(Reuters Health) - Female physicians are more likely to make professional adjustments to accommodate their responsibilities at home, according to a new study.

In particular, male doctors tend to have more help at home for childcare or elder care, the study authors reported in the Annals of Internal Medicine. Nearly half of the spouses of male physicians stopped working professionally, versus 9 percent of spouses of female physicians.

“Although some might argue that the decision for women to stop working professionally, especially after having children, is volitional, I think it’s very hard to disentangle the influence of societal expectations from that ‘choice,’” said study author Dr. Dan Ly of Harvard Medical School in Boston, Massachusetts.

In earlier work, Ly and colleagues had found that the gender earnings gap among doctors has remained at about 20 percent for the past three decades. Furthermore, among physicians who teach at medical schools, women are less likely to obtain the highest rank of full professor.

“To try to explain some of these gender differences in pay and professional advancement among physicians, we have begun to look at home life,” Ly told Reuters Health by email.

Ly and colleagues looked at Census Bureau data between 2000-2015 to understand occupation, income, hours worked outside the home and graduate education status for 30,900 male doctors and 17,600 female doctors. They also looked at the number of children in families with a male doctor, a female doctor, or two doctor parents.

They found that 17 percent of male doctors were married to female doctors, whereas 31 percent of female doctors were married to male doctors.

Income, hours worked outside the home, and graduate education status differed greatly between female spouses of male doctors and male spouses of female doctors.

Overall, 52 percent of female doctors’ spouses had a graduate degree, compared to 40 percent of male doctors’ spouses. In couples with one doctor, the number of children was higher in families with a sole male physician versus a sole female physician. In addition, for all women, the average number of paid work hours decreased as the male spouse’s paid work hours increased.

“We think one possible reason for this is that societal expectations for women to reduce their professional hours to care for children exist, even for physicians,” Ly said.

Future studies will continue to look at the decisions that couples make about balancing each other’s careers and how having children factors into those decisions, he said.

“It’s important to understand why women in medicine and other professions might be facing unique challenges, even today,” Dr. Reshma Jagsi, director of the Center for Bioethics and Social Sciences in Medicine and the University of Michigan in Ann Arbor, told Reuters Health by phone.

“Those of us in Generation X were raised with expectations of the egalitarian division of labor at home and work, and we might not expect the findings seen in studies like these,” said Jagsi, who researches the gender pay gap and gender domestic differences in medicine but who wasn’t involved Ly’s study.

Jagsi and colleagues are monitoring several new programs that have been implemented to help doctors at work and home. The Doris Duke Charitable Foundation, for example, gave grants to 10 medical schools as the Fund to Retain Clinical Scientists to fund more mentorship and career development opportunities for early-career doctors, especially for those with extra caregiving burdens.

“Patients benefit when the medical workforce includes the most promising doctors in our society,” Jagsi said. “We need both women and men in the medical workforce, and we need to figure out ways society can alleviate the greater challenges faced by female physicians.”

SOURCE: bit.ly/2jdZ9LV Annals of Internal Medicine, online November 21, 2017.