Thursday, September 13, 2018

The myth (?) of flexibility

I had a job interview last week, in an odd surprising way, with the medical director of a local system of FQHC medical clinics in our town. It was surprising in that I was on a rotation providing medical care to homeless patients out in a park, working with one of the doctors in their practice (who, interestingly, is actually on staff as their street medicine attending, which is pretty cool!) -- and this attending came up to me, and asked if I wanted a job in their clinic system,

What did I say? "Oh, goodness, that's so kind of you. Umm."

Sometimes, I hear myself fulfilling a female stereotype and I want to punch myself in the metaphorical nuts.

Once I collect myself and act like maybe I deserve having a job, given that I'm a pretty good resident, a rising chief, and would actually be a great fit for their clinic, we make an appointment to discuss it in a meeting in his office later that week.

I agonize over what to wear. Is this a job interview? I'm also caring for homeless patients in the park that morning - it's 95F and 90% humidity. I wear a silk shirt, and by lunchtime, it's slick with sweat and stuck to my back. My curly hair is an untamed frizz ball, and I have to bike 4 miles to the clinic where his office is located. Suffice it to say, I look great.

We had a lovely conversation about what I think I could do for their practice (Adolescent methadone clinic! Expand their home visit program!), but when he asked what was important to me, all I could think about was flexibility.

Being a resident is one of the least flexible jobs I can imagine (though I've never been in the military, which is likely even more rigid). Your schedule is given out to you a year in advance, it's incredibly difficult to get out of shifts for your own illness (or your children's many illnesses), you don't get to choose your own vacations (which is hard for those of us whose partners are teachers, or with kids in school), and when you're there, you need to be 100% all of the time (which breastfeeding mom hasn't been paged for an urgent need while pumping?).

I dream sometimes about a job where I could work full time, but with flexibility - in fact, I've drawn inspiration from some of the schedules of writers on this blog, who have Tues/Thurs afternoons off (I could volunteer at preschool! I could go to the dentist!) or do fun volunteer work on Mondays all day, or get to (gasp) do some research working from home. I want to be productive, I want to be part of a million different things (I wouldn't be Med-Peds if I could make up my mind!), and I want to work full-time, but I'd like some agency over what that looks like.

To this, the medical director responded, "Well, we're open to being flexible. Lots of young mothers want to work part-time."

I'm frustrated that we live in a society where wanting to work ~50 hours/week is seen as wanting to work part time, or that not wanting to drive in during the middle of the night as an interventionalist means you aren't committed to medicine, or that if you have children you can't be a productive educator and researcher. And I'm frustrated that wanting to work part-time is a thing "young mothers" want - working part time sounds amazing, sometimes, and I have no judgment for moms that do it -- but couldn't dads be interested in that too?

I just want to not always be the first to drop my son at daycare and the last to pick him up. Is that inconsistent with being committed to working full time?


  1. I’ll take it one step further. You should be able to do what you want when you’re not at work. Even “nothing” is what you want sometimes. What frustrates me about medicine is that the imposed rigidity is often not actually necessary to providing good patient care. Often it is cultural rather than necessary (see: any job that does not permit people to go part time for less money).

  2. Peaches it is like you are reflecting my own thoughts back to me! I’m also looking for jobs now and literally I’ve thought all I want to do is pick my baby up from day care every once in a while and not be limited to 1.5 hours of family time between 6:30 and 8 pm every day. And I haven’t figured out a way to ask it in a way that doesn’t trigger the “young moms often work part time” response either.

    I don’t have any answers but I hear you and I’ll be with you too

    On a side note kudos to the outreach and adolescent methadone work - no matter what shakes out sounds like you’re in for awesome things ahead!

    1. It makes me smile to read this. Yes yes yes. I appreciate your waving in the dark of night float!

  3. Only in my first year of residency, but YES, it is the most inflexible of jobs, and YES I would like to do the occasional preschool drop-off or pick-up. I am lucky to have a partner with an actually flexible work schedule (works from home as software engineer), but there so many times I wish I could have more say in my own life. I agree that it should not just be a “young mothers” thing, and I appreciate any advice you and others here have about how to actually find the flexibility when you go on the job market.

  4. I have flexibility in my job. I’m home at 4:30 most days. I round in the hospital 7:30-9 (my choice!) and I have two afternoons off a week to do what I need to (yoga, ceramics). I love my job. I get six weeks vacay a year plus most holidays. And I am well paid taking care of more complex primary care patients. You can find this life if you look. Don’t settle.

  5. Laura Vanderkam (168 Hours, I know how she does it, and others) has some interesting thoughts about this -- her implication is that many men want flexibility, too, but don't explicitly ask for it like women do. For example, a man might just leave early to see his kid's soccer game or arrive late after school drop off, without ever announcing the reason for his scheduling or asking permission. We women tend to ask, and thereby draw attention to our desire for flexibility.

  6. This is fascinating, and so true! My husband has been doing the drop offs and pick ups this month due to crazy inpatient hours, and I initially felt so bad, worried that his job would care that he is showing up 30 minutes late and leaving right at the end of the day. I asked him "how his boss took it" when he told him -- and he was a little perplexed, and said, "I don't know, he didn't say anything. I just told him I needed to be late this month." I would never have done that; I'd have bent over backward apologizing and offering to stay later or come in super early the next day. So interesting.


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