The Evolution of Medical Marriages: A Changing Landscape

Medical marriages, or marriages between physicians or healthcare practitioners, were once a rarity but have become increasingly common over the years. According to recent (2014) research by the AMA, almost 40% of doctors marry another physician or healthcare practitioner. This shift reflects broader societal changes, such as the growing number of female physicians and changing attitudes towards marriage and career. Understanding the dynamics of medical marriages offers valuable insights into the unique challenges and benefits these couples face.

Factors Contributing to the Rise of Medical Marriages

  1. Increasing number of female doctors: With nearly half of medical school graduates in the United States being female, there are more opportunities for physicians of different genders to form relationships.
  2. Shared experiences and values: Physicians often find it beneficial to have a partner who understands the demands and passions of their career. This mutual understanding can lead to a stronger bond and better work-life balance.
  3. Opportunity for connection: The long hours and intense environment of medical school and residency provide ample opportunities for doctors to connect and form relationships with colleagues who share their experiences.

Benefits and Challenges of Medical Marriages

Medical marriages offer unique advantages, such as a shared understanding of the medical field, common values, and the ability to empathize with each other's work-related challenges. However, these couples may also face difficulties, such as balancing dual careers, managing the emotional toll of the medical profession, and finding time for family and personal life. By acknowledging and addressing these challenges, medical couples can build strong, supportive relationships that stand the test of time.

According to one study ^1, while most spouses/partners (86.8%) reported that they were satisfied with their relationship with their physician partner. However, the bar was set quite low. Satisfaction strongly related to "the amount of time spent awake with their physician partners each day." The number of nights their partner was on call per week also influenced spouses’ satisfaction. However, the quality of that interaction was strained. Spouses/partners reported their physician partners frequently came home irritable, too tired to engage in home activities, or preoccupied with work. 

Physicians also tend to marry later in life and are better educated than average Americans, characteristics which may serve to protect them from divorce.^2 They are also more financially secure and able to secure help.

We had money … security … you know, I mean I could always have sitters, it wasn’t an issue of being able to afford it. I could always have somebody to clean my house. (Dr. O’Reilly—wife)

Challenges Unique to Medical Marriages

Medical marriages face several distinctive challenges, including:

  1. Family Life and Childcare: Deciding to have children and finding suitable childcare can be complex issues for medical couples, given their demanding schedules and high-pressure careers.
  2. Work-Life Balance: Achieving a healthy work-life balance is a significant concern for medical couples, as both partners often have demanding careers. This struggle can lead to ongoing marital friction and stress.  Role conflict has been found to lead to job stress, burnout, and changes in career change, particularly in dual-physician relationships, as well as younger and female physicians.^3
  3. Decision-Making Dynamics: Physicians may develop strong, decisive personalities, which can lead to power struggles within the relationship. This issue may be exacerbated if one or both partners are neurodivergent, necessitating specialized support from a couples therapist.

4 Themes of Success

In an in-depth interview of 25 medical marriages, the researchers pulled out these themes:

1. "We rely on mutual support in our relationships."

Here is an example from couples relying on this strategy:

Any time he wants to go do something, he can do it. If he ever said to me, “I want to go to Italy for a week by myself” I would say, “Yes.” I want him to do something that makes him happy.… He is supportive of me in that he has hung in there, like all of my work trips and huge amounts of time at work and lack of being an interesting person. He’s really hung in there.

2. "We recognize the important roles of each family member"

Here is quote from this theme:

He does the bills and then I—he hates to grocery shop; not that I love it, but I can, so I do the meal planning and grocery shopping and then we divide up the cooking. We don’t have like I always do this or he always does that, it changes day to day and generally, I think we have felt it’s okay. When he was in residency it was hard because he wasn’t able to do it. (Dr. McDuffy)

3. "We have shared values"

Many couples in the study found that their shared values served as the bedrock of their relationship. These values provided a reliable touchstone when juggling conflicting obligations or navigating life's complexities. This common ground helped them weather storms and solidified their partnership, even in the face of adversity.

We both value the importance of raising kids, that’s number one on the list. [Number] two is we both value each other’s careers. We value each other’s opinions and, believe me, we do not agree on many things and we have had issues with that. But I respect her opinions and I think she respects mine. And we both bring, I think, different things to the marriage that we like and respect. (Dr. Xie)

4. "We acknowledge the benefits of being a physician to our relationships"

Participants also highlighted the advantages that their medical expertise brought to their relationships. The ability to care for a loved one during times of illness or injury, drawing upon their extensive medical knowledge, was viewed as a tangible and valuable contribution to the partnership. This unique skill set not only offered practical support but also deepened the emotional connection between the couple.

There is definitely a benefit to having someone who is not scared at the sight of blood. My son cracked open his eyebrow on the playground and clearly needed stitches. And rather than go sit in the ER for three hours and wait to get this thing stitched up [my physician husband] was able to leave whatever he was doing and meet me at the school. (Mrs. Daniels)

The Role of Science-Based Couples Therapy

Science-based couples therapy can play a vital role in helping medical couples navigate these challenges. By improving communication skills and addressing power dynamics, couples can work together to build a stronger, more supportive relationship:

Resources and Support for Medical Marriages

Various resources are available to support medical couples, including books like "The Medical Marriage" by Wayne Sotile and "Doctor's Marriages" by Dr. Michael Myers. Additionally, organizations like the AMA offer resources and platforms such as the AMA Alliance website, the Physician Family magazine, and the AMA Facebook page, all of which provide valuable information and support for medical couples. See also The Magic of Marriage by Bay Health.

Conclusion

In summary, many physicians find that their relationships and work-life balance are greatly enhanced by embracing the positive aspects of medical marriages, such as shared interests, empathy, and financial stability. However, it is also crucial to address the challenges that may arise, including time constraints, heavy workloads, and the need for career compromises. By focusing on clear role definitions and capitalizing on the unique advantages of their profession, medical couples can cultivate strong, lasting partnerships that thrive despite the demands of their careers.

Interested in asking yourself the same questions that the Pelman et.al (2015) study asked? Here they are:

  • What kind of work do you do, and what is your day like?
  • Is your spouse employed? If yes, in what occupation?
  • How demanding is their career?
  • Did anyone benefit in the career department? How? Is it worth it? Is there resentment?
  • What is it like to be in a dual-academic-career family?
  • What does your spouse’s career mean for yours?
  • What is it like to support a significant other not in medicine?
  • What does your relationship mean for potential career options?
  • What is it like to have a spouse in private practice?
  • How often do you work evenings and/or weekends?
  • How much traveling do you do for work?
  • When did you begin to realize the time demands of the life of a physician?
  • What are some of the benefits for your relationship as a consequence of the demands of your occupation?
  • What is the best part about being in a medical marriage?
  • What do you value most about your medical marriage?
  • Do you have children?
  • How do you make time for your spouse and children? What makes the time you spend together worthwhile?
  • How do you share in the child care responsibilities? What makes that work?
  • How did you balance pregnancy, career, and early child care?
  • How do you ensure longevity in your relationship?
  • What are the challenges of having small children?
  • Do you see any difference between your male and female colleagues and their approach to family?
  • Any similarities between your relationship and your parents’ relationship?
  • What have you found to be the most important aspect of maintaining your relationship despite your career demands?
  • What does your spouse like most about you?
  • What can other medical students or other faculty learn from you?
  • How do you serve as a source of support?
  • How do you share household responsibilities, chores, financial responsibilities, child care? Do you hire additional assistance?
  • What other support does your family have (e.g., housekeeper, outside family, nanny, etc.)?
  • What are the core values that make your relationship work?
  • What time do you devote to personal interests?
  • Footnotes

    Tait D. Shanafelt, Sonja L. Boone, Lotte N. Dyrbye, Michael R. Oreskovich, Litjen Tan, Colin P. West, Daniel V. Satele, Jeff A. Sloan, Wayne M. Sotile,
    The Medical Marriage: A National Survey of the Spouses/Partners of US Physicians,
    Mayo Clinic Proceedings,
    Volume 88, Issue 3,
    2013.

    2. Perlman, Rachel L. MD; Ross, Paula T. PhD; Lypson, Monica L. MD, MHPE. Understanding the Medical Marriage: Physicians and Their Partners Share Strategies for Success. Academic Medicine 90(1):p 63-68, January 2015. | DOI: 10.1097/ACM.0000000000000449

    3. Ibid

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    Dr. Kathy McMahon (Dr. K) is a clinical psychologist and sex therapist. She is also the founder and president of Couples Therapy Inc. Dr. K feels passionate about couples therapy and sex therapy and holds a deep respect towards those who invest in making their relationship better. She is currently conducting online and in person private couples retreats.

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