(Reuters Health) - Doctor moms regularly run up against discrimination, sometimes subtle and sometimes blatant, a new survey finds.

“Experiences of discrimination resonate and relate with the experiences of women in other fields, but some are unique to the structure of medicine,” said Dr. Eleni Linos of the University of California, San Francisco. “And some (have) downstream consequences that could affect not only the woman herself and her family and career, but also the health care system and the patients she cares for.”

For example, Linos said, female physicians “might not be taken seriously when giving medical instructions or recommendations in an emergency situation. We had several stories from participants who described situations where their medical advice was ignored or brushed aside during a medical emergency that could affect a patient’s health.”

As reported in The BMJ, Linos and colleagues recruited women in a Facebook community called the Physician Moms Group, which has approximately 60,000 doctor mom members. Ultimately, 5,782 doctor moms filled out the researchers’ survey, answering questions about physical and reproductive health, perceived discrimination, potential workplace changes and burnout.

On the topic of discrimination, participants were asked: “Have you ever experienced any of the following forms of discrimination at your workplace? (Please select all that apply)” Participants were also told: “We want to hear your story and experience. Please share.”

Many doctor moms said expectations differed by gender. Women, they said, especially those with families, were given limited opportunities for advancement. As in many professions, pay was often lower for women than for men.

Doctor moms also reported a lack of support during pregnancy and after childbirth. They said family leave time was often described by colleagues as “vacation” time. One woman wrote: “Was reminded every day by my peers how ‘irresponsible’ I was getting pregnant.” Another told of how “attendings harassed me for pumping (breastmilk) more than once during my shifts.”

Another mom wrote of how nurses were unwilling to do the same sorts of tasks for her that they enthusiastically did for her male colleagues.

Patients were sometimes biased, too. One doctor mom wrote: “Patients and their families sometimes are condescending, ignorant (they assume I’m not a physician because I’m female).”

The very structure of the medical workplace contributed to problems for doctor moms, with policies and procedures that limit maternity leave, lack of flexibility in physicians’ schedules, lack of a place to breastfeed or pump milk, and long - often overnight - work hours.

What’s most important “are the unique aspects of medical training and working as a physician that perpetuate or even exacerbate maternal discrimination,” said Dr. Albert Wu, an internist and professor of health policy and management at the Johns Hopkins Bloomberg School of Public Health. “This is the first study that I know of to focus on physician moms. And while I was disappointed in the profession I was not completely surprised.”

While medicine is generally based on cutting edge research, “in other ways, it’s very conservative,” Wu said. “It’s interested in maintaining its traditions, some of which date back to the Greeks. There are very high expectations of physicians and there is also a little bit of a machismo culture. You know, ‘stiff upper lip,’ ‘soldier on,’ and ‘this is what you signed up for.’”

That culture developed when very few women were in medicine, Wu said. Doctors, mostly male, had wives to take care of the children and the home. “What we need now are policies that that accommodate both women and men and that promote parenthood,” Wu said.

SOURCE: bit.ly/2TeehJD The BMJ, online December 12, 2018.