn't open, I don't I don't know what the hell I would have done, I honest, I would have had to take him to work with me every day, then worrying about exposing him to sick kids and the clinic and all this stuff.

But like right now, if the pandemic was happening right now, like now he's in first grade in public school, I would not have taught him I don't know what I would have done. I don't know, if I maybe that's the thing you hide, maybe my neighbors, I would have gotten into like hiring a teacher to put them in a small class together, I would have never been able to do virtual, I have not had time off like anyone probably in the past two years, I go to work every day, there's been no break. It's also at the same time I live like about an hour from my parents. So I don't have it's a cultural thing. And they would be there for me in a second. But they don't live close. And I also didn't want to get them sick. So I don't want my little one to get my elderly parents sick. And so I kept them apart for a really long time. And I didn't want to get him sick because of my job. And it's just now that he's finally able to be vaccinated because he was like got it right away when he turned when it was approved. That gives me a little bit of reassurance.

Rebekah Bernard MD 21:43

What we're hearing here are audiences hearing is this really classic role strain, that I'm sure all women that professionals go through, but women doctors really go through because what we're hearing is that sandwich generation, you're worrying about your parents, you're worrying about your children, and then oh, yeah, guess what, you also have to take care of a bunch of patients and you're responsible for their lives in a lot of respects. And of course, you are paying back debt and you have to be potentially the breadwinner. But the other thing that's really unique to women physicians, is that women doctors have higher rates of burnout. And there's really good reason for that. In fact, there was a brand new study that just came out it was so interesting. They showed that women doctors get more portal messages from patients and from staff even when they have they control for things like the actual - the types of patients like not not even because they have more women patients. People are more demanding to women doctors Niran you're nodding your head about that.

Niran Al-Agba MD 22:44

I'm laughing because number one as you know, I'm on paper. So there ain't no portal for me ever. I don't paper. I don't Yeah, I don't answer emails. I don't answer. I mean, I answer phones, and I, you know, see patients in the office. But what's funny is, when I first came to town, somebody called me at like midnight, I'll never forget, they called my house, I think it was listed. And what's funny is my dad had taken care of the mom as a child, right? So this is one of those multi-generation that we have in our practice. And he was on second generation. So it was her kids. And I remember like answering the question, and then calling my dad and being like, I don't know why she called me instead of you, you know what the answer was? The answer was exactly what you were saying. Which is, well, I didn't really want to bother him. And I was like, Oh, wow. I mean, and again, this is 20 years ago. I mean, before we had these conversations, it was so funny, though, because you're absolutely right now it's it's a little bit flipped. I'm older and have been here a long time. And I think everybody knows I'm busy with my kids. So they're a little bit less likely to feel that way. But it was really interesting. It was so like black and white here, you taking care of her as a child, her children as children, they were maybe five to 10 age group, and she's calling me because she doesn't want to bug him.

Rebekah Bernard MD 23:54

It's very interesting, because, you know, they clearly patients and staff are thinking a little bit harder before they ask the male physician, but they have no problem with bothering women doctors, and I think that's so very interesting. The other thing that studies show is that women talk more to patients, we spend more time on psychosocial issues, we do more preventative care, we potentially have better outcomes, and yet, we earn less money compared to men even when they control for things like working part-time and hours. So what are your thoughts when it comes to like salary gaps and gender inequities?

Dr. Sonal Patel 24:32

Oh, my God, I think I could fill a whole hour with that. It definitely exists. And I think we're coming to an age where we like not only a sandwich generation but also in training. We've had role models, physicians, as I remember in the NICU, when I was training down at LSU, six of them were women, and we would laugh and we'd be like, Oh, six, six of my attendings and the head. One was a male physician who was the director, but we'd all laugh that he had a wife at home And we all needed wives at home, to do our jobs, talking to those women having those women as role models to be like, Okay, now I can speak up for myself. So I think there is there's recognition of it. And there are also people helping us to speak up for ourselves that we are worth it. And our value is worth. And so we are able to negotiate a little bit better and it's okay to negotiate. I think that's the biggest thing that we fail to realize that, oh, it is okay to negotiate. You don't have to settle on the first salary

Rebekah Bernard MD 25:33

it's mandatory. In fact, studies show that women are automatically offered like 30% less than men for the same job, I just say to people just assume that you should get paid 30% more than what they're offering. And then, you know, aim even higher than that, and you must negotiate. I didn't negotiate my first job, no one told me to do it

Dr. Sonal Patel 25:51

Me neither, I just walked in, and I was like, Oh, I got a job. And I'm attending now and saying, now it's part-time, and everything's gonna be like rainbows and everything. And then you get into the job itself. And you're like, I remember we were moving from Boston. So I live in Denver now. And my first job and the person in charge had put us on, put myself on call. The first day I was there. And I was like, I'm just like, I'm getting to know your system. The first day of my job as a NICU attending, I'm gonna be on call. And so I spoke up and then yeah, he's like, oh, yeah, that's an oversight, we should have put you like in a month on call. But, you know, it was just like, What do you mean, I'm, like, I just walking into it. And I'm gonna be like, it was just,

Rebekah Bernard MD 26:34

you know, that's a really important point that you made that you actually stood up and said, 'Wait a minute, this isn't right.' I think, you know, a lot of us as women would have just said, okay, you know, being passive. And so I think hearing that story, hopefully will inspire other women to say, you know, just speak up and ask,

Dr. JouJou Hanna 26:49

I feel very proud of myself that I've given more women like, it's okay to stand up for yourself, if it's okay to talk about things, we need to be more comfortable talking about salaries, I don't know why it's faux pas, like not, and I hate to say this, some, some women are just a little bit were more jealous of each other, rather than building each other up. Or I don't know if jealousy is the word, but it's like, it's like a cat fight. Like, guys, when you hear them talk. It's like,

Rebekah Bernard MD 27:12

I do think we have to, we have to break that toxicity cycle in medicine. And I think you're so right about that. And it is interesting when you're looking at employers, I remember once I was at an event, and there was a bunch of administrators, and you know, they never know what to say to you. So they asked me did I have kids, which I don't even supposed to ask you. And I said no. And he said, 'Oh, that's great, I'll be able to get more work out of you.' And at the time, I just went, you know, haha, but now that I'm a little older, and I know better, I would have said, you know, talking about that, and what is not appropriate or you know, something, because studies show that actually, men do take it well, when women basically call them out on what they say and let them know that you know, what they may not even realize. But we do need to start acknowledging those kinds of comments that are, you know, really not helpful.

Niran Al-Agba MD 28:01

And I would also say, you know, to go back to your point about the different pay, you know, the insurance companies, to my knowledge anyway, they don't pay me less, because I'm a woman, you know, I'm in private practice. So whatever the negotiated rate is across our region, or areas we get paid. And so it's less of an issue in that regard. And so some of this difference in salary and difference in pay is going to be how an employer or hospital, which I've never had one of those, so I don't really can't even go there, but how they value you. And there is that idea that once you have kids, or once you have this other stuff, you're not as valuable.

And I want to say I'm an employer, right, so I have five employees, we made it all the way through the pandemic, I didn't lose anyone. And most of the majority of my staff do have children. And we really make it a priority for them to get to what they need to get to, right. It's real simple. Say, I've got an appointment for my son or my dentist appointment for my kid and I'm like, Go goodbye. See you later. Same for spouses same for everything else. And what I've noticed is the flexibility that I'm allowed to have, or I allow my employees to have, they often will come in after-hours to fix something or make something up or they just sort of like often go above and beyond. I'm not saying that's why I hire people with children. But again, I'm a pediatric clinic, I want staff who understand children, I want them to understand how kids behave when they're having a bad day, you know, flexibility. And so someone like me, I actually love when my staff have children or are thinking of having children because we need to teach and we need to model flexibility. And so I would tell you that all of my staff have been with me for a number of years. And I think it's because I treat them well. They treat me great as well. And we're really a functioning team. And so it's a shame that someone says, Well, I'll get more work out of you when you have right and we don't have kids.

Rebekah Bernard MD 29:43

Well, you know, one of the things that's interesting that studies show that women physicians when their children are older and no longer require so much attention, women physicians actually catch up to their male peers like in academics, they actually catch up with publications and then they outperform the men so I think part of it's just getting those kids out of that, you know that young age where they need so much attention. And then you know, women actually really flourish. And one of the things I'd love to see in medicine is to have opportunities for leadership for women, once the kids are a little bit older, and women can start to get more involved in things that they really can't notice when the kids are so young, unless they have the luxury of having child care or somebody, a family member that helps out,

Dr. Sonal Patel 30:26

I think I'll just add for the role modeling part, because in my career I've seen a couple of times, and I want to highlight it when I was a fourth-year medical student, and I used to work at La Bonner. And Memphis LaBonner actually has a daycare right across the sleeping quarters of residents, and one of the residents was breastfeeding. And she literally went from rounding to be like, Okay, I'm just gonna go downstairs and breastfeed my baby. And I thought that was like eye opening. And I was like, Oh, my God, this institution is supporting this.

And then when I moved here in Denver, one of my old fashion attending, NICU PICU attending, he was my boss. And he told me, and I think this is a Midwestern mentality, because in the East Coast, I didn't, I didn't find this, I was very fortunate to train all over the country. But he told me that when you're on the hospital service, your whole family knows you're on service, you're on NICU service, your whole family knows, and they take a back burner to that. So when you plan your vacations, it should be the opposite. That work takes a back burner to it that everybody at work knows that you are off and you are, you know, you're on vacation with your family and your family is important. And I think that kind of little role models, and like I said, the nurses telling me to kind of put myself forward.

Going back to the actual op, that the nurse practitioner who did that, and that with the training and stuff like that, at the end of the day training matters, we all know it, the more experience you get, the more you get in-depth with it, the better you're going to perform. And I just felt bad for her because maybe she didn't know that going into it, you know, not knowing like JoJo had to figure everything out for herself. I had the privilege of seeing my mom go through it and trying to balance it. And that is medicine. I mean, you do have your sacrifices, and you have to make sacrifices, and you have to balance it. So maybe she just didn't know that it was going to be this hard.

Rebekah Bernard MD 32:21

Right? You know, you like guys, this has been such a great conversation. And we're actually out of time for this episode. But we're gonna come back and discuss this a little bit more in part two. So join us then. In the meantime, if you'd like to learn more about this topic, we encourage you to get the book patients at risk the rise of the nurse practitioner and physician assistant in healthcare. It's available at Amazon and Barnes and Noble. And if you're a physician and you'd like to learn more about getting involved in physician led care, and ensuring truth and transparency for health care practitioners, please join our group physicians for patient protection, where you can find us at our website physicians for patient Thanks so much, and we'll see you on the next podcast.

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