As a new parent during medical school, I remember thinking that my pre-parenting life must have had a lot more free time. When my second child was born (also during medical school), the squeeze on time was exponentially greater than with only one child. The other realization was how much richer my life had become by having children, and how being a mom helped me to relate better to my patients in a more mature way. In the article, “You can’t have it all: the experience of academic hospitalists during pregnancy, parental leave, and the return to work,” published in the Journal of Hospital Medicine in December 2018, Emily Gottenborg, MD et. al.* interviewed ten women from top academic hospitalist programs across the country in a descriptive qualitative study. Their results identified five common challenges that these 10 doctor-moms had to overcome:
• Lack of access to paid parental leave, causing the physician mothers to make the difficult choice to endure economic hardship or return to work prematurely.
• Difficulty in performing the daily work of a physician while enduring the physical challenges associated with the peri-partum period: the fatigue, discomfort, and sometimes medical complications.
• Breastfeeding challenges: The physician mothers in the study reported difficulties presented to them to successfully pump and store breast milk, including lack of access to time, space and storage, which resulted in having to quit breastfeeding prematurely. It is ironic that physicians promote adhering to medical guidelines to breastfeed for 12 months, as published by the American Academy of Pediatricians, but are not given the ability to adhere to the guidelines themselves.
• Impact on career opportunities: Physician moms described being passed over for opportunities, as colleagues dismissed them for additional projects.
My unscientific perspective as a physician-mom was shaped by my own experience and the anecdotal experiences described to me by my female doctor friends and colleagues. The work-family balance was a struggle because we needed to be perceived as equals at work. We didn’t want to miss a moment with our kids, but had little control over our work schedules. When the limit to 80 hours/week went into effect during residency, it was certainly an improvement, but didn’t take into consideration the additional hours spent at home each night reading texts and journals in preparation for the next day’s work. As a resident, my insightful daughter who was four years old at the time, asked me, “Why did you choose this job?” I answered that when I chose it I made a commitment (and had student loans), and now I had to honor my commitment. She replied, “Did you not think that you would have kids one day?” I laughed and replied honestly that I knew I would have kids, but I didn’t anticipate how much it would pain me to be away from them.
I recall a conversation with a colleague several years ago, a surgeon and mother of five, who described her previous night. A case had been added on, and by the time she got out of the hospital and arrived late to her son’s concert, the kids were singing the last song. Her husband handed her a program and said, “You made it! He’ll never know you were late.” She breathed a sigh of relief and sank exhausted into her chair. When the song was over she found her son and said, “That was a great concert!” He smiled and said, “Which song was your favorite?”
For a nonmedical mom, missing most of that concert would have been a tragedy. For a medical doctor, arriving in time to catch the last 10 minutes of the concert was an all out victory. The time we steal from our personal lives to fulfill our professional obligations goes unnoticed by the world at large, but our families feel it every day.
As the number of women physicians continues to increase, more investigation is needed to understand and resolve the challenges physician mothers face. Physician fathers face challenges as well, and it is important to understand these and work toward improving them in order that we can successfully balance work with family. As physician parents, we bring a needed perspective to the practice of medicine. By finding ways to balance work and life outside of work, we become more well rounded individuals, which helps us to better relate to our patients. Better work life balance is a win-win for all.