The recent editorial [1] on medical spouses was interesting. When I applied for residencies, one interviewer asked if I didn't feel that I was depriving my husband, a civil engineer, by going into internal medicine. Somewhat at a loss, I stated that my husband had never questioned or interfered in my choice of career or my professional goals. During the last 15 years, we have endured residency, fellowship, and professional life together while having a family.

As you stated, medicine will have to become more flexible with more dual-career medical couples. The decision about who picks up a sick child from day care, or who takes the day off when the babysitter is sick, is never easy and probably is never completely equitable. However, dual-career couples must understand each other's needs and develop flexibility in accommodating them.

In the case of dual-physician families, the ability to practice medicine together, and to share in the stresses of a medical lifestyle, while establishing a family makes both parties more human. Patients appreciate that their doctors have many of the same home problems that they face, and a closeness develops that makes us better able to care for them.

Policies are now in place in many hospitals to allow maternity leave, job-sharing, and on-site day care, which did not exist when I had my oldest child. With the gradual increase in professional families (if you will), further change and growth is likely.