Gender Perspectives on Self-Employment Among Israeli Family Physicians: A Qualitative Study

Background: While previous studies have shown that occupational choices are influenced by traditional gender perceptions, little is known about gender’s role in choosing self-employment among family physicians. Family medicine, with its emphasis on holistic and integrative attitudes that align with independent practice characteristics, presents a unique context for examining gender-related decisions in choosing self-employment. Objectives: To examine the role of gender in family physicians’ transition to self-employed practice, focusing on gender differences in motivations and considerations for this career choice, and to analyze how traditional gender roles manifest in professional decision-making among highly educated medical professionals. Methods: A qualitative study based on in-depth interviews was conducted with 27 self-employed family physicians in Israel who recently chose to start independent practice rather than remaining salaried physicians in Health Maintenance Organizations (HMOs). Interviews were analyzed using thematic content analysis with a gender-sensitive approach. Results: Despite their advanced education and professional status, female family physicians tended to maintain traditional gender patterns in their professional choices. Women emphasized work–family flexibility as a primary consideration and expressed less confidence in financial management self-efficacy, often delegating these responsibilities to their spouses. In contrast, male family physicians displayed traditionally “feminine” characteristics in their professional approach, including emphasis on holistic care and family involvement. Male physicians also cited work–life balance and the opportunity for a more comprehensive, biopsychosocial approach to patient care as key factors in choosing family medicine and self-employment. Conclusions: The findings demonstrate the complexity of gender roles in family physicians’ professional choices, revealing both persistence of traditional gender roles among women and different patterns among men. While male physicians displayed characteristics traditionally identified as feminine, these patterns may reflect both gender role evolution and generational shifts towards work–family integration and collaborative patient care. This study highlights how gender and generational factors shape career decisions in primary care, with implications for medical education and healthcare organization policies.