Even before the dreaded Tiger Mom was loosed upon American motherhood, the lot of the woman surgeon was no day at the beach. Two studies off the press this month offer some insights. And trends suggest that better insights into this particular demographic are going to be badly needed as the health-care system evolves.

A large, cross-sectional survey from the Mayo Clinic and Johns Hopkins drew responses from nearly 8,000 surgeons in an effort to assess burnout and career satisfaction.1 (The authors say that previous surveys were few and tended to focus just on women, while theirs included women and a male comparison group.) Women surgeons reported greater conflict between their own and their spouse’s/partner’s career; more often subjugated their career for the good of their spouse’s/partner’s career; were more likely to believe that their commitment to their children slowed their career advancement; and reported more work-home conflicts. When career conflicts occurred, 41 percent of women surgeons reported that the conflict was resolved in favor of their spouse/partner’s career advancement—more than three times the rate for male surgeons in two-career households. “These findings suggest that traditionally held societal beliefs about women’s role in the home and workforce remain true today for a large segment of the U.S. women surgeon population,” the authors write.

A second study this month reports what the authors call “an unexplained salary gap” between men and women physicians that, contrary to earlier predictions, appears to be growing.2 The earlier tendency for women to enter primary care, with its relatively lower pay scales, has largely disappeared as an explanation, as women are increasingly entering the higher-paying surgical subspecilaties. What may be at work, the authors say, is that “the continued influx of women into medicine has reached a tipping point, and physician practices may now be offering greater flexibility and family-friendly attributes that are more appealing to female practitioners but that come at the price of commensurately lower pay.”

Women represent about half of U.S. medical students. Estimates are that about 30 percent of ophthalmologists in their first five years of practice today are women. As the next half-decade brings some 30 million new patients into the medical system, demands on both primary care and subspecialties will greatly increase. How well the system is able to understand, and then adapt to meet the professional and family needs of women surgeons and physicians will have a lot to do with the success of health-care reform.


1. Dyrbye L, Shanafelt T, Balch C, Satele D, et al. Relationship Between Work-Home Conflictsand Burnout Among American Surgeons. A Comparison by Sex. Arch Surg 2001;146:211.
2. Lo Sasso A, , Richards M, Chou C, Gerber S. The $16,819 Pay Gap For Newly Trained Physicians: The Unexplained Trend Of Men Earning More Than Women. Health Aff 2011;30:193-201.