ObjectivesTo report woman physicians’ experiences, in their own words, of discrimination based on their role as a mother.DesignQualitative analysis of physician mothers’ free-text responses to the open question: “We want to hear your story and experience. Please share” included in questions about workplace discrimination. Three analysts iteratively formulated a structured codebook, then applied codes after inter-coder reliability scores indicated high concordance. The relationships among themes and sub-themes were organized into a conceptual model illustrated by exemplary quotes.ParticipantsRespondents to an anonymous, voluntary online survey about the health and wellbeing of physician mothers posted on a Facebook group, the Physician Moms Group, an online community of US physicians who identify as mothers.ResultsWe analyzed 947 free-text responses. Participants provide diverse and vivid descriptions of experiences of maternal discrimination. Gendered job expectations, financial inequalities (including lower pay than equally qualified colleagues and more unpaid work), limited opportunities for advancement, lack of support during the pregnancy and postpartum period, and challenging work-life balance are some of the key themes identified. In addition, participants’ quotes show several potential structural drivers of maternal discrimination and describe the downstream consequences of maternal discrimination on the physician herself, her career, family, and the healthcare system.ConclusionsThese findings provide a view of maternal discrimination directly from the perspective of those who experience it. Women physicians report a range of previously uncharacterized ways in which they experience maternal discrimination. While certain aspects of these experiences are consistent with those reported by women across other professions, there are unique aspects of medical training and the medical profession that perpetuate maternal discrimination.
At least one co-author has disclosed a financial relationship of potential relevance for this research. Further information is available online at http://www.nber.org/papers/w27594.ack NBER working papers are circulated for discussion and comment purposes. They have not been peer-reviewed or been subject to the review by the NBER Board of Directors that accompanies official NBER publications.
Nudge interventions have quickly expanded from academic studies to larger implementation in so‐called Nudge Units in governments. This provides an opportunity to compare interventions in research studies, versus at scale. We assemble a unique data set of 126 RCTs covering 23 million individuals, including all trials run by two of the largest Nudge Units in the United States. We compare these trials to a sample of nudge trials in academic journals from two recent meta‐analyses. In the Academic Journals papers, the average impact of a nudge is very large—an 8.7 percentage point take‐up effect, which is a 33.4% increase over the average control. In the Nudge Units sample, the average impact is still sizable and highly statistically significant, but smaller at 1.4 percentage points, an 8.0% increase. We document three dimensions which can account for the difference between these two estimates: (i) statistical power of the trials; (ii) characteristics of the interventions, such as topic area and behavioral channel; and (iii) selective publication. A meta‐analysis model incorporating these dimensions indicates that selective publication in the Academic Journals sample, exacerbated by low statistical power, explains about 70 percent of the difference in effect sizes between the two samples. Different nudge characteristics account for most of the residual difference.
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