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Caught in the Act—What We Can Learn from Current Physician Workforce Data :

March 24, 2016

In a study released this month in Pediatrics, Dr. Gary Freed and colleagues examine characteristics of the current workforce of pediatricians who enrolled in American Board of Pediatrics Maintenance of Certification Programs in 2013-2014. 

In a study released this month in Pediatrics, Dr. Gary Freed and colleagues (10.1542/peds.2015-4242)examine characteristics of the current workforce of pediatricians who enrolled in American Board of Pediatrics Maintenance of Certification Programs in 2013-2014. The vast majority of pediatricians (15,351, 87.2%) completed the 10 minute survey, and the responses of the 9,253 (62%) self-identified general pediatricians comprise the data set for this very interesting paper.

Although certain groups were not included due to method of registration, these individuals are less representative of the larger workforce since they include permanent certificate holders (who completed certification in 1983 or earlier) and those 109 persons serving on committees of the American Board of Pediatrics. Thus the survey by Freed et al is the largest and most comprehensive look at the demographics of currently practicing pediatricians in the US, and I compliment the authors on the smart and creative approach they chose to gather their study data.

It appears that the medical stereotype of the pediatrician as a happy person who loves his/her job may actually be correct: 89% said that their allocation of professional time, which I would interpret as “what you do every day,” was approximately what they wanted. Pediatricians in this study spent a mean of 85% of their time performing inpatient or outpatient work and care, and about 80% of their clinical time was dedicated to the outpatient sector.

This information alone has implications for both resident training and for post-residency CME (continuing medical education) curriculum development. The authors collected several demographic descriptors, including gender, years since training, part vs full time work status, practice type and practice ownership, and looked at correlates of participation in Quality Improvement initiatives. The information is clearly summarized and very interesting, especially if you would like to know who your colleagues are and what they are doing.

What interests me most, though, is the information about part time work and about gender. Decades ago it was heresy to even whisper about working part time. Part time pediatric work was considered a sign of weakness, incompetence, poor character or worse. (For anyone who is shaking their head “no” on this – please send me an email and let’s talk…I was there!) How could you possibly follow up on everything and be available to your patients if you were not in the office from 7 AM to 7 PM? In this study, 64% of pediatricians are women, and 25% of all general pediatricians are working part time.

Clearly, something has changed. Higher likelihood of working part time was associated with being a woman (OR 12.21), and also with both not having an academic appointment (OR1.32) and not working in a private practice (OR 1.15). While such associations are not very surprising, as the authors point out, these (and other) results suggest that gender disparity is not an issue of the past.

Are women working in academic settings but not entering the promotion path? Fortunately, those who work part time are actually more likely than those who work full time to report that their positions matched their desired professional and/or clinical duties, but women were less likely to be in positions that matched their desired allocation of professional duties. The data is fascinating. Is the cup half full or half empty from the gender equity viewpoint? I think it is half full, but of course I am (most days!) one of those proverbially happy pediatricians who loves to see my patients.
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