Thursday, May 28, 2009

Friendship and Female Physicians

I've noticed over the past several years that it hasn't always been easy for me to make friends.

Sometimes I wonder if I'm the reason.  Am I simply un-like-able?

When I was in grade school I constantly found myself blurting out goofy things and wincing afterward.  I'm sure my social awkwardness cost me some friendships at that age.

Then there was high school  Oy.  Recently a friend from high school whom I've always admired told me I could sometimes be intimidating back then.  ME?!  Intimidating?!  But I'm so sweet!  And shy, and awkward! And un-tall!  But I suppose my love of Renaissance history, French poetry, and molecular biology might have struck some people as off-putting...

I had a great time in college.  I found like-minded people, kindred spirits, people in different spheres who loved a lot of the same activities, subjects, books, etc.  I made some life-long friends in college, as many of us do (and a few good friends in med school and internship as well, though not as many).

I can think of a few things that can make building new friendships and maintaining existing ones hard after college.  Relocation. Marriage.  Parenthood.  Jobs.

And if your job is in medicine as a resident of some kind, you get the added challenge of sleeplessness, no time, no energy, no patience, high stress, contact with suffering on a daily basis, making lonely decisions in what can be an isolating profession, all free time spent sleeping or running errands.  Relationships of all kinds suffer during residency; friendships are no exception.

But I think there's yet an additional layer for female doctors.  I can't quite put my finger on what it's made of, but it's there.  

When people find out you're a doctor - that's if you can even get around to meeting new people in the first place - sometimes their whole vibe toward you can change.  It's almost imperceptible, but there's a turn somewhere.  It's there. A pulling back, maybe, or the inexplicable sudden presence of an invisible veil between you and the person you'd like to befriend who happens not to be a physician.

I'm not sure why that happens, or even if I'm making something out of nothing.  Women-doctors want to hang out and watch chick flicks as much as any group of women friends, or go to cafes to chat, or cook together.  Why the sudden barriers?

I have a friend - a drop-dead gorgeous, brilliant, super-sweet, supportive-beyond-measure, talented, couldn't-be-nicer friend, fellow-mom, and fellow-physician - who meets with a group of women on a regular basis to engage in a much-enjoyed activity.  She told me that for a long time she didn't tell the other members of the group she was a doctor.  She was concerned they might not be as relaxed, or their attitude to her might change, with the knowledge of her profession.  I have another, newer friend - also multi-talented, also a fellow-mom and physician, very nice, with lots of different interests - who has observed a shift in others when she strikes up a conversation but then reveals that she's a doctor. 

I don't think we're all just imagining this.  There's something about us female physicians that seems to make some people hesitate to get too close, which makes making friends even harder in the context of busy, demanding lives juggling work and family.  I tried googling "women doctors" and "friendship" to see if I could learn more, but no one seems to be talking about this much, or I'm not looking in the right places, or no one else thinks there's an issue.

Do male physicians experience anything similar?  Am I just being over-sensitive?  I don't know.  But I do think the whole subject of physicians and friendship in general, and women doctors in particular, is worth exploring.  


  1. I'll comment since I'm in the "non doctor" group...

    I can't profess to explain why this seems to happen, but I have caught myself doing it - ie: behaving differently once I find out a woman is a doctor when I meet her in a social setting - whether it be a book club or on the sidelines of my kids sporting events.

    I don't know if for me it's a sort of awe! Because as a kid I wanted to be a doctor but for many reasons it didn't happen, and when I meet doctors outside of their's often hard to relate to them as normal people...and doctors who manage to balance that proffession with motherhood - now that is indeed an awesome accomplishment...

    This may sound silly, and maybe it's my own self esteem issues, but it's like I almost don't feel worthy of actually having doctor "friends"...they are like another species that are far superior (even though I know you may all not feel this way about yourselves...some doctors sure act like they do...but that's another story)

    Love this blog by the way, I hope you don't mind me lurking as I think you are all fantastic and it's like being a fly on the wall of what it's like to have a job that actually matters!

  2. I absolutely agree that identifying onself as a physician changes the interaction between me and a potential friend. I have lots of friends from before med school, med school, residency, but not a single one from the more than a decade I've been in practice. I feel this lack sharply and can't explain why this is such a problem. I have tried to join book clubs and so on, but seem to run into an invisible wall. I have tried to conceal my profession but living in a small community, the word gets out. I wish I could understand this.

  3. A big amen to this post! Also to the comments above - living in a small town as one of 3 docs makes friendships extrememly difficult. Not only do others act differently with me, I also have to be careful - what I say and who I trust - because of the small town dynamic. Recently one of my trusted friends (one of just two in town) moved away and it just all but crushed me - it's an empty feeling but probably why I'm out of town most weekends not on call to be with my friends from college/med school and family!

  4. I sometimes feel self-conscious revealing that I am a doctor to other would-be friends. I think it does change the dynamic for some - not all - but some. One time, a woman seemed to feel guilty for needing to take a smoke break in front of me (I'm not judging you!)--I can tell that there's some fear of me judging them like their doctor would. Another felt embarassed to be eating a donut in front of me. We do, like it or not, carry the weight of our profession over to our personal lives. I can reassure to this person that I really don't care about what she eats and am not keeping nutritional scorecards on everyone, but I'm sure those secret thoughts would linger. You can't be BFF with someone who doesn't want to do anything "improper" in front of you because you might think less of them.

    There's a status element- real or perceived - that can get in the way. I'm very self-conscious about mentioning anything relating to material things.

    I do still find new friends who are not threatened at all by my profession - I love this. I wish it were always this way.

  5. I completely agree with your post, T. I have felt this "pulling back" time and again in my female friendships. Just this week I got a thank-you card from a patient (with whom I have a really great rapport) that said..."I wish you weren't a doctor, because then we could be friends!" Er, thanks?

    I have only made one good, non-physician friend since I left residency. She is the only one who did not pull away when she learned my profession...everyone else stays at arm's length. Anyway, long comment, but basically, I am right there with you. What to do about it? I have no idea.

  6. I joined a choir right after I finished fellowship. There wasn't a lot of chit-chat time before or after rehearsal, but I felt friendly toward almost everyone. I clearly remember when someone (a man) at the Christmas party asked what I did for a living, and when I replied, he literally stepped away from me.

    For years afterward I didn't tell anyone up front, and I found myself sort of keeping my distance a bit to avoid being asked. That didn't help me make friends. I did make friends at work - docs and NPs.

    My husband had the same experience when he told people he taught physics.

    I do have a several good non-doc friends now, mostly people I met through my synagogue, and I realize they're either academics with PhDs or they're non-doc clinicians (psychologists, mostly). The small-town issue pops up for me, too - just this week I sat at a meeting for shul and realized I couldn't comment on the issue at hand because my knowledge came from a patient's disclosure. Boundaries, boundaries...

  7. I've experienced the same thing. People just act weird when they find out. I try to avoid the question about what we do for a living. I've even lost friends that I had before medical school, despite my best effort. My husband says it is because they are intimidated by what I've accomplished.

    It's strange how we work so hard for this, but in the end we lose so much.

  8. Thanks, all - I feel less alone!

    Kathy - as for a "job that actually matters": no job matters more than yours, raising those adorable kids! Doctors can be replaced; you are irreplaceable.

    Wish I could figure out how to get past this friendship barrier. It's not universal, of course, I know, but it seems prevalent enough...

  9. Try being a psychiatrist who lives and works in the same small neighborhood!

    I cannot have casual banter in the schoolyard. I have to listen first and gauge a situation before I speak. I am lucky though to have a few good female and male doctor friends as well as a few non MD mental health professional friends.

    One other psychiatrist has a pool party every year called Shrink or Swim!

    Heck, I frequently do not post some of my most interesting thoughts on the blog I share with Jay because I am concerned that nothing online is really private and mights just be forever.

  10. I signed up for this online adopt-a-mom service where this woman was giving me advice about breastfeeding. Several weeks later, she found out I was a doctor and totally freaked out and said she was afraid to say anything to me anymore.

    However, the good thing about my job is that if someone asks me what I do, I can say I'm a physiatrist, which usually just confuses people rather than intimidates them.

  11. I love this post -- it's a great raison d'etre for this blog as it would be hard to read & understand this on many other blogs.

    Being in a bigger city helps, but I definitely still bend over backwards when meeting other moms to avoid saying what I do, for as long as humanly possible. And when I do "confess", I find I immediately try and minimize it "well, um, I'm a family doctor actually, but, you know, just part time, mostly I'm with the kids". I never know if it's me or them, but I feel it. They are freaked out.

    A very funny moment came once last year when I finally had to confess to a woman I'd been chatting up for several months at a playgroup -- and she practically jumped for joy as she confessed that she, too, was a family doc and OMG!!! it was too funny.

    I find it really hard. All of my previous friends are far away. It's lonely, you know?

  12. T. I hope I didn't come across as saying that raising my kids doesn't matter! That is my most important job...unfortunately that one doesn't pay well - and when I referred to "having a job that matters" I was referring to my paid position producing junk mail at at advertising agency :))

  13. To Anonymous 11:56pm: I recently had a similar thing happen. A mother of one of my preschooler's friends and I had been talking for awhile at the playground. At some point, jobs came up, and I answered that I work in a clinic (my version of getting around it vs. saying out loud. A whole other post, but people seem to assume I'm a nurse or manager if I just say I work in a clinic). She kept pressing me, and I finally admitted that I was a doctor. She "fessed" up as well to much laughter. How strange that after years of hard work and struggle and sacrifice, we achieve our goals of becoming a physician, only to feel a need to hide that fact from people. I am curious if other degreed professionals (i.e. lawyers, PhDs) feel a similar retiscience to admitting their profession to other mothers on the playground

  14. Interestingly, I am completely intimidated by hairdressers. I am definately a laid back kind of person regarding my looks since I had #'s 3 and 4 children. So when I meet someone who is a hairdresser, I immediately try to remember when my last hair cut was (over 7mo ago), what kind of comfy (but slobby) looking shirt I'm wearing, etc. And since I never really learned how to put on make-up (I'm actually trying to learn now), I am intimidated by these gorgeous women who know how to get their hair perfect and their face beautifully and artfully done.

  15. I'm not an MD, but a future PhD in Biomedicine. I don't tell people what I do. I simply say that I'm still in school, and most people don't ask anymore questions beyond that. I don't have kids or a husband, but my main social venue is church, where every other woman my age is married and most have kids. I love kids, and I really don't mind when "hanging out" turns into playing with toddlers and getting puked on by babies. Still, I don't get invited much, and when I do join some of the other women, they are usually surprised that I could make it. I like laughing till I cry and cooking and baking and watching cheesy movies and eating chocolate. Yes, I work in a lab and do things most people only see on TV, but I'm a human being first and a scientist second!

    One of me best friends (who, unfortunately, lives in a different town) says it's the education that's intimidating. Others are afraid to make a fool of themselves or appear boring. Really, by the time I head home from the lab I don't particularly want to talk about cell biology anymore, but people seem to think I'm not interested in everyday type of things.

  16. I'm Anon 11:56 again.

    MommyDoc: You cracked me up because I really hate confessing what I do when I'm actually getting my hair cut! I don't go to one regular person, I move around to different places, and I avoid at all costs saying I'm a doctor then. I just don't want to get into that conversation when i am so trapped in the chair!

    Interestingly I find that *partners* of doctors are generally OK. Friendships are still a bit odd but generally much more comfortable than "regular" people.

    "L", you're right, I am comfortable with profs or PhD types as well. It's complex isn't it.

  17. Amen, amen, amen! I think sometimes that I am evolving into a socially inept individual though the years preceding my doctorhood would tell me otherwise. My only absolute confidante remains my best friend from high school. There IS a shift in how people interact with you when you tell them you are a doctor. I tell my husband NOT to mention it unless asked in a social situation for this very reason. I generally try to avoid the topic. So sad.

  18. I can relate. My only female friends for now are my good friends from elementary and high school, university, med school and residency...since I've finished it's been impossible to meet new people. I just moved to a new city, the city where my husband is from so I have to make new friends. I just joined a meetup group for new moms but in my profile I purposely left out the fact that I'm a physician. The distant relatives in my husband's family (working moms like me) aren't too friendly to me, and whenever they speak to me, they ask about medicine, or they ignore it all together. There's no balance.
    This situation is very real. It's unfortunate.

  19. I have this same problem as a professor. I'm so glad to hear someone talk about it! It does help to be friends with some of the wives of my colleagues because they are not freaked out by my job. And I have one very self-assured non-academic friend. But now that my son is in school, I really notice this when I meet the other moms on the playground or at school functions. Sometimes I say "I teach" but then they inevitably want to know where and the cat is out of the bag. I wish it weren't this way.....

  20. I've definitely had this experience. I think part of it is how much time and attention mothers devote to their child's health care and choices. Inevitably, mothers take time and do research (whether it be internet searches, gossip or otherwise) and come to conclusions about what to do with their child's health choices-a prime example is vaccinations. I think it's pretty typical for a group of lay person mom's to share info, talk about these choices and have understandably strong opinions. How many times have you doc moms gotten stuck in a conversation about how conventional medicine is evil? Or how many times has the conversation turned cold when you're "found out" as a doc? I think part of it is how threatening it must be to have your own strong conclusions drawn into question in a format that is usually social, endorsing and equally informed. As a physician, it's our job to try and really weigh research, facts and make health care decisions. We may not always agree with the status quo in medicine but I think other moms fear engaging us in these conversations on the chance that we disagree with their decisions. I think often moms make different decisions for their kids (organic food or not, bedtimes, vaccines, etc) but to have the conversation with someone with a professional background on the subject is potentially threatening and let's face it-we moms mostly like to talk to each other so we can share about our own kids, decisions and experiences as moms.

  21. My husband and I are both systems analysts working in corporate america. There's a husband and wife couple that lives in our neighborhood (in a much larger house); they are both doctors. We have not pursued a friendship with them because we automatically assume that they would not be interested in a friendship us (people who make far less money and have less education than them). But, if they initiated the friendship, say, by inviting us to their house for dinner, we'd get the signal that they were interested in us. So what I'm saying is, you (as a female doctor) need to initiate the friendships if you want to have friends! Which is what is necessary among us regular folks too; you just need to do it more because of your doctor status.

    Think about it...How many friends do you have that make significantly less or more money than you? Friendships almost always are aligned with income levels. People say that racial differences are the biggest dividers in friendship. But income levels are more divisive.

  22. I've been mulling over whether to respond to this last comment or not but it elicited some pretty strong feelings in me, so here goes.

    Question: "How many friends do you have that make significantly less or more money than you?"

    Answer: Almost all of them.

    I vehemently disagree that "friendships almost always are aligned with income levels" because it just has not been my experience. Perhaps a correlation with levels of education would be more accurate, but even that isn't entirely or always true.

    You also write, "We have not pursued a friendship with [the physician couple] because we automatically assume that they would not be interested in a friendship with us." This statement simply PROVES my POINT as I described the responses of non-physicians in my post. The PREJUDICE lies with those who ASSUME, not with the physicians!

    You also write, "You as a female doctor need to initiate the friendships if you want to have friends." I find this idea silly and offensive. I don't believe people should be "penalized" or have to play by special rules simply because they occupy a certain lot in life or profession. Also, if you had read the post carefully, I describe women physicians INITIATING friendships, then having people REJECT them AFTER they find out their profession.

    The point: it seems, once again, that the problem lies not on the physician side but on the non-physician side. I don't know what it is - prejudice? Insecurity? Unfounded assumptions? But WE are not the problem. It's the people who call themselves "us regular folks," failing to acknowledge that physicians are "regular folks" too, that have some reflecting to do, in my opinion.

  23. agree completely with all; there is something about being a mom physician that sets you apart from the other moms. especially the nonworking moms. i don't know why. as a radiologist i work part time so actually do have a lot of free time to do things with friends. unfortunatey, i don't have many! one very strained situation occurred when i had to rec. a breast biopsy to a mom of my daughter's friend, and she exceeded weight limit for a stereotactic brest biopsy table.
    i feel lonely about the friendship aspect, but i love my job, my income, and my free time. i love my kids, had them later in life, and can enjoy them immensely. i think finances do play a role, when you can afford to do more fun stuff with your kids, other people just seem a bit jealous.

  24. I very much agree. I'm an ER doc, a military officer, and mom of 2. Two of those titles mean people approach me with caution.

    Rather than take it personally, I chose to take action in my hospital. We started a Lean In group at my hospital. There are about 12 of us who meet every month for lunch, and talk about medicine and being in the Air Force and being moms. There are a few of us that don't have kids yet, but there is a lot of support for women at all stages of their careers.

    We were able to offer advice on how to approach a commander about accommodations during pregnancy, and support one of our ladies as she applied for a job. We all share a housekeeper, and our members have gone out and taken the Lean In idea to other hospitals.

    It's been a great way to meet other ladies, break past the ER doc stereotype (I know, everyone hates getting phone calls from me!), and make some friends along the way.


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