We identified work and non-work-related predictors of work-family conflict experienced by physicians, such as job demands, job strain, high workload, and high number of children. In addition, we found that support in the workplace, i.e., co-worker and supervisor support has shown a significant attenuating effect on work-family conflict among physicians. These findings suggest that the conceptualization of work- family conflict as proposed by Greenhaus and Beutell (1985), and Frone, et al. (1992b) is also applicable to physicians in a unique cultural setting. According to this concept, lack of social support functions as an antecedent to or moderator of work-family conflict (Thomas & Ganster, 1995) and differences in the level of support to individuals may lead to different levels of perceived work-family conflict provided there is no change in the number and intensity of stressors.
5.2.1 The psychosocial characteristics of social support
Hence, we further explored the psychosocial characteristics of social support experienced by physicians using qualitative techniques. Our results show significant gender-specific differences in the provision of social support and its relations to work- family conflict among physicians. Whilst our findings suggest a role for spousal, peer, and organizational support in reducing work-family conflict among physicians as a whole, lack of parental, peer (i.e., access to same-sex professional role model or mentor or gender equity) and organizational support appear to be associated with work-family conflict among female physicians.
5.2.1.1 Lack of parental support and female professional role model or mentor
Lack of parental support manifested itself in discouraging female physicians to embark upon a career in medicine and reminding them of the traditional male-female role dichotomy. Such practices may promote antagonism between women’s assigned professional self-actualisation and enforced domesticity, which prepares the ground for the development of work-family conflict. An important finding of our study was the lack of female professional role models/mentors identified by a large proportion of female physicians. Professional role models or mentors can help women develop a clear and concentrated professional focus and can provide solutions to problems associated with the harmonisation of the work-family interface. Lack of interaction with and support of female professional role models or mentors may therefore contribute to corroboration of work-family discord.
5.2.1.2 Lack of gender equity
Lack of gender equity (i.e., gender discrimination) has been reported with increasing frequency by female physicians (Carr, Ash, Friedman, Szalacha, Barnett, Palepu, &
Moskowitz, 2000). Among our respondents, gender discrimination was strongly felt during medical training and in the evaluation of residency candidates applying in different specialties. Furthermore, implications of gender discrimination in professional advancement during residency and after board certification have also been made. These observations are consistent with findings in other studies, which confirm gender discrimination as a stressor and the negative impact of discrimination on women physicians’ and students’ professional commitment (Frank, McMurray, Linzer, & Elon, 1999; Yedidia & Bickel, 2001). Our findings that female medical students and physicians in Hungary are exposed to gender discrimination at every level of medical training as well as during their professional life address the need to investigate and change attitudes, behaviours, and traditions within the medical profession in order to
ascertain equity of opportunity and more peer and managerial support for female physicians.
5.2.1.3 Lack of spousal support for women
Furthermore, our findings demonstrate that spousal support with household work (instrumental support) is rare among female physicians suggesting that the division of domestic roles and labour still reflects traditional sex-role stereotyping in the majority of the female physicians’ families. Lack of emotional support by the spouse has also been reported by female physicians. This finding merits further investigation as emerging evidence suggests that lack of emotional support may be more important in predicting work-family conflict than instrumental support (Kaufmann & Beehr, 1989), which may explain the lack of associations between work-family conflict and lack of spousal support with household duties in the present research.
5.2.1.4 Lack of organizational support
High proportion of physicians perceived their organization as unsupportive due to the limited provision of family-friendly policies to enable better integration of the professional and domestic domains and consequent reduction of work-family conflict.
Mechanisms and policies to alleviate strain and to prevent the development of work- family conflict should therefore be implemented. Such mechanisms should aim at enabling the female physician to increase sources of self-esteem, competency and personal enrichment through promoting social change, recognition, education and empowerment. The introduction of part time employment, retraining programmes or customised work-schedules with minimized odd-hour duty and enhanced flexibility for female physicians might offer affordable solutions to this problem. Further prevention strategies may include the improvement of the person-job fit, elimination of hazards, introduction of growth-oriented settings, such as fitness centres, reduction in role ambiguity, encouragement of participative management, and provision of opportunities
for social interaction. Indeed, recent research by Brough, O’Driscoll, and Kalliath (2005) has confirmed that organizational interventions including family-friendly resources have led to attenuation of work-family interference and to improved psychological outcomes for employees. In addition to enhancing the provision of family-friendly benefits, improving female physicians’ perception of a family supportive organization per se (e.g., supportive peers and managers) should also be considered as a means of minimizing work-family conflict. Research by Allen (2001) showed that employees who perceived their organization as more family supportive made greater use of available work-family benefits, and experienced less work-family conflict. In the Hungarian context, failure to implement organizational interventions in order to reduce strain has been associated with excess mortality, life and job dissatisfaction, as well as poverty (Andorka & Spéder, 1994; Andorka, 1994; Andorka, 1996), income inequalities and subsequent conflict (Sági, 2002), and social alienation (Andorka, Ferge, & Tóth, 1997).
5.3 Potential consequences of work-family conflict experienced by