In
Don't Quit this Day Job, a recent New York Times OP/ED essay, Los Angeles anesthesiologist
Karen Sibert, MD voices concern about the rising trend for physicians, particularly women, to choose part time positions. She argues that society has invested in the education and training of a select group of individuals, and physician shortages are leaving many patients without anyone to care for them.
Dr. Siebert states, “It’s fair to ask [aspiring physicians] — women especially — to consider the conflicting demands that medicine and parenthood make before they accept (and deny to others) sought-after positions in medical school and residency. They must understand that medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve.”
Not surprisingly, this essay has evoked strong responses from many.
I wanted to set down my thoughts about the issue, hoping that they will spur further conversation about balancing our personal and professional obligations within the context of the Duke Department of Medicine.
The issue
I don’t believe that part time work is a “women’s issue”, but rather that it is a caregiver’s issue.
In the last
Duke Faculty Life survey, both male and female faculty rated family caregiving issues as one of the most important stressors in their professional lives. However, women faculty are significantly more likely to report having a primary caregiving role, and are more likely to have a partner who is also a working professional. As a result, female gender is a “confounding variable” in statistics that are influenced by caregiving responsibilities. Framing part-time work as a gender-related issue is a disservice to both men and women, because it portrays women in unfair ways, and leaves men out of important conversations on how to balance professional and caregiving responsibilities.
Facilitating flexible schedule
Juggling these responsibilities is not easy with a traditional physician’s schedule. Work hours generally start before adult day care opens and last past the end of soccer practice. Kids and parents
always seem to get sick on clinic days when our partners are out of town, and don’t even get me started about the “summer camp spreadsheet” that we start working on in February.
Duke has made efforts to facilitate caregiving for its employees; for example, providing enhanced access to the
Duke Family Support Program,
childcare networks, and severe weather day child care. But it still takes creativity and flexibility to manage complex professional and family schedules, and physician burnout is a real threat.
We need to strive for a work culture where it is okay to leave a meeting early to go to mom’s oncology appointment or a son’s school music program, with an understanding that the work will get done outside of “traditional” medicine work hours. We need to be more comfortable talking about flexible scheduling options with our supervisors, but we also need to plan ahead with our families for times when we know that our work responsibilities will not permit much flexibility. It helps to formally or informally develop groups of colleagues with similar roles who can cover for each other when “life happens.”
Making use of the mechanisms
There are seasons to our professional and personal lives. Children grow up (too fast), parents age, grants are completed, new administrative positions are assumed. It only makes sense that our effort in these arenas will fluctuate too. It is and should be okay to use
flexible schedules,
family medical leave,
tenure clock pauses, and other mechanisms to manage the seasons of our caregiving responsibilities. In the end, our service to our families, our patients, and our profession will be measured over a lifetime.
There is no doubt that we are remarkably privileged to be Duke Physicians, and that our privilege comes with a deep responsibility to consider the needs of our patients and society in addition to our own.
These decisions go far beyond work schedules: what specialties do we choose? What populations do we serve? What diseases do we study? How do we participate in our community outside of work?
I am proud that we struggle with all of these questions at Duke. I do not accept that our commitment is measured by our schedule, and I hope we will continue to support each other as we struggle to find the right balance for our patients and families.
Please join the conversation by adding your comments below.