Monday, November 17, 2014

MiM Mail: Middle of career life crisis

I feel like I am in the middle of a career-life-crisis.

I am a mother to an almost-3-year-old, and a 9 month old. I am an OB/Gyn. And, I love being both.

After residency, I joined a large private practice. Even after I had my son, I was fairly happy with my schedule. I worked about 3 1/2 days a week in the office, one day on call per week, and one weekend on call per month. But, I thought it was a pretty good life for an OB-Gyn. I sometimes missed holidays, wedding anniversaries, and important family events, but realized that those things came with the territory. After all, babies don't take holidays from coming into this world.

About two years ago, we moved to our home state to be closer to family. In doing so, I changed career paths. I now work as an OB hospitalist, doing about seven 24-hour shifts per month. It's a different role than I ever thought I would have. I see patients in the hospital that have no physician and take care of OB emergencies when their on call physician cannot make it to the hospital in time. In short, I still get to deliver babies and help women in emergent obstetrical issues, which is very rewarding. And, I get to have a lot of time with my children. Now, for example, when we sign up for a 2 week swimming class, I only miss a couple classes, whereas before, I would have only made it to one class. I get to go to the park, the zoo, the mall carousel, and all the daily little things that a lot of mothers in medicine have to miss out on.

I feel guilty even saying this, but when I first transitioned to this job, I definitely had to adjust to being at home so much. I felt guilty at times, because there were definitely moments when I (and my son, for that matter) felt bored. I would call my sisters and ask what they do each day with their kids. But, now, we have gotten into our groove. We have play dates, learning activities, favorite fun spots, and of course, naptime. So, before I know it, the day has passed and we are on to the next. And, just when motherhood starts wearing me out, it is time for me to go to work the next day. And, actually, it is a nice break to get away and have some career time. My 3 year old son asks every morning if I am a doctor or a mom. With this job, most days I spend "being a mom", and only some days do I spend "being a doctor".

So, what's the problem? One of the reasons I went into OB/Gyn was the hospital-office balance. I loved forming long-lasting relationships with patients that continued throughout life stages, multiple pregnancies, and through difficult diagnoses. There is something about delivering someone's baby that bonds you to them. You become important to them. It almost feels like you should be invited to sit at their table for Thanksgiving dinner. And, now, I don't have that relationship. So, I keep looking at job opportunities and wondering if I should return to private practice so that I can have relationships with my patients like I had before. The thing is, that if I make that career jump back to traditional OB/Gyn private practice, I will be giving up a lot of time that I have with my kids. So, I worry that I would end up in a "grass is not always greener" situation. I'm not as familiar with the business aspects of medicine, but to the best of my knowledge, it is difficult to keep a practice afloat (paying overhead, salaries, benefits, malpractice) in the OB/Gyn world and work only part time, so full-time it would be.

I know you guys can't decide my future. The truth is, that getting it all in writing is actually helping me process it all. But, any advice would be nice. Is it possible to have a part-time OB/Gyn practice? Should I just count myself blessed that I get so much time with my kids, even though my particular position as an OB/Gyn is not quite as fulfilling as it once was? How do I not feel guilty thinking all these thoughts?

Confused mommy doc


  1. You are right, this is one decision you will need to make yourself. I had a working mom, and it wasn't easy for either of us, but my mother makes one heck of a role model and I learned so much about being a strong, independent, caring woman who didn't pretend to have it all but she did everything she could to try!

  2. Few questions from someone at the beginning of her career: how long did you do private practice and how long have you done hospital medicine - have you given yourself enough time to really get into it? If you continue to do your 24 hour shifts would it be possible to volunteer 1 day a week with a community clinic/ federally qualified health center (FQHC)/ birthing center providing care to just a few patients that way you can have those relationships that you want without missing out on the time with your family? I am Peds and have heard of one provider working a few days a week with an FQHC and having a small private practice on the side. Is there any way you can keep your 24 hour shift position and see just a few longitudinal patients? Have you looked into any FQHCs?

    1. That is a great suggestion...and it just might be a great opportunity to fill the void that I feel. Thanks so much for the suggestion. I will definitely look into it. I live in a big city, so I am sure that there is definitely a need for that service! Thanks!

  3. As a mother with children ages 5 and 8, I understand the dilemma you are facing. For some of us, there needs to be a balance with being a mother and career satisfaction, as one or the other is not sufficient. I am not in medicine yet, as I am a career changer, currently interviewing at medical schools, but I have had a demanding career in the past as well as time home my children, when the economy was not so wonderful.

    Personally, I have noticed that my children are needing me less and less as they are getting older and more independent. This has left me with more free time. Do you feel the need to be in a practice setting now, or can that be postponed until your babies are a little older, and in the interim pursue something as Mommabee suggested?

    1. Thanks for the insight. I imagine that as they get older and are in school, I will feel better about working a bit more. That is a very nice suggestion, and maybe I can think about changing things up in a few years. Thanks so much for your fantastic advice.

  4. Hi Laura
    My story is similar in that I am currently a SAHM and I have 2 small children. My story differs because I did not complete residency, I took time off unexpectedly. I know that I need to return to residency because the longer I stay out the harder it will be to secure a spot upon my return. However, now that I have been home with my babies I realize how precious this time is with them. It's a tough decision, I have large loans and I haven't found any nonclinical jobs that pay enough. Returning to residency makes the most sense financially and logically but my heart wants to stay with my children until they are at least 3 and 4. If anyone has advice for me I would appreciate it as well.

  5. As an OB/GYN in a practice similar to the first one you described, I can definitely see your dilemma. I will say it is hard to practice part time in private practice due to overhead (which is the same no matter how many hours you practice).

    My thought would be to stay a hospitalist until your kids are in school then go back to private practice, but you also have the unique position of having done both so you have to do what fits your personality.


Comments on posts older than 14 days are moderated as a spam precaution. So.Much.Spam.