Editor’s Note: The recent commentary in ACEPNow on women in EM prompted Dr. Yafai to pen her thoughts.  

To all those ER physicians who are angry with “supporting” your female colleague who is pregnant or otherwise woman-ly disabled,
The thing about working in an ER that has a 50/50 or 70/30 M:F clinical ratio is that you rarely see the other side.  I have been working as a full time ER MD for the last 8 years in a community hospital in Los Angeles. My ER is predominantly female run. And predominantly moms. And it works GREAT.
The reason it works so well, is that women are covering pregnant women and women who are breast feeding/pumping. It’s not only men that are “supporting” their female colleagues. We cover each other happily. Well, actually, that’s not always true. Sometimes we grumble about how long someone is taking to pump and reminisce how we used to pump while intubating a patient, because we were awesome, unlike the new generation. Just kidding. We do this with open hearts. We ask each other how it’s going and sympathize with the peripartum docs we know are trying to do it all and holding it together sometimes by a thread. We can comfort and empathize and do the work.
For the most part we are women helping women. Not angry men burdened to subsidize women who are “disabled”. What a twisted version of reality that is! It’s not just our right to bear children, it’s our right to be able to feel safe at work and not be intimated by our colleagues. How is it that physicians are so behind the times of the rest of our country?  Many ERs doesn’t have a room reserved to pump. And we are a freakin’ hospital for crying out loud!
You know why? Well, I have a theory…
I think women are shamed as soon as we can’t spend every day and night at work that our voices are choked. We are trying so hard to fit in the boys club that we have forgotten that we are women. In residency, we would  watch female attendings get mocked behind their backs because they called their children to say goodnight in the middle of a shift. What is that about? Why is that OK?
Something else that is frequently forgotten …. many working ER physician mom’s “choose” to be nocturnists.  We know they do this to spend more time with their children, be present at soccer games/practices, functionally filling the roles of stay at home parents. Are they ever recognized for departmental benefit of covering the nights? No. Let’s be honest, if a male ER physician works nights, it’s usually to make more money. Are there some men who do it for their children? I’m sure there are, but I haven’t met them yet.
But back to my department. I have a different theory about why this particular department is so desirable to working moms. It is based on how we do our scheduling.  Like all ER’s we are required to work 12 shifts a month, 1/4 of which are nights, 1/4 of which are weekends. BUT…I have a control over which combination of Saturday/Sundays I work. When I was single, I worked all Sundays and went out with friends on Saturdays. When I got married I worked every other full weekend, so we could go away for the weekend occasionally. When I had kids, I started working Saturdays. The flexibility of moving my schedule as my life moves forward has been critical in sustaining and maintaining happiness in my career. There is nothing unfair or one-sided about workplace flexibility. It works for BOTH men and women.