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Thursday, December 17, 2015

"Your child has a fever--Come get your kid"

Has anyone ever gotten this kind of call from daycare/school before?  (I am sure someone has...)

Yesterday I was nearing the end of my clinic day, without any more patients scheduled, when I got this kind of call.  It was about 2 PM and my first thought was, "I wonder if they can just keep her until 5?"  But they said no, come now.  I figured, "Well, no biggie, nobody is scheduled anyway."  

I went to the front desk to inform them that I was heading out early and was met with a sour face and a lecture on parenting.  The secretary informed me, "Now, you know that you need back-up child care for situations like these?"  (This actually went on for a few minutes while she proceeded to tell me how it was irresponsible of me not to know who was going to be picking up my child in case of emergency while I was in clinic.)  The conversation came to an end when she said, "When you're a real doctor, you're not going to be able to just take off, you will have actual responsibilities."  All of this, mind you, when I actually had zero patients scheduled the rest of the afternoon.

I was furious the entire drive home (still am, as you can see).  How dare she give me a talk on parenting and doctoring!  Then I thought of a million reasons other non-parents might need to leave clinic on a short notice.  Maybe they themselves aren't feeling well (crazier things have happened.)  Maybe another non-child member of their family has an emergency.  Maybe they have car troubles on their way in and actually come late rather than leaving early.

What do the other moms-in-medicine-without-reliable-husbands do in situations as above?  Does everyone have an emergency back-up besides themselves for sick days?  Is there a single person out there who has never, not once, been to work late, or had to leave early, or missed a day altogether, for a sick child/sick parent/sick themselves?  Are we not just human people working as doctors, that do have the same ailments as our very own patients??

15 comments:

  1. Also, as any doctor knows, as any mother knows, sometimes only Mummy will do. Any person working in a medical situation, including a secretary, needs compassion. Doesn't sound like that person has enough.

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    1. Wow, the way you phrased that makes me, as a female physician and parent, feel really uncomfortable. Do you think you could rephrase to "only a parent will do?"

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    2. Agree with Larval Doctor. I think the real point is that people can arrange their lives in many different ways, and sometimes it'll be Mommy or Daddy or Nanny or Grandma or Auntie or Babysitter or whatever it is that you have figured out to work for your family.

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    3. Interestingly, I interpreted the comment as sarcasm. But meh, maybe I'm wrong. Secretary shouldn't have said anything, but you do need back up care in case you can't leave (or god forbid, you get into an accident on the way home or something). Some friends of mine hired a sitter on retainer for those kinds of emergencies. We use an au pair for pickups (or my husband goes). Some use neighbors or friends. It can be done.

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  2. I think it was amazingly out of line for the secretary to speak to you that way. When I was a resident I had a chief resident chastise me for taking off when my daughter was febrile and I had no patients scheduled that I "needed to value patient care" -- my husband was taking care of actual patients that day! I got sick of taking crap from people and called him out on it to the program director. People will do crappy things if and only if they're allowed to get away with them!

    Now, I'm grateful to work in an amazing department with another young mother. The two of us cover for each other as much as possible. When my daughter starts to look sickly at us, my husband and I enumerate our days and make plans for one of us to bail. We're also lucky to have a few close family friends nearby who help out -- so when my daughter last had a fever and I had to call out from work, one of my friends took our daughter for two hours so that I could make sure my patient cell lines were fed.

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  3. Yeah, she was out of line. We all manage our lives differently and we all value patient care. In one of my first jobs out of residency, our boss called out one of my partners because of this. His wife was an OB and he was primary care and so he usually stayed home when their kids were sick. Our boss told him they needed to hire an au pair or nanny rather than use a preschool/daycare so he could work no matter what. The partner left a year later, and I followed him out the door.

    I have a reliable, flexible husband who usually stays home when Eve is sick - and I have still missed work, rescheduled patients, phoned in to or cancelled meetings, been late and left early. It happens. Everyone survives.

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    1. Taking a deep breath...the secretary has absorbed the ethos of the organization and has also undoubtedly been the one who had to reschedule angry and frustrated patients. And I bet *she* can't take a day off when her kids are sick (if she has kids). It's a systemic problem. She's the symptom.

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    2. I really love your perspective. Thanks for this extra dose of empathy.

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  4. I'll be the voice of sort of dissent.

    It's none of the secretary's business what you are doing and what she said was out of place for her position.

    That said, you do need to have back up childcare in place. And when a non emergency situation like a child with a simple fever arises, you need a plan to deal with it because you don't always have the luxury to leave like you did that day.

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  5. Emergencies happen. I think it is worthwhile to explore your backup options now. In a true emergency if you just didn't show up to daycare until 5 they'd deal...however, that can't be done often. Incredibly rude of the secretary (I'm sure she would never speak to a male resident that way, etc.) but I do agree that she's probably reflecting the organization. And people say those things and letting them go is the best option, perhaps remembering your future earnings potential just a little.

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  6. So, yes, this has happened to me and yes we technically had a back up plan, but during residency you are broke and those back up plans are often more reliant on prayer than actual organization. We were lucky that my daughters fever days happened when I was post call or when my hubby had a half day or when a family member just happened to be in town, because the truth of the matter is, if it had happened any other time we would have been screwed. I personally hate the general throwing about of "you have to have a back up plan" as if that is easy to do and even when you have one there are no guarantees. The problems are so systemic and the lower on the totem pole you are, the less options. I'm a fellow now and technically have many of the privileges of faculty from an administrative standpoint and can use the "parents in a pinch" service from our hospital which will get a sitter to you within like 2 hours for a pretty minimal fee. But you know who doesn't have this service available to them - residents and hourly staff like the secretary likely is. The system is broken and flawed. I could go on forever but I'll just stop now. Good luck to you. Keep doing the best you can and being the voice that will help bring change.

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  8. This is such a huge problem for working mothers and physician mothers in particular. Our clinic schedules book up months in advance and our patients take time off their work schedules to come see us. I have a 2 physician family which oftentimes leads to a discussion of "whose schedule is more important" in the event of a childcare emergency (ie- who has the most procedures booked for a particular day). Yes, we have a backup plan (many, in fact). But every once in awhile, none of the backup plans work and a sick child gets dragged to work with nanny iPad and tylenol. This is not ideal, but this is real life. It takes a village to raise every child. For physician families, your village is extremely important; take time to cultivate your village!

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  9. I can feel myself getting angry and upset for you! What a horrid thing for that woman to say. And I echo what Cutter said above. Residency is that unique time of financial constraint with excessive work pressure and time constraints that means that expensive back-up plans are just not feasible. My husband has a more flexible job than I do, but we still scramble when she's sick. No family in the area, all our babysitters have day jobs, and who can ever afford to pay a nanny full time for that 1-2 days per year when your little one is too sick to go to school?

    It totally takes a village. And part of that village would have been that receptionist offering to keep an eye on your little on in a back office with an ipad while you finished clinic that day. I try to remember that when other parents have unexpected childcare issues that come up. I can take the extra call when we have no plans, I can pick up our friends' daughter from school when their meetings run late and make macaroni and cheese. And when there is absolutely no alternative, I have no shame in asking my program director for a few hours off to take my sick child to the doctor. We have to support each other. There's no other way!

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  10. I'm with KS totally on this one.

    The secretary was completely out of line, and she would not have done this with a male resident announcing that his apartment just flooded or he had an urgent toothache. In fact, I doubt she would have had the same response if you mentioned an apartment flood or a toothache It's something about the childcare situation that pushed her buttons.
    Those of us who went to medical school before many women were admitted, kept up such pretenses through our early jobs. Sooner call in sick yourself than mention the sick child.

    And things have gotten so much better. The several young mother physicians working in my practice do a great job of covering for each other's patients so they can actually get out not just for illness but for school plays, and patients don't need to be cancelled.
    BUT - you need backup and backup to the backup, all planned in advance. I know it's not easy. I had no family nearby and a husband in the OR when we had young kids. Daycare is your primary childcare, not a dependable answer. There are school holidays, snow days, early dismissal, and fevers and vomiting and rashes. None of these are an "emergency".
    I used home day care people, became friendly with stay at home moms whom you pay back with weekend favors, took sick kids to clinic with me when I had a sympathetic medical director, and needed to call out of town family when one day care provider quit suddenly.
    The risk you run right now is a professional one for you. No one cares about that secretary, but if you have too many "emergencies" which are minor stuff life a fever, you will earn the title "hobbyist" in your profession. I've seen it happen!
    Please don't take this as criticism. I mention these thoughts simply as someone who now can hire and fire and give recommendations, so I see the employers side as well.

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