Researcher Asks: Do Childbearing, Surgical Residency Mix?

Leading one of the first studies to explore how attitudes regarding childbearing in surgical specialties influence women physicians in pursuing careers in surgery, AMA member Patricia L. Turner, MD, has been awarded funding as a recipient of the American Medical Association (AMA) Women Physicians Congress (WPC) Joan F. Giambalvo Scholarship.

"Female physicians might change their plans about childbearing or pick a different career based on perceptions they may encounter trying to plan a pregnancy during training," said Dr. Turner, as she discussed problems challenging women in medicine today. "This issue is very relevant when talking about work force issues and the face of medicine--and the face of care."

The Joan F. Giambalvo Scholarship Fund--established by the AMA-WPC last year to support research on issues affecting women in the medical profession and the physician work force will assist Dr. Turner with funding to identify and address these attitudes and concerns through her proposed research project, "The impact of attitudes regarding bearing and rearing children on female general surgery residents."

Her study will investigate whether women who pursue surgical residencies make family-planning decisions based on or influenced by perceived hostile attitudes toward childbearing during residency. Dr. Turner will also explore whether women avoid surgical residencies rather than postpone childbearing for five to nine years. According to Dr. Turner, assistant professor of surgery at the University of Maryland and associate program director of the general surgery residency program, this study will be one of the first that focuses on this specific issue in a scientific and methodical manner.

"If we eliminate potential candidates from going into surgery, this will ultimately have an impact on patient care," she said. "This current generation of trainees, both male and female, are more interested in work-life balance issues than were people 20 years ago--not just in surgery but across the board. I believe these issues are going to be important for anyone who is going to consider training now."

Ethan Alexander Jewett, also a 2007 Giambalvo Scholarship recipient, will use his funding for research to identify barriers that may keep inactive physicians from returning to practice after an extended leave to care for children or aging parents, or other personal or professional interests. He hopes to develop useful solutions and models for physicians who are interested in resuming their careers and re-entering the physician work force.

AMA Stands Up to HMO Giant

In recent testimony to the Nevada Commission of Insurance, the AMA strongly opposed United HealthGroup's buyout of Sierra Health Services--a proposed merger that would allow UnitedHealth to control an estimated 95 percent of the health maintenance organization market in Las Vegas.

AMA Immediate Past President William G. Plested III, MD, testified that unchecked consolidation and concentration in the Nevada health insurance market endangers the competitive process and threatens health care quality. Without competition, UnitedHealth would be free to dictate unreasonable terms that would hurt Nevada's quality of patient care.

Dr. Plested shared the experiences of California's patients, physicians and employers after Anthem bought out WellPoint and its subsidiary, Blue Cross of California. In the first year, Blue Cross of California increased premiums faster than any other health insurer and reduced its spending on medical care to less than 79 percent of the premium dollar.

"It is entirely predictable that patients, physicians and employers of Nevada will experience a similar single-minded focus on profits as UnitedHealth will wield a dramatically greater market share than that of Blue Cross of California," said Dr. Plested.

Economic studies show that it is very difficult to achieve long term efficiencies in mergers involving large HMO health plans.