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Personal, professional lives of cardiologists vary between sexes
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The results of the American College of Cardiology third decennial Professional Life Survey showed substantial differences in personal and professional characteristics between sexes among cardiologists.
“Discrimination continues to be an issue reported by a clear majority of female cardiologists,” Claire Duvernoy, MD, FACC, associate professor of medicine (cardiology) at the University of Michigan, Ann Arbor, and chair of the ACC Women in Cardiology Council, and colleagues wrote. “Addressing the changing demographics and practice settings of the workforce, increasing diversity and achieving parity in race and sex continue to be important goals for the cardiology community.”
The survey included data collected from 2,313 cardiologists and fellows-in-training (42% women) who responded out of 10,798 who were emailed an invitation in 2015 to participate in the survey. The survey was previously conducted in 1996 and 2006.
Demographic changes
The data showed a large change in demographics in the past 20 years. For example, there was a significant reduction in cardiologists working in private practice compared with 10 and 20 years ago (21% vs. 31% and 49%, respectively).
A greater percentage of respondents were aged 60 years or older than in previous studies (men: 17% in 2015, 15% in 2006, 11% in 1996; women: 18% in 2015, 8% in 2006, 6% in 1996), according to the authors.
Most participants were white (63% in 2015; 76% in 2006) or Asian/Pacific Islander (21% in 2015; 15% in 2006), although women were more likely to be black (4% vs. 2%; P < .01) and men were more likely to be Hispanic (6% vs. 3%; P < .01), Duvernoy and colleagues wrote.
Women were more likely to work in a medical school/university practice compared with men (43% vs. 34%; P .001), but less likely to work in a hospital-owned (33% vs 37%; P .001) or physician-owned (17% vs. 23%; P .001) setting.
Compared with men, women were more likely to practice clinical cardiology (48% vs. 39%; P .001) or echocardiography (10% vs. 3%; P .001) but less likely to practice interventional cardiology (23% vs. 8%; P .001) or electrophysiology (10% vs. 6%; P .01), the authors wrote.
Career satisfaction was reported similarly for both sexes, with men and women reporting being moderately to very satisfied with their careers (90% and 88%, respectively). However, women were less likely to report that they had advanced higher than their colleagues and were more likely to report that their advancements were less significant than their peers; this did not change significantly in the last 20 years, Duvernoy and colleagues wrote.
Reports of discrimination
Women were nearly three times more likely than men to report experiencing discrimination, although the percentage of women reporting discrimination declined from 71% in 1996 to 65% in 2015 (P .05), the authors wrote. Women in practice longer than 10 years were more likely to report discrimination than those in practice less than 10 years (P .001).
Men were more likely than women to report being married (89% vs. 75%; P .001) and having children (87% vs. 72%; P .001), whereas 57% of men reported that their spouse provided all child care vs. just 13% of women (P .001). Women were more likely than men to report that family responsibilities hindered their ability to do professional work (P .001) and travel for professional advancement (P .01).
According to a press release from the ACC, in 2013, just 13% of cardiologists were women.
“We need to increase the diversity of our workforce, and find ways to recruit higher numbers of women and underrepresented minorities,” Duvernoy said in the release. “While we are heartened by the finding that the vast majority of cardiologists, both men and women, report high levels of career satisfaction, it is clear that much remains to be done to improve the field for everyone.” – by Dave Quaile
Disclosure: The authors report no relevant financial disclosures.
Perspective
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Nanette K. Wenger, MD, MACC, MACP, FAHA
One of the most important findings of the survey is the need for more younger physicians in cardiology. The responding workforce is aging and we are seeing fewer people in individualized practice.
A problem with the survey is the lower percentage of respondents than previous surveys (21% vs. 50% in 1996 and 30% in 2006); generally people who respond to surveys are more likely to be those who have concerns. That means that there is less reliability that the results reflect the total population. It may be that more cardiologists who are older have concerns because so many things are changing. I would have liked to see how the respondent population reflects the demography and practice settings of ACC.
Given that, it would not be surprising that the men who responded are the ones who were having problems, perhaps because they are assuming more responsibility for home and child care, and are experiencing for the first time the problems that women have seen longitudinally.
Of interest, women were more likely to have a woman as a mentor, and less likely to report their mentor asserted a negative influence. This indicates that there are now more women mentors, and many of them are family people who convey that having a family is an option in cardiology.
Almost two-thirds of women reported experiencing some sort of discrimination in their training, which is a sign that there is much more progress to be made. It may be a reflection that we’re now educating women that this should not happen, so they are more likely to report it. Previously, many women accepted that they were not going to be treated as well as men. We’ve now defined that their expectations should be comparable.
Cardiology has to be seen as welcoming to women. What is needed are mentors, both women and men, who show that both women and men can tailor what they do in clinical practice so that it is not 100% of their life. Trainees are now emerging from training programs where they were protected in terms of hours and free time, then they enter the real world, which doesn’t have those regulations. That needs to become part of the negotiation process. It didn’t have to be before, because they came from a training program that was comparable to practice.
These issues are important because there are now far fewer solo practitioners who can control all aspects of their lives. More cardiologists are now employees of hospitals or hospital systems, and some of those positions have a limited ability for negotiation. I suspect many of the aging cardiologists went from independent practices to hospitals or hospital systems and lost control of what they could and could not do.
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