Wednesday, December 12, 2012

Why we cut back

About a year and a half ago, there was an op-ed piece of the New York Times called Don't Quit This Day Job by Dr. Karen Sibert about how women in medicine have an obligation to work full time, and an obligation to take on the same workload that men generally take on. I've been thinking about this lately, and why mothers increasingly do not make that decision. I'd like to present an entirely plausible scenario to you:

Mary is a physician and a mother of two children, ages 2 and 4. Her husband is also a physician, and she learns in September that he will have to be on call for the upcoming Christmas. The daycare that her children uses will be closed on Christmas and Mary has no family in the area. The babysitter she usually uses will be out of town. So she requests to her boss that she have Christmas off this year, hoping to get priority given her predicament, even though several other people have also requested it off. She receives one or all of the following replies:

“If you work in the medical field you should realize that you will be working holidays and it's presumptive to assume people without kids should work holidays just because it's hard to find child care.”

“Your inability to find childcare does not mean I should be forced to take second pick at holidays.”

“Well, kids are expensive and stressful. Didn't you know that before you had them? I don't feel bad AT ALL for doctors who have kids during training and then discover that childcare is expensive and inconvenient.”

“If you can't pull your weight and do your fair share due to your situation, then you need to leave.”

“You chose to have children. Parents who both work in professions that work on holidays chose to do so.”

“Not wanting to leave [your kids] with a stranger is not an acceptable reason for someone to cover you.”

“If you want holidays off get a new job and stop bitching.”

“But bottom line is that reproduction and child rearing is, at the core, a choice we make as human adults. I never once said that it's easy or painless to have an abortion or give a child up for adoption, only that those are choices available to women who are not ready to deal with child rearing and the stress/hardship/etc that it entails.”

“If someone decides to have kids then they need to bear the brunt of what ensues and not expect other single or childless colleagues to sacrifice just because.”

“Sorry, Mom, you cannot have your cake and eat it too.”

“If you want to make the big bucks you have to do what it takes to prove to the employer that you are worth those big bucks.”

“You may see your time with your kids as a priority, don't expect others to do the same.”

“You may see that as selfish, but my 'me time' takes priority over other people's kids.”

“A good Christian is one who deals with their own problems like childcare without complaint or burden to others. They are your children, dear. Not mine.”

“You chose to have kids. You chose a profession that requires you to work holidays. Get a backbone and deal with the consequences of your choices and stop trying to make the rest of us who made good life choices or are happy with them suffer for your decisions.”

“If you feel your very young children need to be watched that carefully, why work at all?”

“One of the major responsibilities of being a parent is having adequate childcare, which includes backup and backup for your backup. “

“The fact of the matter is that the decision to have kids is a personal one. Once you make that decision don't expect everyone to plan their lives around yours. People who are really concerned about having holidays off become teachers or find office government jobs. “

If these comments sound familiar, it's because they all appeared when I suggested on this blog that someone in Mary's predicament have priority.

And maybe all of you are right. Maybe she shouldn't have priority. But if anyone is wondering why women cut back on medicine and even leave the field after having kids, now you have a taste of what we face. Can you really blame us? And just to hammer the point home, here are a few other comments that will give you a flavor of what we mothers in medicine go through:

“At times childcare falls through, and I'm forced to rely on the goodwill of others.”

“How many babies go to daycare and end up with a febrile illness within 3 weeks of starting? Practically all.”

“My sister has three kids and hasn't had a Thanksgiving with her family in 20 years.”

“Then I had a kid. So I moved to a field where I do not have to work any holidays or weekends unless I want to.”

“When I had to work in a remote hospital thirty minutes away, I arranged for my childcare to spend the night and went there to stay in a hotel so I could make the 8 am frozen sections."

“Our state would expect an emergency worker to respond, including physicians. our employer, and state, expects you to have appropriate emergency coverage for children in the event of a disaster.”

Just food for thought.

90 comments:

  1. Often one parent (does not need to be the mother) must find a more accommodating job. I ended up taking a job that was part clinical and part management with no weekends or holidays, and only occasionally an evening meeting. The family comes first, career second! It was a hard decision but the right one, and our kids thrived. We had no family capable of child care in the area, and you can only rely on friends just so often. It wasn't the holidays that were a problem so much as the general unpredictability of the schedule, and the fact that I frequently got stuck at work much later than anticipated.

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    1. It's true... the problem goes way beyond the holidays.

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  2. Well, you either pay out the nose for childcare, you have a relative who can help, or one parent finds a more accommodating job. Making concessions is part of life. This is an EVERY day problem though, not just one that happens around the holidays.

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    1. Very true. I just gave this example so the comments would be relevant. But for a family with two high-power jobs, it probably comes up constantly.

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    2. What OMDG said. Also, it's september. These parents have 3-4 MONTHS to find acceptable back up childcare that they either pay through the nose for or leave their kids with friends for xmas that year. I really don't think this is unreasonable.
      -Mom to a one year old

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    3. Anon: I'm not saying this inflexible attitude is "unreasonable." I'm just saying it's attitudes like this that drive women out of full time jobs or medicine entirely.

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    4. Agreed. All two physician households I know either have one parent scale back hours (usually mom), expensive child care or a lot of family help. Or all of the above.
      -same anon

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  3. I'd be curious how people would see the same situation if the sexes were reversed:

    "Dave is a physician and a father of two children, ages 2 and 4. His wife is also a physician, and he learns in September that she will have to be on call for the upcoming Christmas. The daycare that their children use will be closed on Christmas and they have no family in the area. The babysitter they usually use will be out of town. So he requests his boss that he have Christmas off this year, hoping to get priority given his predicament, even though several other people have also requested it off."

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    1. I suspect none of that stuff would get said to him.... they'd say, "Dave's reliable and never asks for anything. Let's give him what he needs."

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    2. It is probably less true now than in the past, but I believe it would be a rare male physician who would take on this responsibility. In fact, my ex, who was quite informed and liberal for his time, still expected me to arrange childcare when I needed to travel, which was fairly frequent. I honestly don't know what he would have done if one of them got sick. All I am saying is that in many, if not most families, childcare responsibilities and scheduling belong to the mom. (No mom ever says that they are babysitting their kids, but males often say just this.)

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    3. I hate it when men say they're babysitting their own kids. I've never heard a woman ever say that.

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    4. THIS. Why is it always the mother who is requesting the time off? Why is it always the mother who is responsible for finding the child care?

      Also, when my male friends are taking care of their kids and call it "being Mr Mom" I let them have it with both barrels. It's called being a FATHER, it is what you signed on for when you decided to have children, so stop making it sound like you're being asked to re-invent the wheel single-handed.

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  4. Agree with Grumpy...it'd be very curious to see what the replies would be in that case. Sometimes people are so inflexible. What happened to compromise? As an RN I would ask for Thanksgiving off so I could work Christmas as I don't have children....I'm sure Mary would switch another holiday with someone in order to have Christmas with her children. Hope this doesn't happen to you Fizzy!

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  5. This really makes you think.

    I feel like people who replied with such nasty comments have never actually had to make the decision between family and their job because not too many careers actually force you to make that decision. Do I think she should have priority, yes and no. If she can't find someone to watch her kids she can't leave them alone!
    It makes me wonder also, what would a single parent do in a situation like this? I imagine some single parents have help from family and what not, but many don't. Are they to be punished because they need to work and they're the only one available to watch their own kids?

    Perhaps Mary has a friend who can watch them for the night? It would be asking a lot, but at least they'd be cared for.

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    1. I know some single mothers and although they usually have family that helps, family can only do so much sometimes. Usually these women cut back as much as they can afford, but since they only have one income, they might not cut back and end up just seeming very unreliable a lot.

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  6. The only way we solved this ongoing issue was to have a live in au pair. I know that not everyone can or wants to have a stranger in their home, but we had extraordinary luck with ours; well, with two out of three, anyway. It is almost easier to find care when they are younger than older when after school activities are so important. Just as an aside, one year our au pair was delayed due to visa issues. We decided it would be okay to leave our girls home without supervision for one day - the day after Christmas. Husband assured me that they were old enough and responsible enough. Well, they accidentally set the house on fire! Everyone, including the pets, survived, but we were forced to live in a trailer on our property for 4 months while our house was reconstructed. Just saying, no decision is perfect. Tricia

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    1. Well, you have convinced me not to leave my kids alone till they're twenty :P

      I never employed an au pair, but I can't imagine how that would work for us, since we have always lived in apartments that were barely big enough as is. I'd imagine you kind of must have a house.

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    2. Yeah, the house is kind of necessary. The au pair, the kids, and you all need to have some privacy some time. Remember that, Fizzy? Privacy? Tricia

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    3. Nope. The other day, I was peeing in the bathroom and I asked my toddler for some privacy. She left and brought back socks.

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  7. I'm not in the field yet, but I think that, particularly with Millenials, we are beginning to expect employers to understand that we have familial obligations. Family-friendly policies are going to have to become the norm soon enough, even for doctors, and even if that means on-site childcare. And it infuriates me when people say that having children is a choice. Yes, it is ultimately one's decision whether or not they keep their child, but saying that having children is a choice is like saying eating every day is a choice. It won't kill you if you eat every other day, but it's unlikely that you will. Same with kids. As long as people are going to have sex, they are going to have kids, even if only because of a slip-up. And expecting those people to have an abortion or put the child up for adoption is immoral. It is a woman's choice whether or not to keep a child she's conceived, not her employers, and she should not be punished for doing what is natural.

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  8. This is a highly controversial and emotional topic, that won't be resolved through a blog post or reply obviously, but I would like to give my two cents as the childless employee. Childless employess always were in the minority where I've worked. Every holiday, there was always one parent who NEEDED the holiday off because of a spouses work schedule, babysitter out of town, daycare closed, etc. So I always ended up working every holiday. It really hurt when I would request a holiday off and remind my boss of who had been working holidays for the past three years. ONE Thanksgiving, I actually had the holiday scheduled off, then a parent had a sudden emergency and asked for the day off. Boss agreed and I worked Thanksgiving day. Turns out, the parent LIED and just didn't want to miss the holiday. The fact that that coworker had no regards for others (me) hurt me so bad. So yes, I quit and went into a field where I no longer have to work holidays, but I also don't have to find a replacement if I'm out sick for a day. So as a result of that experience and the parents who have been my coworkers, I say this: SUCK IT!

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    1. So b/c of your bad experience, you think all parents should suffer? I see no reason why people can't trade off holidays. And it seems that your boss is at least partially to blame for your situation, too.....

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    2. I wouldn't want to work in a place where my coworkers were liars either. If a childless colleague told you they needed a holiday off because they had to have emergency surgery and you found out they were lying, would you be less angry? People with and without kids can lie.

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    3. Of course I wouldn't be less angry, but we shouldn't judge an entire group of people based on the bad behavior of a few. Beyond that, I know some parents are worthless as people, but why should innocent children suffer? If everyone does their job the way they should, is respectful of others, and if employers have some basic policies in place that establish a work-life balance, then we wouldn't have this problem. And we certainly shouldn't judge everyone based on a few.

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    4. Those who are single, in any profession or industry where there needs to be coverage on holidays, are always expected to sacrifice every holiday for the benefit of others. It's the way of the world because we are in the minority, so we are always required to cover for one parent or another. And we are the ones routinely expected to work later than the parents. And the ones tasked with the most time-consuming projects. And the tasked with the projects that require the most travel. etc. etc. etc. And for a while, I was ok with this arrangement, and sympathetic for my co-workers with kids, until I realized one day, many years later, that this was how it was always going to be.

      And that is no more fair or right than having parents work on the holidays.

      And we singles are the ones who are told we owe parents a favor because we are the "selfish" ones for not having kids. Bullshit. For one thing, this is the 21st century, not the 1st century. The human population is hardly at risk of fading out of existence (unless there is a global, apocolyptic calamity, and in that case, I'll be glad to not have kids suffering through something like that). So arguably, we are the ones doing everyone a favor by not adding to the world's over-population. Second, when do we single people ever get the right to celebrate the same holidays on the same day as anyone else? Because I would think even the parents out there would agree that we ought to get one of the holidays off from time to time. Well, I'm still waiting for my day off.

      And another thing. Since none of us can predict the future, we all should be allowed the same amount of time off on important holidays, so we can enjoy them with the ones we love, even if we don't have children. Example: I missed my last Christmas with my mom because I had to work on that day when all the parents I work with were home with their families. The next Christmas, she was gone from cancer. I would like to think that, had I known in advance she was going to die, my co-workers who were parents would have covered for me so I could have spent that last holiday with her, but you know what? The way they behave with their "me, me, me, my wants and needs are more important than yours" attitudes, I seriously doubt that they would have. Hell, when my doctor pulled me out of work for a bit because of a serious, life threatening condition, you want to know what they told me? "The timing of your medical leave of absence is inconvenient for us, so could you please stay on the payroll until WE find someone WE decide can take on your work?" Not once was I asked if I was ok, and whether there was anything they could do for me. And when I got back to work, it was suggested that I forfeit my accrued vacation (just 10 days' worth, not a huge amount by most standards) because apparently, medical leaves of absences are just one long vacation according to my co-workers who wanted me back in the rotation for holiday coverage.

      You think I've just had a run of bad luck? Not according to my other single friends, who work in other jobs at other companies and report that they are treated the same way.

      If EVERYONE was considerate of others, things would sort themselves out and we would all have to work some holidays, and get others off. But that's not how it works in real life because, for the most part, people want what they want for themselves, and to hell with anyone else. And when you factor in the bias against people without kids (yeah, that's right, there are biases against US, not just biases against parents), we single folks seem to draw the short straw an awful lot.

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    5. The thing is, a lot of people are inconsiderate. In my residency, the first year there was not one person with kids, yet people still managed to be unreliable or inconsiderate. Having kids is a great excuse for people who are already going to be inconsiderate to do what is natural for them.

      There are plenty of other parents who go out of their way NOT to inconvenience others and as a result, are barely hanging on by a thread. When my daycare calls me and says to me that my daughter has conjunctivitis and I'm required to pick her up within the hour, do you think that gives me pleasure? Generally, I plead with them for extra time, trying to get done with whatever I can, usually with my blood pressure sky high, half in tears over the unfairness of it all.

      In any case, people have kids, that's an unchangeable fact. Either we can provide flexibility for parents (usually moms) who need it, or face them all cutting way back or leaving the workforce.

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    6. Fizzy, I'm the same Anon who posted yesterday at 6:05 pm.

      I don't disagree that it is very difficult for women with kids to both work and raise a family, especially when they are in medicine and other demanding careers. And I don't WANT them to leave the workforce. I work in a profession that, although not in the medical field, is also intense, demanding, and highly competitive like medicine is. And the one thing I have learned in my 12 years within that profession is that people truly cannot "have it all." Because there are too many pressures in one's professional and personal life, and having kids, for better or worse, exacerbates this problem.

      All of my colleagues who try to have it all, especially those who have DELUDED themselves into thinking that they have it all, are interesting to observe. Their kids typically are a MESS in one way or another (usually behaviorally) because mom or dad is so busy with the career and personal distractions, they don't have time to really be the parent they have fooled themselves into thinking they are. These people are also hated by their work colleagues because they have been very selfish on matters like who gets/doesn't get to work on the holidays.

      I'm not saying that women with kids shouldn't work. But it's more complicated than you seem to make it out to be. It's not just about having single co-workers cover holidays for all of the parents out there. It's about inequality within the marriage (because in most marriages, although not all, the husband/dad does less with the kids), it's about extended family pitching in to help wherever possible, it's about getting the EMPLOYER (not co-workers) to find ways to be more accommodating to moms with kids, it's perhaps about government funding to help out moms, especially the single moms out there (maybe funding affordable day cares that operate 24 hours for parents who have to work holidays or second and third shifts). But it is most definitely NOT just about the single folks taking way more than their fair share of lumps when it comes to holiday coverage.

      But that whole "can't have it all" thing I was talking about before? I suspect that will still be the case even if working moms get some much needed relief in the forms I mentioned above. Because we are talking about life in the 21st century. You can have a career and kids and deal with other personal issues that come up from time to time, but there is always a price to pay, because it is not possible for a normal human being to do all of those things WELL. There are simply not enough hours in the day.

      It's sad. I don't like it, and admittedly, I don't know how to fix the problem. But it's the truth.

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    7. I entirely agree there's no simple solution. If there were, we'd be doing it! My initial post was about flexibility during holidays from coworkers, but considering how much people seemed to dislike that, this and my other subsequent posts are more aimed at: well, what CAN we do? Because the solution isn't just to shrug and say "you chose to have kids, work it out." Like I said, that's just going to drive women out of the workplace or make them perform poorly at their jobs.

      I think there IS a solution, but like you said, it's complicated and will likely evolve over decades as there are more and more women in higher level positions. The things you say about the husband and extended family pitching in more is great, but it's not an option for many people.

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    8. My final comment on this debate -- until this situation gets sorted out and moms have an easier time juggling everything, you cannot require that the singles out there shoulder more than their fair share. Because it is not their fault, and they don't owe the parents they work with anything more than 50/50 sharing of the holidays. And I know in your initial post you said you don't believe that singles should shoulder all of this burden. But at the moment, they DO because that's how things tend to work out, since the single people are always outnumbered by those with kids. And singles have every right to be upset about it, and since no one seems to want to be serious about working out this inequality, they have just as much right to be pissed off about it as all the moms who are pissed off about struggling to find childcare and/or other support.

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    9. I think we can at least agree that the current system is flawed, and needs to be sorted out, which will ultimately help both those with and without children.

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    10. I agree! For 6 years I was the single childless employee who worked every Thanksgiving and Christmas-- for six years!! I got married this last Thanksgiving and not one of the other 6 coworkers (all with children) offered to work the holiday- and they complained that I shouldn't have chosen Thanksgiving for my wedding as it's too hard for them to find childcare! And yes they put me down to work for Christmas holidays too. Thank goodness I finish this job in June! When I have kids, I vow never to be that inconsiderate and selfish with my coworkers.

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  9. Live-ins are an excellent solution IF you find the right one and IF you have the facilities/resources to accommodate one. Many do not. This is where the organization or federal/state/local government needs to step in: to provide child care facilities. If an organization expects its employees to work non-usual-business hours, day care is something it NEEDS to provide. Even if they don't fund it totally. Insurance is usually the big stumbling block, but it can be overcome. Until people with dependent children are accommodated, Fizzy is right: Highly-skilled women will not work at their full potential since they bear the brunt of childcare arrangements whether married or not.

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  10. I've had good luck finding people using www.care.com.

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  11. I actually grew up in a household with two physicians as parents who practiced primary care in a more rural setting. This meant that both parents were on call every week, often at the same time, and worked at hospitals in different towns. We had a nanny who lived with us (actually still does) to help take care of us. But there were still times that my parents had to rely on their friends to watch us or when we had to watch ourselves. It is interesing that no one has commented on the impact this has on the children themselves. There were definitely times growing up when my parents had to choose work over showing up for something for us, but we never felt that they would rather be there than with us. I never felt neglected or that I was missing out because our holidays were less than traditional. My parents were helping people which is a noble calling and I have no regrets about the career choices they made.

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    1. You're right. I think it probably doesn't bother the kids as much as we think. But that doesn't mean we shouldn't worry about the parents. When I was young, my single mother had to work weekends and nights, and we had a live-in. I loved the live-in and wasn't bothered by that at all. But the live-in was a little unreliable, and because of that and the stress of work, my mother ended up becoming very ill for a while and had to take a leave from work, which made things even worse for financial reasons. So in that sense, it was worse for me.

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  12. Its all about planning way ahead. Years ahead in some ways. As an ER doc, my schedule is planned, few surprises. But it includes lots of nights, weekends and holidays. My husband is a pathologist, so he rarely has immediate obligations (slides can wait a couple hours if he has to run and pick up kid, bring her back to hospital with him, etc.). I am able to work at my "full potential" b/c he is flexible and fully engaged in parenting. If I was married to a surgeon, I would have live in help - no question. Your scenario is a straw man argument. How many docs are actually going to leave home and go do a shift on xmas? (answer: residents, ED, trauma surgeon). OR schedules and clinics will be empty. If you have to round on some inpatients, take turns or have the kids visit at the neighbor's for a couple hours. If you have 2 physicians who both have "in person" work demands on xmas, they would certainly both have high stress careers through the year. They should have planned ahead better.

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    1. Actually, most doctors I know work on weekends and holidays. Most clinic docs have inpatient responsibilities too where I live.

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  13. Couldn't agree more. I'm a vet, so a little different. My agreement was I would work every other Saturday. Slowly it started turning to every Saturday, because of this or that reason. Finally had a sit down with my boss and essentially told her I would walk if things didn't go back to the way they were supposed to be. I needed to be with my kids at least every other weekend. She is childless, but it still worked. It doesn't hurt that I'm the biggest producer when I am at work. One nice thing about the veterinary field is that it is tipping heavily into female domination, so I think this breeds a lot of room for understanding issues of work/life balance.

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  14. Wouldn't it be easiest if it was just in your contract that you would work X holiday and have off Y holiday, and that this would change each year in order to accomodate, and if you wanted to switch with someone you could? If this is planned a year in advance, it shouldn't be too hard to figure out. Obviously there are always emergencies, but then it should fall on the company, not the other employees to figure out how to deal with the issue. In my opinion, it's discrimination to do any sort of scheduling based on whether a person has children or not.

    It's obviously a tough situation for everyone, but I don't see why it can't be dealt with long before the holiday comes around in order to avoid conflict. Either way, you should be able to plan vacations and be able to take them without any sort of guilt or consequence. Tell me if I'm missing something.

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    1. I mean, there are always ways to juggle things. Some of the people I quoted above were praised for managing to juggle all those balls, which involved hotels, relying on goodwill of friends and neighbors, never having a family Thanksgiving in 20 years, etc. And we praise them, and say, "That's awesome that you did that!! Everyone should be able to do it!" Maybe instead we should say, "That's awful that you had to do that. Maybe medicine needs to change."

      The question is then, who will work holidays? Well, I've found that hospitals that hire per diems to cover weekends and holiday shifts are never at a loss for volunteers.

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    2. I should also add that it's miraculous how little spending the holidays with their families seems to mean to many people when there's extra money involved.

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    3. You definitely shouldn't HAVE to rely on good fortune in order to have childcare. Or spend money on hotels in order to make money.

      It seems like the simple answer is just pay people extra if they want to work holidays. Hospitals should just all do that for the sake of their employees' happiness (hahaha). Especially if like you said, there's plenty of people able and willing.

      One of my mentors is a physican-scientist who normally only puts in 2 half-days in the clinic, and actually bought herself out of call so she didn't have to worry about it. Seemed reasonable to me. I'm sure someone else enjoys the extra cash.

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  15. I am one of the child-free by choice. After 5, 10, 15, 20 years of coming early, staying late and working weekends and holidays to cover for family "emergencies" I have no sympathy whatsoever for parents.

    You say not to paint the whole group (parents) because of one bad incident or liar, but it becomes commonplace. It is not just one bad incident or one liar. It is just what happens. Child-free individuals in my field are few with the exception of students who have other obligations.

    The problem becomes that Mary needs Thanksgiving this year because her daycare is closed, then Sue has an emergency at Christmas, then Tanya's husband suddenly gets called in for New Year's and so on. The child-free person is expected to cover for ALL of them.

    Add on top of that that Sue cannot get to work until 9:30 because she can't drop her kids off until 9, so someone else must start her daily work. Then Mary has to leave no later than 3pm, because her 12 year old cannot possibly walk home, and never can stay in the house alone, so her daily work must be finished by someone else. Then Tanya's teenager has a migraine and she has to rush out. Then who is doing all of the work?

    I have found that I have no sympathy for anyone. Regardless of whether they have done it before. I am burnt out on all of the excuses. I walked home from school. Stayed alone until my mom came home from work. And even stayed home sick without a parent occasionally. I realize that times have changed but, seriously, a 16 year old who drives her own car, doesn't need mommy to hold her hand when she has a migraine. She just needs quiet and dark.

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    1. Your comment proves my point though. In spite of all the moms who brag on here about how they make it work and all the childless people who say that parents need to suck it up, moms obviously do NOT make it work most of the time. So expecting them to do something they either can't do or don't want to do so much that they're willing to lie is an exercise in futility. And it just needs to bitter feelings among the childless.

      Wouldn't you be happier if Sue, Tanya, and Mary had it in their contract that they didn't have to work hours they couldn't, and got paid comparatively less? And then people who wanted to work those holidays or whatever and wanted the extra money could do so?

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    2. Or if she got more $ to cover!

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  16. Fizzy I appreciate your post. Now that you have pointed out a problem, maybe do something about it? Petition for rules to change? Write a letter to the boards of (fill in the name of appropriate assosiation). I'm sure you and your brilliant mind must have a solution to a problem you keep on presenting?

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    1. One person writing one letter is pretty ineffective.

      Too bad I can't write a bunch of high-traffic blog posts about it to point out the problem to other medical professionals.

      Oh wait :)

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    2. Done. What's the next step?

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  17. Clearly this isn't a problem that can be solved on the individual level. More likely it would require hospitals/practices to put some sort of childcare assistance in place in order to alleviate problems faced by parents. And don't tell me that, as a single person, you don't want your company subsidizing the care of other peoples' childcare. Just because you don't have a child now doesn't mean you won't EVER have a child someday. And if it meant that parents would no longer need to leave work early or come in late due to childcare issues, I'm sure it would also benefit you indirectly.

    I think what surprises me the most, though, is the ease and viciousness with which parents (especially mothers) are essentially told to either fully devote themselves to work or quit and take care of their children. As a society with a serious shortage of medical personnel already, is it really in our best interest to encourage a significant proportion of our medical professionals to stop practicing for years when they have children? Somehow I think that would make single people in the medical profession more busy and frustrated, not less.

    Of course the other option would be that we discourage medical professionals from having any children at all. But do we really want to effectively neuter one of the smartest, hardest working, and most socially conscious sections of our population?

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    1. YES. To repeat a cliche, I wish I had a "like" button for this comment.

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    2. I guess I just get frustrated when people devolve the argument into "other peoples' children are inconvenient for ME!" Healthy, happy children are CRITICAL for a well functioning society. In any cases, don't you think that a doctor who is happy and doesn't have to worry about who is taking care of their children will be more productive than a doctor who is stressed and focused on figuring out their childcare dilemmas? Who would you rather treat you? Which do you think is better for society?

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  18. Let's not forget that most people only have child care issues for 15-20 years of a 30-40 year career. My husband worked in the fire service-- they (at least in our area) take care of their own. Prior to having children, he covered often for those with kids. His co-workers covered for him when our kids were little, and after they were old enough to be home alone, he once again covered for those with young kids. All very informal and utopian.

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    1. It's more common that the young and childless cover for those with children and then later when they have kids someone else covers for them. It's less of a quid-per-quo and more of a building of karma system. The informal nature of the system causes some people feel taken advantage of. Either that they always have to cover for those with kids, or gosh golly it's a pain to arrange child care and so they want every holiday off.

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  19. I love how you can repeat the same post multiple times on your blog and at MIM and receive umpteen replies each time, yet still can't figure out why not everyone agrees with you. Give it up.

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    1. Actually, a lot of people DO agree. I would never expect everyone to agree with me.

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    2. I wouldn't mind her repeating the same post on her blog and MIM multiple times if she actually had a solution for it. It's like reminding everyone every day that it sucks so bad to be a mother and a doctor, and leaving it there. There are a million other things my mind could be focusing on that actually have a solution. But, if I'm just going to sit here and think about how much my life sucks because of a situation I can't change or that has no solution then I might as well shoot myself.

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    3. I've actually repeatedly mentioned a possible solution in the comments.

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    4. Maybe it's time for another post about how thin you are even though you grew up on McDonalds.

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  20. I'm single, no kids. While I've got no problems for coving for others when they genunienly have no other option, I am reply tired of the preferrential treatment given to those with kids when it come to public holidays and the like. I can't tell you how many times I have been jibbed at the last minute because all other people have "family functions". I am so tired of being treated like a second class citizen.

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  21. Speaking as a single female physician with no children, I again don't think that the general sentiment of taking responsibility for the life decisions that one makes is so out of line. You have reworded the responses in a way to make them much less sympathetic and more inflammatory, but the basic fact remains that parents are responsible for the care of their own children, not their childless colleagues. Parenting has its challenges and sacrifices, but it comes with the package. In the above scenario, the parents have several months to work out childcare issues, and if it happens that they have to pay a higher amount for childcare, then it's certainly fortunate for them that (as a professional couple) they can afford it -- imagine the case for a single mom who works in a lower-wage blue-collar position. The solution may not be ideal (i.e. leaving the child with a "stranger", or imposing on a family member), but in my opinion, not the worst thing in the world, and certainly not enough to justify forcing a policy of preferential treatment upon your childless colleagues. Basically, if you have a good enough relationship with your colleagues, you can make shift trades to work through these problems (as I have done in the past with my colleagues), but you would certainly burn any such bridges by suggesting such a policy (which I can't imagine would be approved given the resistance from those of us without children).

    ER MD

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    1. Several of those replies were just single sentences people posted, so I could not have spun them any differently. I swear I didn't change a word of any of them.

      You must admit that these policies ARE driving women with children out of medicine. If you read Sibert's article, she gives evidence of that. So the policies result in a physician shortage. How do we deal with that? It seems to me, especially from reading these comments, that the women who need flexibility will either take it no matter what and make their colleagues hate them, or they will cut way back or leave medicine entirely. I don't think the solution is just to shrug and say they can deal with it.

      Also, I should point out that between low reimbursement in primary care fields and current private med school tuition of $50K per year, many non-specialty physicians are not in as good financial condition as you assume.

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    2. This is a topic that you clearly feel passionately about (given the number of postings relating to it on your blog), and it’s very interesting to hear the different perspectives, but there seems to be a bit of blurring of the edges with respect to the issue being discussed. Here, you are referring specifically to a policy regarding preferential treatment for holidays off. There are not too many holidays during the year, so this would only be an occasional inconvenience (albeit, i guess, a stressful one from the parent’s perspective). In my opinion, and in the experience of my colleagues and friends with children, it gets resolved by some means, which may not always be ideal for the parents or children (e.g. the child staying with a relative, the parent agreeing to take a particularly undesirable trade, etc), but certainly not the end of the world. We are not talking about mat leave, which I think most reasonable people would agree is necessary, as there really is no way to work as physician and take care of a newborn at the same time. Mat leave is a necessity, whereas ‘holidays off’ is a luxury.

      On the other hand, you also seem to be advocating for some sort of policy allowing for a general unfettered flexibility for parents with respect to any and all childcare issues (in order -- presumably-- to keep them from leaving medicine or cutting down their hours), which is not really well crystallized in your postings. I am not sure how you propose that that flexibility be implemented without placing a HUGE burden on those who don’t have children. Would parents then do fewer calls, fewer weekends, start later and leave earlier as a general rule in order to accommodate their childcare schedule? Given that someone would have to cover, would that responsibility fall to the childless physicians? That may be enough to drive ME to cut down or work half-time! I don’t find the argument of a potential physician shortage (as a result of women working part-time) to be compelling enough for me to take on the added workload (much as – I assume – mothers in medicine who wish to work part-time will not find it compelling enough to lead them NOT to work part-time). If a woman decides that her child’s childcare needs are so extensive that she needs to cut back to half-time or leave medicine all together, I am not sure what kind of compromise can be worked out that won’t be unacceptable to her childless colleagues. Perhaps there is a solution. Perhaps your position (with regards to increased flexibility) would garner a bit more sympathy or support if you proposed a way to do this without imposing on your childless colleagues. But as for priority for holidays off, that’s a no-go for me.

      As for physician compensation in primary care, I don’t have to “assume” – I am in primary care. While primary care physicians don’t make as much as specialists, I think we definitely do better (financially and with respect to job stability) than most other fields.

      ER MD

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    3. I agree with ER MD that what I found frustrating about these posts is that it is not clear what exactly you mean by giving priority to the parents. When we set up our call schedules, we always give priority to anyone who has a good reason not to cover the call, which has included middle-aged physicians with sick parents, and an extended leave for a physician with overwhelming depression. Certainly parents requesting certain days because of childcare issues are a priority. I also work with good-hearted people who would never abuse the system. I completely believe that you, Dr. Fizzy, would never abuse the system, because from what I can tell, you have a strong sense of fair play and are a hard worker. However, I am concerned that if parents carte blanche got priority, there would definitely be people who would use it to unfair advantage.

      Also, I am not sure how any group would implement a system that would cover a situation like you describe, where the call schedule has already come out and someone has a childcare emergency. Certainly, we have rewritten call schedules when a provider has a death in the family or a medical emergency. However, I must say that I would really be most upset if my organization were told I needed to give up my ski vacation and cover Christmas because someone's child care arrangement fell apart. I would likely feel different if you yourself approached me and begged me to cover and offered chocolates and to cover my next two holidays and cover if I every had an emergency.

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    4. *if my organization told me

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    5. ER MD: Yes, I feel passionate about this. As do many, many other people, as you can see by the passion in the responses I received. Plus, for the record, ER docs everywhere I've worked get paid far more than primary care docs.

      If you read this particular post, I never said that childless people should give up all their holidays (actually, I repeatedly said I didn't believe that), only that parents often NEED flexibility. And full time jobs these days generally can't provide it, which is why mothers either take parttime jobs or no jobs at all. Then we vilify them for ruining medicine and contributing to the physician shortage.

      Despite how much the single people here have argued that they desperately want see their family on holidays, I've noticed that moonlighting spots on holidays get filled pretty rapidly. Apparently family isn't so important when there's a little extra money to be made. And maybe that's the solution, ultimately. Provide parents who need it with a schedule free of call or weekends for a lower salary, and hire moonlighters to cover. That way you don't have parents putting together questionable childcare plans that may very well fall through, and end up causing resentment among their coworkers. Considering it sounds like mothers often take that flexibility anyway, because they really do need it, this seems like a situation that would be good for everyone.

      I do find it interesting, ERMD, that you said maternity leave is necessary while the holidays are not. Considering that many, many women go back to work at 6 weeks and most daycares will accept 6 week old babies (so obviously there IS a way to do it), do you still support covering women for a full 12 weeks? If you do, I have to tell you, there are a large faction of people I have argued with who agree with you. What would you say to them?

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    6. Interesting response. Since it's addressed to me, I'll field it. terms of parents NEEDING flexibility (more so than, say, single people with sick relatives, sick partners, or other segments of the population with family or other obligations), again, I am not sure how providing that flexibility is possible without imposing INflexibility on other colleagues. You mention moonlighters taking on the load -- if you can find a moonlighter who is willing to do ONLY holiday shifts, please send him/her to my ED, as all of us would love to not work on holidays/long weekends! Perhaps the moonlighters in your hospital are a bit desperate for extra money, and they may only be available sporadically and not for every holiday. Plus, that still leaves the issue of overall increased flexibility that you seem to be advocating for for any childcare emergency -- not just holidays. I am definitely in favor of more support for parent physicians -- some of my friends and colleagues are physician moms/dads and it would be great to find a way to make their lives less hectic. HOwever, this would have to be done without imposing on those of us that are childless and expecting us to pick up the extra workload, which I'm not sure is possible (again, using moonlighters is not a permanent solution, as by their nature, moonlighters are transiently available). Plus which my friends/colleagues seem to manage fine without such a policy in place (again, by trading shifts, owing/cashing in favours, getting help from family members). I think the more pressing need is to provide accessible childcare for women who are in a financial situation where they are not able to afford day care so that they can work and provide for their families.

      With regards to mat leave, I am not sure what your question is. If a woman feels she is ready to go back to work at 6 weeks, then she can go back to work at 6 weeks. I guess it would depend on the nature of her job. Medicine is much more gruelling and unpredictable than, say, accounting. Mat leave for residents in Canada is much longer (6 months), though if the woman feels she is ready to go back to work before then, she can. Most female residents choose to take the full 6 months.

      As for primary care salaries, I trained in family medicine myself, so I'm not sure what you mean by 'primary care docs'. If you mean primary care as strictly office-based work, then yes, of course the salaries are not as good as if one is doing ER as well -- family practice offices are not open at 2 am to deal with MIs and sepsis, etc. HOwever, salaries in that type of 'primary care' are still better than in most other (non-medicine) fields. As well, referrring back to your original issue of 'holidays off' -- I'm not sure what the problem would be for these strictly office-based physicians, as clinics are not open on holidays (or even weekends in the majority of cases). In fact, these are exactly the types of jobs that female physicians with children looking to cut back take on, which is their prerogative to do.

      ER MD

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    7. If you work in Canada, then we're talking about some different things here, which is part of why we may be having a disconnect. Family medicine trained docs almost never work in the ER where I am... it is a separate residency and you don't do clinic, and the pay is much higher. Also, where I am, most people who work in clinics also have inpatient responsibilities on weekends and holidays. And yes, there are always people who seem to be willing to work a holiday IF it's for extra money.

      As for maternity leave, many many medical professionals here take only 6 weeks, sometimes less, and they make it work. I took 8 weeks with my first. So how could you argue that 6 months is medically necessary? I mean, it's lovely, but it's in my opinion not even remotely *necessary*.

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    8. Ok, so by 'primary care' you mean in-patient medicine as well as outpatient, but not ER? I think the whole reason that 'primary care' entered into this discussion was that I had brought up the fact that physicians (as relatively well-paid professionals with a reasonable degree of job security) can afford daycare/childcare, and specifically the excess fees associated with childcare over the holidays. I still believe that, even if the physician is in 'primary care' -- they are still better off financially than most other fields, and chances are that they're not going to get laid off due to 'corporate restructuring' or whatever. I also sometimes work as a family physician in a clinic, so I have some ideas of the salaries for family docs who only do clinics (is that 'primary care'? now I'm not sure anymore!).

      As for maternity leave, I really don't have any strong feelings about it one way or the other -- usually when people go on mat leave (in residency or otherwise), nobody consults me! Typically, from my experience, other residents have gone on mat leave longer than 2 months, but if you want to come back earlier than that, then great. I think the original reason I brought mat leave into the discussion is that time off after a newborn baby is both 1) necessary *during the first X months, however many months that may be* (due to the baby needing around the clock care and the mother being exhausted and not being able to handle, say, 1 in 3 call in OB with a newborn at home - but again, if she has the social support to leave baby at home/daycare and come back to residency so she can finish and be an attending and get on with her life, then more power to her), and 2) coverage for mommy for X months is workeable. Mommy and the program director have a discussion far in advance, a schedule gets worked out, the other residents pick up the slack (which is certainly not *welcomed* by the other residents, but no real other way around it vis-a-vis the 1 in 3 call for mommy) until mommy comes to full schedule, and does holidays/weekends/etc like the rest of us. If mommy is in post-residency practice, a locum can get hired for an X-month contract (or whatever they can work out, and whatever period mommy feels is financially feasable for her to be out of work) to cover their practice -- and her colleagues are not affected by any increased workloads. Again, mommy can't work and change baby or breastfeed at the same time. But again, I'm not planning on going on mat leave, so I really don't feel strongly one way or the other -- just that I can definitely see the justification for it much more so than for priority for holidays off for parents.

      This is the reason why mat leave is pretty commonplace, whereas I have never heard of a preferential policy for holidays off for parents at any hospital, nor have I even heard it being proposed anywhere (but here) even by parents themselves (in my ED, parents outnumber non-parents, so they would presumably have the force of numbers to push something like that through); parents can manage --somehow -- to get childcare for holidays. If you know your schedule 3-4 months in advance, it is hardly an 'emergency'. I think even some parents who've posted on this topic have mentioned that. Typically, when schedules are made, people make their requests for days off, etc, and some (I would say 'most') of those requests are met and some aren't. And people deal in the ways that I mentioned. And as far as I know, no toddler was ever left in the care of the crazy guy who lives in a cabin in the woods.

      This is quite a debate -- I can see why people get sucked into these online discussions! :)

      ER MD

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    9. Yes, it's a tough debate that doesn't have any easy solutions.

      I do think any argument you've been making for maternity leave could easily be applied working holidays:

      1) Being exhausted -- you may not realize this, but plenty of kids wake up during the night for more than the first few months, and my 5 year old still deprives me of sleep many nights.

      2) The child needing around the clock care -- actually, a one year old needs to be watched MUCH more easily than a newborn, who actually sleeps much of the day. And all small children need around the clock care.

      3) Coverage is workable if it's far in advance by a locum, etc -- how is this different than the situation with Mary where she needs time off three months in the future? Couldn't a locum be hired in this situation too? Why is this so much more of a burden?

      4) Mommy can't work and change baby/breastfeed at the same time -- Babies need to be changed for up to three years, and many are breastfed for over a year, so that argument doesn't really apply.

      I have been affected by maternity leaves of my colleagues and it was not great. And other people have been affected by my maternity leave and made me feel guilty. Trust me, the same hard feels exist over maternity leave.

      I suspect the reason why maternity leave is probably more commonplace is that women have been in the workforce for much longer than women have been in medicine, so there has been time for practices to evolve to accommodate this. As I suspect/hope medicine will evolve.

      (And just to explain the primary care issue, what generally happens here is that a physician works in a primary care practice during the week, but then has to cover their own outpatients admitted to the hospital on weekends and holidays.)

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    10. Er, a one year old needs to be watched much more *carefully* than a newborn...

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    11. Allright, here is the post to end all posts ...:)


      I guess I just disagree that mat leave and holidays off are the same. It seems to me that mat leave is to give mom a chance to recover from the pregnancy/childbirth, acclimitize to the baby, let the baby acclimatize to her, get a routine set up for childcare and her supports in place before she comes back to work; basically provide some transition period from pregnancy until mom is ready to get back to work. It seems like something that is specific to the peripartum and post-partum period. I’ve heard many women say that the first few months with a new baby are the most difficult and exhausting, but I guess that’s not true of everyone. I suppose an argument could be made that none of this is necessary, and that technically women can all just come back to work right after discharge from hospital; it’s just not an argument that I am personally interested in making. I also don’t think that my thinking that mat leave is a good thing means that I also HAVE TO think that holidays off for parents is a good thing, no choice, logic says! I don’t agree with that…

      You mention that children are a lot of work, exhausting, and require round-the-clock care, and that’s why parents should have holidays off. I do agree, but isn’t this an “everyday” thing, not just limited to holidays? Does this mean women should get every day off? Presumably, women get somewhat acclimatized to the exhaustion, and put in place their support system for providing their baby with round-the-clock care (which includes family, day care, and let’s not forget daddy!) – otherwise no woman would ever have a second baby and no woman would ever come back to work! So, yes, as you correctly pointed out, daycares are closed on holidays. They are also closed on evenings, overnights and for the most part on weekends (all times that a female physician may be required to work). This is because day care is an adjunct to childcare, and the presumption is that you have some other childcare in place when daycares are closed – which seems more reasonable, and more workeable that making sure that you ONLY work when daycares are open.

      ER MD

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    12. So in that case, if someone with kids moves to a new city, do they then have a grace period of a year to not have to work weekends or holidays because this is a *transition* and they need to get supports in place?

      My issue, which I think is hard for non-parents to understand entirely, is that caring for small children (I'm not talking about a teenager with a migraine, as someone mentioned above) is incredibly challenging. Watching a 2 year old is essentially suicide watch. A kid that age can literally die in their own home while the babysitter is texting. So finding a sitter you trust when your kids are that age is essential and sometimes very difficult, especially if you have more than one that is small. By 7 or 8, they are more independent, and easier to just drop off at a friend's house or whatever.

      For the thousandth time, I'm not suggesting that single people cover all holidays and weekends for no extra compensation. I'm simply saying that jobs that don't include those extra days should be more readily available to people who need it, which includes not just parents but anyone who needs it.... may include someone taking care of a sick relatively, who has serious medical issues, etc. Right now, that option isn't always available.

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    13. Well, equating moving to a new city to having a baby is not a reasonable suggestion just because you use the word 'transition', so I'm not going to address that.
      As for leave to take care of sick relatives or other emergencies, I completely agree with that -- as long as that priviledge is not limited to just parents, and that parents don't come to depend on it (which is what you've been arguing all along).

      Ok, lets use a concrete example vis-à-vis the necessity issue. I don’t know all the major stat holidays in the U.S., but let’s talk about the big three: Thanksgiving, Christmas and New Years – just because these are likely the most desirable holidays off. So, let’s say you (not YOU specifically, but theoretical ‘you’ – let’s say Mary) asked for Thanksgiving, Christmas and New Years off in your schedule. It’s unreasonable to think that you would get all three off, but you wouldn’t be scheduled to work all three, since that’s unfair (parent or no) and you could easily complain to your chief of department. Let’s say it’s a particularly bad schedule and you’re working on both Thanksgiving and Christmas. It sucks, but at least you have a very good and persuasive case for NOT working next Christmas and Thanksgiving – two Christmases and Thanksgivings in a row also seem very unlikely and unreasonable! So here are your options:

      1) your husband/partner/baby’s father looks after child care (assuming that there is a father – if there isn’t, it seems like even more reason to ensure a good back-up such as living close to family or getting a live-in aid, as this would again pop up on more occasions than just holidays). Chances are he will not be working the exact same holidays as you. But let’s say he is also a physician, and he has unluckily been scheduled to work on Christmas and New Years. That’s really bad luck, but at least HE won’t be working next Christmas and New Years, and Thanksgiving is taken care of. So you need to take care of Christmas. You can

      2) Try both of you to switch Christmas with other colleagues. It’s a hard sell, but not impossible; there is a possibility of a trade if you agree to a particularly unpleasant one or agree to owe a favor. But let’s say both your colleagues are already booked and all have other obligations (that are, in their minds, as important as yours). You can

      3) Place the child with family or friends. The great thing about Christmas is that almost everybody is home! Is it an imposition? Maybe, but that’s what friends/family is for – and you do have 3-4 months to sort it out. But let’s say you have no friends and both of your families are in Siberia. Ok, then you can

      4) Employ an alternate childcare provider. There are licensed child care providers who come to your home, or who can look after your child in their home. It’s Christmas, but probably for the right fee, they would be able to do this. You don’t have to go with any dodgy person; you have 3-4 months to check references, ask around, do interviews, etc. And hey! If it works out – you have an established rapport with someone who can act as a back-up the next time there’s a child care “emergency”.

      Also, you can also utilize the many and overabundant moonlighters and locums that seem to circulate your hospital like Poinsettas around the holidays. Just get one of them to cover for Christmas and nobody who doesn’t want to has to work over Christmas – everybody wins! I am not sure why this privilege would only apply to parents and not everyone.

      If none of these (very workeable) options work, then you have to explore the possibility that perhaps you would only agree to the option that you proposed which is more convenient and ideal for you. To which I would say that it is not really the obligation of your colleagues or hospital to provide you with the ideal solutions you desire.

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    14. Now, let’s see how workeable your proposal is. Let’s say there is a preference system for parents in place. You keep stating that this won’t mean more work for single/childless people. If there is such a preference system in place, I can’t imagine most - if not all – parents won’t use it and book off all three holidays. It’s not really “abusing” the system since, daycares ARE closed, and getting childcare IS pretty complicated (look at all those steps!), so why not book all of the holidays off and save themselves the trouble? Well, in my ED, parents outnumber non-parents, so I’m not seeing how, with a system like this in place, myself and other childless colleagues won’t work every holiday, indefinitely, until I pop out a couple of babies of my own! Locums and moonlighters willing to ONLY work holidays for the next X number of years (as opposed to a 4 or 6 month contract) are, I think, endemic to the Midwest and aren’t as readily available in my part of the world. But again, if this is an option – great! Why should it only apply to parents?

      I imagine this is the reason why this proposal has actually NOT come forth in other (female dominated) professions who have to work on holidays (such as nursing). Anyway, I do agree that medicine is evolving and hopefully will continue in the direction of better work-life balance for everyone, regardless of lifestyles or family structures.

      ER MD

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    15. It's not actually realistic for an individual to find their own moonlighter to cover, since they don't work with the recruiting agencies. It makes much more sense for hospitals to hire them.

      I just think that there should be more options of a 8 to 5, no weekends, no holidays job for physicians who want it, rather than having to beg for each day off individually. There aren't docs who are willing to ONLY work holidays, but in this economy and with the considerable loans acquired from med school (up to half a million dollars these days), there are tons of young physicians willing to supplement their income. A while back, I'd sometimes get emails about moonlighting jobs on holidays, and they'd usually be snapped up by the time I'd reply. As I've said before, nobody seems to feel quite so strongly about seeing their families when there's extra money involved.

      And if that's not an option, then yes, there should be more easy-to-access childcare during holidays, possibly provided by hospitals. Right now there certainly isn't.

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    16. well, I have some thoughts on that, but given that I've already chewed through enough bandwidth (?) on this topic, perhaps I'll leave it, and just point out that we have had a fairly extensive online debate on a topic without it devolving into some silly ad hominem "well you're just an irresponsible mom who can't get her life sorted", "well YOU'RE just a selfish bitter spinster who hates other women"-type shenanigans.

      I'll pop by next time this topic comes up!

      ER MD

      p.s. very impressed at the 'accent grave' symbol that your website put on the "a" in the "vis-a-vis" in my comment. Your website appears to be polylingual!

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    17. If it's polylingual, it's through no achievement of my own :)

      Like you said, it's nice to have a debate with someone that doesn't devolve into namecalling. If someone starts in on me with the vitriol, it's very hard not to do it back, but I prefer a respectful back and forth.

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    18. nope -- the 'accent grave' is gone. nevermind.

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  22. I never found the holidays to be that big a deal, just because we always knew who was covering the holidays months in advance at every place I've worked. I found that if I knew far enough ahead of time, no matter how inconvenient, I could generally find some way to make it work.

    What I did find far more difficult to handle was what you describe, of suddenly finding a month or a day ahead of time that what I thought was a solid childcare arrangement had completely fallen apart. It doesn't matter if it's your fault or someone else's fault -- it was the most stressful part of my life for at least a dozen years. Because of this, I do think if possible, every family needs to have at least one adult with a really flexible schedule, and I completely understand why many female physicians are opting for the "cushier" jobs.

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  23. I am a RN - I work holidays and have had to send my daughter to spend holidays away from me. I have had to ask her friend's parents if they minded another person during the holidays. I don't get a choice on which holiday I work - I had my first Thanksgiving off in 4 years this year. I knew when I started this field, that I may miss holidays but I know my income provides for my child and I would do anything for her. I am thankful I have a job, there are many who do not have jobs right now who cannot provide for their kids. Nobody deserves special treatment during holidays. I have made sure I have a lot of backup for childcare....

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    1. Well, why should employees ask for lunch breaks, health insurance, overtime, etc? I mean, shouldn't they just feel lucky to have a job and grateful for anything their employer deems to give them? This was the attitude before labor unions. We shouldn't feel like we have to accept anything dished out at us because we're lucky to have a job.

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    2. I get the impression that you're just a $h!t disturber or enjoy playing devil's advocate. Unless someone outright agrees with you, you manage to twist around what they're saying or provide some alternate contradictory scenario. You strike me as a very inflexible type of person.

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    3. That's called not being a pushover.

      I was discussing the matter above with another anonymous commenter above who was single and childless, and I conceded several of their points. If I think someone made a good point, I agree with them. If I don't agree, I say so. Sorry, I just don't agree with the argument that we shouldn't complain because we're lucky to have jobs.

      What's especially frustrating for me is that it seems like certain people don't actually read my post or any of the comments, and then argue with something that I never even said.

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    4. For the record, I think several people on both sides have made some great points, and I've actually learned a lot from discussing this matter.

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  24. I have not taken the time to read all of the responses, But my stance is so what, I fully support anyone that wants to work less than a "full load" to spend time with their family. My Doctor has tween kids, she works three days a week and guess what, my care under her is better than any other Docotor I have had

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  25. I work part-time. I did before I had kids. I figured out early in my residency that I was miserable working more than 40 hours a week, so therefore the part-time. I get paid less, but I have more time to read, exercise, keep up with my medical CME etc. I figure I do a better job at work when I'm not miserable-- who knew?
    In my practice, there are many attendings that want to work more, there are attendings that like working all their nights in a row, attendings that can't work saturdays etc. Put us all together, and the OR works just fine. The best part is that the part-time people can be more flexible to cover when people have to take leaves for injuries or pregnancies or even just during some of the more popular meetings. Those who work more get more money, of course.
    I worked plenty of holidays when I was single, and I expect to work them again when my kids are older. This is not wartime, there is no reason to work until we drop. Again, I think I'm a better doctor--a better person-- and will have a longer and more productive career. If it is a matter of paying back the money invested in my training, I'm pretty sure that over the 30 or so years I'll be practicing there isn't a hell of a lot of difference between me working part-time versus full-time.

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    1. (the first sign that perhaps there is something wrong in medicine's attitude to work is that working 40 hours a week is considered "part-time")

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    2. Great that you worked it out! I feel similarly. I might go back and work more hours when my kids are older and it's not one emergency after another. Right now, I am grateful to have the option to work full time.

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  26. “Sorry, Mom, you cannot have your cake and eat it too.”

    ^ This is how I feel. I am still in medical school, but as a single man in the military and in medicine, I'm asked to carry a disproportionately large load. I am much more likely to be deployed or to be placed in an undesirable location than my married and/or female colleagues. The boards that decide duty stations/posts are secretive and subjective. Medical officers have chosen the same career path, we have made the same commitment, and we have dedicated ourselves to the same cause. Professional decisions should be made based only on the soldier/doctor/GMO's skill and qualification.

    I imagine I will be volunteering every Christmas and Easter for the rest of my life, and I'll probably be the sop changing plans to cover for a parent with a sick kid. Family is so important to me that I could do this with a smile on my face. Being pressured to do this, or having a policy in place to systematically put me in this position, makes me angry. Mostly though, knowing that even a small number of my colleagues feel entitled to preference makes me sad- miserably sad.

    [Fizzy. I have enjoyed reading your blog, I will continue reading your blog, and I love your writing voice. Sorry that my first comment is a bit confrontational. I would love for you to revisit this topic at some point.]

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