Why where matters for working women (especially physicians)

Work-life balance is an issue for anyone trying to raise a family in our country today. As of April 2016, the Bureau of Labor Statistics reported that in more than 60 percent of married-couple families, both parents work outside the home. Statistics also show that work-life balance is more complicated for women than men. This will always be the case because child bearing can instill a strong desire for a traditional maternal role. Same-sex couples and single parents aside, women often find it more challenging to balance career and family by choice.

The status of women in the workforce is a major topic during this election season, and perhaps no source is calling greater attention to the issue than the Institute for Women’s Policy Research, which has created an amazing map resource for information about women in the United States: Status of Women in the States.

There are more women in the workforce than ever before. I’m almost 34 years old. A year after I was born, reports focused on how the number of working mothers had hit a record high in 1984—59 percent (six out of 10 mothers with children under the age of 18). At that time, if you looked back to 1970, the exact opposite was actually the case—six out of 10 mothers stayed home. Today, the percentage has further increased—70 percent of all mothers with children under the age of 18 participate in the labor force. This should come as no surprise because it’s well known that women today outnumber men in American colleges. Again, this has been a trend since 1970. The percentage varies by school type (public vs. private) but is generally in the 40 to 60 percent range.

One profession that has seen the greatest shift is medicine. In 2015, 48 percent of medical school graduates were women, according to the Kaiser Family Foundation: Distribution of Medical School Graduates by Gender. This percentage has grown by over 4 percent (by almost 2,000 more females) since 2002. Why this matters so much but particularly for physicians has a lot to do with physician shortage projections, combined with the likelihood of women physicians opting for part-time versus full-time work during child-rearing years. This presents a unique challenge when trying to address projected demographic trends. While “women physicians are more likely to serve minority and urban populations, and are twice as likely to go into primary care” (Nowlan, 2006), the American Medical Association reports that 33 percent of female pediatricians work part-time, compared to 4 percent of male pediatricians (Nowlan, 2006). This is because women often require a work-life balance that considers family planning and childcare needs. As a result, women entering the medical profession are willing to compromise pay and hours spent at work for lifestyle happiness. An increasing number of reports reveal that the newest generation of physicians is not willing to work very long hours and has a clear sense of priorities when compared to previous generations. “The real problem: Career building and family building take place during the same years” (Nowlan, 2006). Women are also clustering in specialties that better accommodate part-time work or offer higher pay in order to achieve work-life balance (Nowlan, 2006). Historically this has not included primary care due to lower pay and a less flexible work schedule.

To address these challenges, the National Health Service Corps is working with communities through the U.S. Department of Health and Human Resources to identify Health Professional Shortage Areas (HPSAs). These are areas where a physician can apply for service for which he or she will receive compensation beyond a salary, including benefits such as living expense reimbursement or loan repayment over a period of time (Wegley, Hess & Sauter, 2012). While the program has seen exponential growth in recent years (Gorman, 2012), it does not address lifestyle needs that may take priority when choosing a location to practice.

A new solution is needed in the medical professions to meet the needs of women while also addressing nationwide issues surrounding the demand for primary care doctors. This is where (To) is perhaps poised for the greatest success. (To) seeks to address national physician-to-patient deficits while also considering user-defined social, environmental and cultural desires to yield optimal geographic placement for individuals. We do this by first understanding what each individual wants in her career and her life as it relates to geography. We include in our place-based results those geographic areas where shortages exist for primary care and dental and mental health workers based on HPSAs as defined by the National Health Service Corps. We also present users with information on appealing resources in specific locations, including social, environmental and cultural opportunities that align with an individual’s personal interests. Because we not only work but also operate with spatial data for decision-making at an individual scale, (To) achieves results quickly compared to competitive products that attempt to incorporate location data points later-on.

Professional women in medicine, especially those with children, seek lifestyle balance to help them achieve a meaningful life. Meaningfulness is considered to be the most venerable of all happiness types (Seligam, 2008). “Women physicians generally practice fewer hours than their male counterparts, work part-time and avoid specific specialties because they might interfere with the way they want to live their lives.” (Mobilos, Chan & Brown, 2008, p. 1286.e1). Positions with flexible hours therefore present the greatest opportunity to achieve work-life balance. Social interaction opportunities and access to cultural and community resources are also primary factors for women when considering where to locate for a position. Flexible work hours may not be as important if community resources and access to them are close by. Valuable social interactions are critical because a direct connection between happiness and being extremely social has been found (Seligam, 2008). There is also evidence to support that those people who identify lifestyle as a factor for decision making often do so because they seek meaningful lives (Seligam, 2008). Access to quality education, both for women and their children, is also a primary factor when choosing where to practice. Studies have shown that women desire mentoring systems both in medical school and throughout their career (Royal College of Physicians, 2001). Highly ranked K-12 education systems have long served as a reason to pursue long-term community investment. Educational opportunity is critical because it is most desirable to have physicians who locate in an HPSA area remain part of the community beyond the agreed-upon term. Understanding community assets, characteristics and amenities is essential for achieving such long-term success as a community and economy.

It has already been established that HPSAs define which communities are in greatest need of primary care physicians. But what do these communities have to offer women physicians beyond early loan repayment? What does a woman pursuing a career in primary care need or want to know about a community, especially if she has or is planning to have children? To achieve work-life balance and lifestyle happiness, it's important to understand community characteristics including demographics; available community assets and resources; types and cost of housing and their location in relation to community resources; and other information considered critical to a woman’s ability to evaluate her options. If through and with (To) we can build community profiles rooted in geography that allow a woman to identify places that best meet her pre-established requirements, then we’ve been more than successful.


Global Workplace Analytics and the Telework Research Network. (2013, September). Latest telecommuting statistics. Retrieved from http://www.globalworkplaceanalytics.com/telecommuting-statistics

Gorman, A. (2012, February 13). Sebelius in L.A. to announce $9.1 million in aid to med students. Los Angeles Times: L.A. Now. Retrieved from http://latimesblogs.latimes.com/lanow/2012/02/sebelius-in-la-to-announce-91-million-in-aid-to-med-students.html

Mobilos, S., Chan, M., & Brown, J.B. (2008). Women in medicine: The challenge of finding balance. Canadian Family Physician, 54, 1285-6.e1-5.

Nowlan, M.H. (2006, October 6). Women doctors, their ranks growing, transform medicine. Boston Globe. Retrieved from http://www.boston.com/yourlife/health/diseases/articles/2006/10/02/women_doctors_their_ranks_growing_transform_medicine/?page=full

Royal College of Physicians. (2001, June 26). Women doctors need major change in NHS working patterns. Retrieved from http://www.rcplondon.ac.uk/press-releases/women-doctors-need-major-change-nhs-working-patterns

Seligam, M. (Presenter). (2008, July). The new era of positive psychology. TED: Ideas worth spreading. Podcast retrieved from http://www.ted.com/talks/martin_seligman_on_the_state_of_psychology.html

Wegley, S., Hess, A.E.M., & Sauter, M.B. (2012, October 20). Doctor shortage could take turn for the worse. USA Today. Retrieved from http://owl.english.purdue.edu/owl/resource/560/10/

Sarah Linden

myPlace-Seed, LLC, 901 N Washington St, Suite 208, Alexandria, VA 22314

Where matters, because place can make you better!