Thursday, August 21, 2014

Guest post: Doctor guilt

I have been a faithful reader since sometime in med school (6 years ago?) and have so appreciated all of your posts! I haven't found a community anywhere else with as many talented, empathetic, articulate and amazing women. I'm a family practice doc in a rural town practicing full spectrum family medicine. I have been in practice for two years since residency and absolutely love my job, even when it is stressful and hectic. I am a wife to an underemployed lawyer and mom to a beautiful, sweet, developmentally delayed 11 month old girl with tuberous sclerosis. She is the joy of our lives.

Having worked my whole life, I was really looking forward to maternity leave. I thought, finally, time for a break! As any mom knows, maternity leave isn't any kind of a vacation, but it really was a much needed mental and physical break from work. However, it was also disorienting to not have a schedule and frequent social interaction. I absolutely loved maternity leave and I think part of what kept me sane was knowing that I was going back to work. When the time came closer, people warned me about how hard it would be, and that I was going to cry my first day back.

I shed a few tears the day before, but the day I went back to work I was 100% ok. I enjoyed it, actually. I felt like I was back at my second home with my second family. The first night back I assisted with a crash c-section and had a blast.

It's been 8 months and I'm still going strong. I work in clinic on Monday, Wednesday, and Friday. I do 4 to 5 24 hour ER shifts per month. I am there nearly every day rounding on patients, since I almost always have a patient in the hospital. In reality I probably average 40 hours per week even though I'm considered "part time." I love having every other day off. After a crazy clinic day it is nice to have the next day to decompress. After having a day of playing with my daughter and being at home I look forward to the fast paced environment of being at work the next day.

Strangely enough, I never experienced the mommy guilt that is so prevalent among working moms of every profession. I love both of my jobs. I know my daughter is in good hands. (My husband is with her most of the time when I'm at work, and we have a wonderful neighbor who helps). I miss her when I'm working a 24 hour shift but that's not the same thing as feeling guilty that I'm not there. I don't know if it's because I'm the primary breadwinner or some other reason. I am 100% at peace with my decision to work. How many men who are breadwinners feel daddy guilt? Is mommy guilt something that is part of our genetic makeup or something that we are told culturally we are supposed to experience?

What I have felt sometimes is doctor guilt. I think part of this is because I was 32 when I gave birth so working is what I've known my whole life. I wonder if I should be working when I'm playing with my girl. I wonder if my colleagues are jealous that they don't get more time off to spend with their kids. (They never say anything - I just wonder). Maybe we'd all be better off as doctors, moms and dads, if we had the flexibility to have more time with our families.

Anybody else have doctor guilt, rather than mommy guilt?


  1. I'm not an MD, but an academic, and I often feel guilty about irrational things, like if I have a high priority due soon thing, sometimes I'll work on a low priority due later thing and I'll feel guilty about that even though both have to get done and both will get done on time. I think the guilt spurs me on to procrastinating productively instead of doing nothing.

    I don't ever feel mommy guilt. I come from a long line of working mothers, so I assume that guilt was bred out generations ago.

    I do often feel guilty that I'm not getting more work done, but that's not tied specifically to time spent with my kids, just a more general angst thing. I don't think it's weird or bad or abnormal or anything, just part of a type A personality. Unless you only feel guilty when you're with your kids and not when you're say, websurfing or watching TV or whatever else one does besides work. But I bet it's a general, too much to do, the to-do list is never empty sort of thing. Because if the to-do list gets empty one just adds more stuff.

    1. "I don't ever feel mommy guilt. I come from a long line of working mothers, so I assume that guilt was bred out generations ago. " - love it. Thankfully feeling doctor guilt is not a frequent occurrence. I was more than anything wondering if there was something wrong with me for not feeling mommy guilt.

    2. We actually have a post on that exact question exactly in our drafts, but I couldn't think of anything to say about it.... right now it's just a title ("Is there anything wrong with me for not feeling mommy guilt") and a single word post ("Nope"). I just haven't come up with anything else to say about it because the idea is just so weird to me. I've talked about it with my mom too and she doesn't get it either and not only that, but pre-internet and her NYTimes subscription she'd never even realized mommy guilt was a thing. She's skeptical that it's really a thing now, in fact, but believes me when I say I've met people who say they have it.

  2. This post really hit home. I am on maternity leave now with my first, and this was after an unexpected medical leave for preterm labor at the end of my pregnancy. I am the first in our group to be in this situation, and while my partners have been wonderfully accomodating, I am still filled with guilt for not being at work!! I wonder every day why that is.

  3. Glad to know I'm not the only one! I think it does come partly from personality guilt. Jen H I also had an unexpected medical leave for preterm labor at the end of my pregnancy. I hope you truly enjoy your time with your little one and don't think too much about work. :)

  4. Ha - I meant personality type, not guilt. :) Also I am the original poster of this article - it didn't have my name at the end because I forgot to put it.

  5. I empathize so much with this post - I think you've coined a great term. I felt the exact same way on maternity leave. It was a head break but I was also a resident (3rd year and chief year) so I had tons of guilt about not being there. I don't think I had clinical post partum depression but I was really overwhelmed with the solitude of maternity leave and new mommyhood - where was the village, I wondered? What in the hell do I do? I heavily leaned on a mom friend two doors down and a doctor mom friend to show me the ropes and support me. I, like you, really need a schedule to feel and be productive and grounded.

    It sounds like you have created a fantastic balance. I am trying more in my practice to pick smarter vacation time - trade back full weeks for partial weeks and long weekends so I get more frequent time off to get things done. It makes me much more sane. We have a large group - we are like a family - and there are personalities that work very long hours. I used to feel guilty but I cannot live there (although I have an OCD part of me that could let that happen and I stay much later on days when dad and stepmom have kids). So I'm trying to let go of that and I get better as time goes by. You created your own balance and cannot control if co-workers are jealous or not you are less compensated for your choice so be proud!

  6. Sorry if this is a duplicate - not sure if it went through.

    I'm a third-generation doc and the first to have any kind of boundaries around my work. Also (not coincidentally) the others were all men. Never had any mommy guilt - my daughter loved daycare, has always liked school, and is far better off than she would have been if I'd stayed home with her and been angry and resentful.

    Doctor guilt - oh, yeah. When I was younger, especially. In addition to setting clear boundaries around my work, I also get all my paperwork done and don't complain about how much I work or about my patients (I was raised to believe that's unprofessional). So my colleagues have always thought that I work less than I do, which compounded the guilt. I don't feel this nearly as strongly now. One of the perks of age, I suppose.

  7. I didn't think I could relate to this, until today (funny how timing works, isn't it?). I've been trying to decide between three jobs - one is community but with after hours, the other is specialty so longer hours during the week, plus after hours, then the last is clinic based, regular hours during the week and no after hours at all, ever. Chose the last one, after much deliberation,and felt very happy with my choice. It's been a long time coming. Then I read your post, and thought, no, I've never felt Doctor Guilt, nor known anyone who has. Until a friend texted me (who supported my job choice) to say she will now be doing on call. Bam! Doctor Guilt - so that's what you look like? Now I feel terrible, as if I'm 'skiving off' somehow, picking the easier hours, leaving the hospital system and it's ever changing shifts, long hours, on call and weekend work. So perhaps it is a personality thing - maybe I'll feel guilty no matter which choice I'd made. Or maybe I'll get over it, once I get to enjoy my new work/life balance. I think it's actually just a sign that we care, that we taking caring for others and contributing to society and our families seriously! At least that's what I'm going to tell myself .....

  8. Great term, its perfect. I also never feel mommy guilt. But yes, the doctor guilt, I get. I feel like everyone must assume I work crazy hours and call all the time as a doctor, but truthfully, I chose an academic position with very little call and very regular hours...with the resultant low pay. I traded $$ for flexibility and lack of call, basically. Others chose differently---I should not feel guilty, but sometimes I do!

  9. I'm not in medicine yet, but I'm applying this fall to start med school next year. I've had people ask me if I feel guilty taking so much energy away from my family to go to school with a young family, and I really don't. For the two years before I started school, I was a stay at home mom and I was miserable. My children are wonderful, but I need more in my life than just them. My identity doesn't end at 'mom.' My daughter loves daycare (now preschool) and my son would be in school anyway, and we are all much, much happier having our own things outside the home.

    But I know I'm going to end up having to take less demanding paths in my career because of my family, and I feel a bit guilty about it. Like I'm going to take up a medical school seat that could instead go to someone who won't limit themselves.

  10. I'm so glad I saw this because I've been feeling intense "doctor guilt" lately. I am new to the working mother thing, my son is 4 months old so I have just been back at work for 1 month now. I had re-arranged my schedule pre-maternity leave so I no longer have evening hours and spend more time in my specialty childhood obesity clinic then my primary care site to minimize call, all in an effort to head off mommy guilt. While this has worked well for my family I've had an un-expected amount of doctor guilt. I was always staying late returning phone calls and having long heart-to-hearts with families and now I'm leaving earlier to get my son from daycare and feel like I'm shirking my patient children in favor of my own. But of course the moment I see my son I feel like rushing out of the office was worth it.
    I'm still getting used to this schedule and the balance of work and family, but it's good to hear other peoples stories and know that I'm not alone in sometimes feeling the doctor guilt over the mommy guilt.

  11. I'm so glad i found this site. I'm a 4th year surgery resident with a 3 month old. i had the 6 week maternity leave and while I almost didn't come back to work because I wanted to be with the baby, once I came back i knew it was the right decision--except for the doctor guilt you describe, making me feel like i'm not able to give 110% to my training and patients. How can i possibly breastfeed, pump, study for my inservice, and apply to fellowships as well as be a surgery resident 80-100 hours a week? The worst is the feeling of inadequacy and helplessness to be able to do everything to the best of my ability. I hate rushing out of the hospital--i feel like i'm letting attendings, co-residents and patients down. Having a surgery resident for a husband does not make it easier. Like the above poster, seeing the baby after a long day of work makes it all feel worth it but i have not reconciled my doctor guilt. I can only hope and pray that I am still a worthy surgeon and mommy--I know there are people out there who do both well (probably many on this site!), I just pray that I'm going to be one of them too!


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