This story is dedicated to all my female friends in medicine.
Didi does not love her job. What started as a noble purpose of helping people made her feel as though she has become a glorified customer service representative. She focuses on her Hippocratic oath, all right. She’s an internist in her 30s, seeing about fifteen to twenty patients per day, and she’s fed up with the sense of disrespect.
It does not matter what happens—she can’t tell her male colleague, “the partner” or the “manager,” as he may listen but won’t act on her concerns.
Her respectful patients question her ethnicity, and some tell her that they can’t understand her accent. Some downright call her “honey” or ask her, “Where is the doctor, nurse?” even though her white coat clearly emboldened her name, Dr. Diana Chow. Some already come to the appointment after their own “research” (aka non-PubMed free information on blogs, Dr. Google) and question every decision she makes. Some demand disability paperwork approval or work excuse letters even though their presenting complaint has nothing to do with disability. Some are 20 minutes late to their 20-minute appointments and yet get angry and yell at her staff, demanding to be seen by Didi even when she and her staff explain that there are other patients who were on time and are waiting to be seen.
Didi tries to get through her day by telling herself that not all patients are mean, that she is trying to make a difference in their health. Yet she wonders why her patient population seems to have a different expectation of her compared to her male colleagues. A female doctor should effuse that nurturing, caretaking vibe. The moment she speaks her mind, others get appalled. If she makes a direct statement, others say she is rude. What is a young Asian female doctor to do in America? Did she pick the wrong profession?
The worst part of her job is dealing with all the patient calls, especially after-clinic-hour calls. Perhaps people need to be reminded that there is no such thing as a free phone consult. Yet they demand to speak to an on-call doctor after hours when the clinic is closed, and they write bad reviews or throw anger tantrums if they are reminded that (1) they are calling after hours when the clinic is closed and (2) they would be charged for what is considered a telephone consultation. Would anyone argue with a lawyer if they charged their client for every ten minutes of telephone consultation time? Apparently, it is easier to walk all over a young female doctor.
Thus, one day, Didi reaches her breaking point. During a routine patient care visit, she turns to a patient’s friend who presents as a “patient advocate.” When asked to clarify a concern, the advocate explodes, yelling, “You do not question me. I do not like your questions. I demand a different doctor.” All Didi asked was why the patient wanted a stronger pain medication after an extensive and unremarkable work-up for fibromyalgia. The advocate storms out of the room, dragging the patient with her, and as they exit, the advocate yells in the hallway about how terrible and incompetent Didi is.
Didi is crushed. In this community private medical setting, patient reviews and satisfaction substantially impact one’s reputation. And she feels alone. She is the only young Asian female doctor in this medical group. She has no mentor. She has not worked with a senior female physician who has already walked through her experiences. She turns to her senior male colleagues, none of whom share her cultural background—and as Caucasian senior physicians, they do not recognize her struggle. In fact, one of her male colleagues alludes that maybe the problem is her.
Oh wow. Is it Didi’s fault that she wanted to become a medical doctor? She wanted to help patients in need. It is not her fault that she comes from a blue-collar family—she did everything she could through high school, college, and medical school to support herself without financial help from her family. Grants for low-income students? She got them. Scholarships? She got them. She studied harder than anyone else around her, maintaining a 3.99 GPA even though English was her second language. And because she couldn’t dare ask for allowance money, she worked part-time jobs to support herself. By the time she graduated from internal medicine residency, she had $350,000 in medical school debt. The worst part? She lacked financial education—no one warned her about loan interest accrual during the forbearance period of her loan during residency. What started as a $200,000 loan became $350,000 after interest accrued into her original loan during forbearance.
Thus, here is this woman, whom people envy for holding the title of “doctor” (the real medical doctor—she has MD at the end of her name!), and yet she is stuck in the grind of getting through her day.
Yes, blame her. It’s easy to blame someone for their misery, isn’t it? Social media trolls are cruel, saying, It’s your fault that your patients don’t like you. It’s your fault for being you. But let me tell you—by blaming her, you fail to recognize the systemic issues that set her up for this misery.
What has society done to advocate for and support young female doctors?
Now, I’m offending Didi because she would say she is old enough—after all, even if she is considered a junior attending physician in her 30s. But I want you to hear me out.
Young female doctors—especially when the majority of their patients are white Americans with perfect American accents—already sense sexism, ageism, and racism when they enter the room. I am not saying all patients are cruel, but when she works in an underserved area, these discomforts always arise in one way or another. The system around her puts her in a vulnerable situation. Perhaps the health care system should explicitly state standards of respect for physician-patient relationships so that there are clear expectations for how both patients and physicians should treat each other with respect. Didi respects her patients. She respects them so much that she doesn’t call out their negative behaviors until things get out of control.
It is also the system’s fault that we don’t have a supportive environment for young female doctors. We are so short of doctors, yet we do not create a “supportive environment.” But we live in a digital age. Leadership could create a support program for Didi—offering female-to-female mentorship, creating a safe, supportive environment where she can turn when facing challenges, or even offering tele-mentorship if in-person mentorship is not feasible. Make her feel like she belongs. Make her feel that she has a purpose in this stressful work environment. Make her feel that she will not drown alone in these challenges.
This can also be as simple as setting clear expectations in her clinic: Patients should not call after hours expecting free physician consultation. Telephone calls should be billable as telemedicine visits.
So what happened to Didi? She is still paying her education debt. She just decided to stay quiet and suffer—because if she complains, upper management will see her as a complainer and not take her seriously. But she is silently quitting. And in her downtime, she is trying to grow—finding a hobby, applying to educational programs for guidance, and looking for future jobs in a different environment.
Whatever happens to Didi, please don’t blame her. She is a thoughtful and conscientious physician, yet people step all over her because of her gentle appearance. And when she asserts herself, people perceive her as rude or bitchy. Please don’t tell her to get coaching or accent training—she has already gone through therapy, spent her own money on executive coaching, and worked on herself tremendously. At the end of the day, she really tries to be a good human being.
It is well known that every doctor burns out in this field. How long will Didi last? She is determined to make it until the last penny of her education loan is paid or forgiven. But by then, she will have no savings to prepare for an alternative career. Dislike her all you want, but I believe that Didi will change our system in the future. I believe she will become the wise, gray-haired Yoda who will guide the future Didi’s.
Wherever you are right now, Didi, hang in there. I believe in you.
The author is an anonymous physician.
