The productivity of medical mothers

Towards the end of the 1960s, my mother was told by her father that women could still become secretaries or flight attendants. Women doctors were the exception at the time. Thirty years later, my grandpa encouraged me like no other: “Sky is the limit, Valérie”. Women could act “like men”, he told me.



Valérie Trottier-Hébert

Valérie Trottier-Hébert
Woman, mother and psychiatrist

Since then, in Quebec, there has been a concerted shift in the recruitment of physicians. We aim to train candidates recognized for their humanism and personal balance, and it is by specifically evaluating these aspects that the admission interviews are conducted. In doing so, there is now a majority of women in medical schools. This shift was not made without reason. We recognized the contribution of women in medicine, their approach and their vision.

By diversifying the face of medical practice, the aim is to improve the quality of care, particularly among the most vulnerable populations.

Another, not insignificant, consequence was to enable a good number of women to reach a high income threshold which was, and which is still for the majority, reserved for men. As a general rule, men can, more than women, invest in their careers without the “mental load” incumbent above all on us, former queens of the household, who have abandoned our crown to assert ourselves differently, while maintaining our vocation of mom.

It is wonderful to see how far we have come in Quebec, and the place occupied by women in medicine. But when the time comes to choose a profession, young women still have to ask themselves several questions, including the crucial one of work-family balance. Because if we choose to have children, we have the right to choose to be there for them.

While recognizing that we are more advanced in Quebec than elsewhere on this aspect, we should not play ostrich either. It is illusory in my opinion to think that a woman who wants to compete with men in law or in business will have it easy if she chooses to have children. Yet in medicine, she can. Not easy in all specialties, of course, but she may, after graduating, be paid as much as her male colleague for the same act performed.

Is it scandalous to think that the feminization of medical practice, just like the recruitment of more “humanist” and “balanced” candidates, has possibly resulted in a reduction in the number of hours worked in total, or even in productivity measured in terms of the number of patients seen?

And if we come to this “terrible finding”, what do we do? We regret our choice of society by concluding that women cannot behave “like men” instead of seeing that they are doing otherwise? We blame a minority of doctors who do not work enough? Well, I fear that it is above all my colleagues who are female doctors who feel targeted, rightly or wrongly, by the recriminations of our government. Because they are also, in significant proportion, mothers who seek an impossible balance. Because in today’s society, the pressure to be a present and nurturing mother is very strong, if not more than before. Even if the selection of future doctors now takes into account other aspects than the quality of the academic record, it still attracts young performers, hardworking and demanding of themselves. Who says perfectionists says women who will put a lot of weight on their shoulders. In the long run, not just during their studies.

The feminization of the medical profession has clearly not solved all the problems, and it is probably true that it has affected the average productivity of physicians. But what about the quality of the care provided? We want patients to be seen, taken care of, but how, and with what result? We must be proud of our society which encourages women who wish to become doctors, and which even provides that these women will be able to take maternity leave. But the role of mother does not end there. This conciliation involves daily sacrifices, and maintains a feeling of guilt, encouraged by the simplistic model of productivity.

Do we want to go back to the old stereotype of the doctor? Is this the solution? We could instead give up ignoring the elephant in the room and review the organization of care for the entire health network, taking into account the reality of the majority of physicians, a majority of which will be made up of women, which was clearly not the case in my mother’s time.

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