Power couples: common in medicine, rare in business?

tweet this morning from Andrew Rosenthal of Harvard Business School (HBS) and  MassiveHealth announced that at conference today presented by the HBS Women’s Student Association, it was reported that 80% of women at the top (in business, I presume) have husbands who don’t work.


As high as that number is, I believe it – and I’m sure the reverse is true as well.

What fascinates me is the apparent contrast with medicine, where so many of the women and men at the top seem to have spouses who not only continue to work, but often are physicians as well.

For example, Boston.com recently presented an interesting spread on power couples in the Boston medical scene.  This feature – including such notables as HMS Dean Jeffrey Flier and his wife, endocrinologist  Terry Maratos-Flier; oncologist and New Yorker writer Jerome Groopman and his wife (and occasional co-author), endocrinologist Pamela Hartzband; and Barbara Bierer, SVP of research at the Brigham, and her husband, neuroscientist and former Harvard Provost Steven Hyman — only scratched the surface, and could easily have included many more examples.

I follow this area with particular interest, as my parents are both physicians, my wife is a physician, and many of our colleagues from training have married other physicians as well; generally, both partners continue to work and climb their career ladders together.

Dual career couples were also a prominent feature of my training. I learned immunology from the late Charlie Janeway, whose wife, Kim Bottomly, is also a distinguished immunologist, and currently President of Wellesley; one of my favorite preceptors in medical school was the late Nina Braunwald, a cardiac surgeon whose husband is the legendary academic cardiologist Eugene Braunwald; I learned about fetal ultrasonography from one of the field’s leading lights, Beryl Benacerraf, whose husband, Peter Libby, is chief of cardiology at the Brigham.

What’s different about business (assuming for the moment there is a difference – it’s always a bit perilous to base sweeping generalizations on a second-hand 140 character summary)?  Why are power couples in business seemingly less frequent than in medicine?

The obvious answer is that it’s the money, stupid.  Most of the “top physicians” I’m thinking of are leading academics – one of the ways a “top physician” is often defined.  Consequently, while many may be distinguished, or even outright famous, and can certainly afford and enjoy a relatively comfortable life, few are filthy, flying-the-Gulfstream-to-Fisher-Island-for-the-long-weekend rich, in the way that perhaps a number of top business people are.  Thus, choosing not to work, or to work significantly less, may not be an option the way it is if your spouse is pulling down seven or eight figures.

Yet, I don’t think this is the real explanation.

Rather, I’d argue that there’s something intrinsic about being a doctor, and about those who choose to become physicians, that is different than what attracts many people to business.  I think many in medicine view their careers at least in part as a calling, and derive deep satisfaction from the work that they do, from the people that they treat, and from the daily interactions that they have.   Their jobs are not always enjoyable, but may be at least too definitional to easily give up.  (That said, many physicians also feel that their work is increasingly becoming less satisfying and less remunerative than they had anticipated.)

In business, on the other hand, I think many pursue it for the money (radical, I know), and hope to retire young and rich.  Perhaps couples that share this goal – or more charitably, some form of this vision of success — figure out that it makes more sense to consolidate their efforts around the person who seems most likely to achieve this, and thus increase the chances of arriving at their desired destination.  The hypothesis here is that the spouse electing to pursue the supporting role in this sort of relationship may feel he or she is giving up less than a spouse making a similar choice in a doctor-doctor relationship.

Two additional thoughts:

First, I’d be fascinated to see if the data for the spouses of successful female entrepreneurs (or of entrepreneurs in general) is similar or, as I’d predict, quite different.  I’ve previously discussed a somewhat arbitrary division of business careers into the traditional and the entrepreneurial, and I’d argue the entrepreneurial feels to me much more similar to that of physicians, where your career is a true calling, and there’s a tremendous amount of self-actualization (again, the David Brooks term, which I also discuss here) associated with your work and your goals.   Perhaps you might expect there to be more entrepreneurial power couples than traditional business power couples.

Second, I also suspect there’s a generational trend (as David Brooks also thoughtfully argued in a recent column) towards careers that are maximally fulfilling, rather than just good enough.  It’s possible that an increasing number of spouses will be engaged in careers that they deeply enjoy and would not consider giving up; thus, the 80% number is likely to fall, in any case.

Those are my reactions – looking forward to hearing what you think.

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