Showing posts with label part-time. Show all posts
Showing posts with label part-time. Show all posts

Tuesday, June 3, 2014

What Does "Lean In" Mean? Whatever You Want It To.

Genmedmom here. You'd think that as a doctor and a mother and a blogger with a focus on work-life balance, that I'd have been psyched to read Sheryl Sandberg's Lean In. Truthfully, I dreaded reading it.

I figured I'd have to read it sooner or later, given what I do, and I wasn't looking forward to it at all. From the bits and pieces I'd heard about it, I assumed that it must be a pushy, finger-wagging manifesto designed to make me feel more guilty that I already felt.

But I felt guilty NOT reading it. So one day, when I ordered a bunch of books on Autism (our son is autistic) and a few Barbara Brown Taylor essay collections, I also ordered Lean In. It sat on my bedside table for about a month. The other books got read (I read a lot), but Sheryl's smiling face looked up at me night after night, book closed, waiting.

Finally, one night, after the kids were down and charts were done and my brain needed some book reading for an hour or so, I realized I had nothing else to read but smiling Sheryl. I very reluctantly opened it...

And she had me at the second paragraph of the introduction.

She describes how she gained seventy pounds in her first pregnancy, and suffered from brutal nausea the whole time; how she struggled with simply walking, and realized that Google needed to have pregnancy parking close to the building, for all pregnant employees. So she made it happen. Wow.

Flashback to my pregnancies, where I gained, yes, seventy pounds, and felt awful, and struggled with simply walking... Like many employees of my big city hospital, I park at a garage about a mile away, and walk in. For my first pregnancy, my manager gave me a handful of parking passes that I used in the last ten days. That was great, but it was the last ten days, and there weren't any for my second pregnancy. I remember waddling painfully to and fro...

The point of her sharing the anecdote is to illustrate that she didn't realize how helpful pregnancy parking would be until she experienced it for herself. She wondered how no one brought it up before:

"The other pregnant women must have suffered in silence, not wanting to ask for special treatment. Or maybe they lacked the confidence and seniority to demand that the problem be fixed. Having one pregnant woman at the top- even one who looked like a whale- made the difference".

The book continues in this style, outlining the significant challenges women face in today's workplace, dotted with personal anecdotes and shared stories, humor, and problem-solving suggestions. There's plenty of data, but it's not boring. I was surprised at the praise, validation and encouragement for women at all angles of leaning in, including those who work part-time or stay at home. There is very little by way of exhortation; actually, I had to search for anything:

"I have written this book to encourage women to dream big, forge a path through the obstacles, and achieve their full potential. I am hoping that each woman will set her own goals and reach for them with gusto."

I actually enjoyed this book, and strongly recommend it to any woman considering a career in anything.

So, why did I dread reading it? Why did a book described everywhere as "an inspiring call to action" sit gathering dust on my bedside table for a month?

Well, as an internist who works part-time and mother of two young children, I've been exhorted, invalidated, even attacked. So, I assumed Sandberg's book would be another attack. It's not every day, but I'm sure I'm not the only part-time physician who has encountered this, the face-scrunching and "So, how does THAT work?" or a "Don't your patients get frustrated that you're not fully available?" kind of thing.

The attack most famous came from a senior female physician. I remember how sick I felt when I read anesthesiologist Karen Sibert's Op-Ed "Don't Quit This Day Job" in the New York Times (June 2011). In this essay, she doesn't just frown upon women working part-time in medicine: she crushes them. Worse, she crushes the aspirations of those considering medicine as a career:

"I recently spoke with a college student who asked me if anesthesiology is a good field for women. She didn’t want to hear that my days are unpredictable because serious operations can take a long time and emergency surgery often needs to be done at night. What she really wanted to know was if my working life was consistent with her rosy vision of limited work hours and raising children. I doubt that she welcomed my parting advice: If you want to be a doctor, be a doctor....You can’t have it all."

The death blow, however, was to people like me,

"Patients need doctors to take care of them. Medicine shouldn’t be a part-time interest to be set aside if it becomes inconvenient; it deserves to be a life’s work."

The... what do you call this? It wasn't an implication or an accusation, it was a sound dismissal of MY life's work. I have a small panel of patients, commensurate to my four clinical sessions per week. I work in a warm, nurturing environment, in a group practice of all part-time female internists. We have excellent clinical support staff. We enjoy great flexibility in our hours. We also are also regularly evaluated and rated by our patients, as well as our hospital, on various criteria ranging from patient satisfaction surveys to outcomes data comparisons between practices, and we perform extremely well.

I also have two small children, ages two and three, a working husband who is a wonderful partner, and family close by. I'm almost always home for dinner, and enjoy most weekends with my family. Yes, we carry pagers and are on call for ourselves Monday through Friday, with weekend calls shared, and there are occasional calls at less opportune times (bathtime, bedtime..). And, with the advent of the patient portal, where patients can communicate with providers online (kind of like email), they can send me a message basically anytime. But overall, clashes between work and family are few and far between.

My gut sense is that what I have going works. Most of my patients are working women, and I'm open and chatty about being a working mom (can you tell?). My kids' photos are up in my exam room, regularly updated, and patients eagerly ask about them, just as I inquire about their families. We trade stories. I receive solidly positive feedback from patients and colleagues alike. (I feel weird putting it on paper, all this positivity, but isn't that what we women do, is downplay our achievements?)

THIS is my "leaning in". I do not aspire to be a department chair, to publish in the peer-reviewed literature (though I have), or to have my own office with puffy leather chairs. I have made the considerable achievements of graduating from medical school, surviving residency, and thriving in a highly regarded primary care practice. I want to be a good doctor and a good mother (and to write about it!) I believe that you CAN have all this, because I do.

That is the beauty of the message from Sheryl Sandberg: "leaning in" isn't a one-size-fits-all formula. As in the quote above, she hopes that women set their own goals and reach for them.

Sandberg also talks about how women need to help other women achieve their goals. I agree with that, and it starts with pregnancy parking! It also includes calmly ignoring even senior female docs like Karen Sibert when they try to force a one-size-fits-all, my-way-or-the-highway approach onto a career path as variable and malleable as medicine. Sandberg discusses the phenomenon of senior women not only being unhelpful, but even hindering the progress of the up-and-coming women:

"Critics have scoffed at me for trusting that once women are in power, that they will help one another, since that has not always been the case. I'm willing to take that bet. The first wave of women who ascended to leadership positions were few and far between, and to survive, many focused more on fitting in than on helping others. The current wave of female leadership in increasingly willing to speak up. The more women attain positions of power, the less pressure there will be to conform, and the more they will do for other women."

So, read the book, and either make your way up, or reach a hand down. Set goals and "lean in" any way you choose, because only you know what is right for you, and if it's right for you, it's all right.

And I'm interested to hear what others think of smiling Sheryl's book.

Thursday, May 23, 2013

Guest post: Choosing part-time work in emergency medicine

First I want to tell you all how grateful I am to have found your site.  I now check it regularly and see it as my "lifeline" to others who have been through (and are going through) a lot of my own struggles and joys of being both a mom and a doctor.   I am a part-time practicing Emergency Physician 6 years out of residency.  I live in the Midwest.  I have two children, a 9 year old girl and a 4 year old boy.

For a while now I have been wanting to write something about choosing to work part-time.  I have been inspired by all the great posts from the other MiMs, so here is mine:

I am a part-time ER doc.  It is something that has taken me a while to feel proud to admit.   I love being an Emergency Physician, and I know that there is nothing else in the world I'd rather (and am meant to) do.  BUT....I am also a mom.  I had my daughter right before intern year started, and nothing could have prepared me for that experience.  I think I must have deluded myself in thinking that it would somehow be doable to juggle the responsibilities of both a newborn and intern year.  Without my husband it would have been impossible. I missed out on so many moments with my daughter during her first few years!  Do I regret this?  I guess in a way I do, but I know that if I didn't miss out on those moments I would not have been able to succeed in this career I love, and would not be able to support my family financially as I do now.  I want to tell all you other MiMs out there--nine years later, my daughter has NO recollection of the first 3 years of her life, she has NO idea that I was gone for most of those years, and despite all those missed moments we have a very close relationship. 

I started working full time after residency to pay off debt and our mortgage, but I cut down to 80% when my son was born.  This has allowed me to continue to support my family and enjoy our life by going on vacations, going out to eat, and spending time as a family.  But after a few years the time had come to decrease my hours even more.  Being in EM for so many years has taught me one thing:  life is short, and you never know when it is your time--time to get sick, time to become injured, time to die.  I know that there is a lot of controversy and stigma out there about "part-time docs", but in the end this is a personal, not a socioeconomic decision.  I have dedicated 13 years of my life to medicine.  After 3 years of residency and 6 years of practice I am confident in my skills and knowledge.  It is now my children's turn to have my focus and attention. They will only be this small and will need me this much for so long.  It is their time.

Wednesday, June 25, 2008

Goat farming, return to residency or the status quo?

I work two days a week, and I'm home with the kids for three. Apart from a full-time stint when Pete took a ten-week parental leave in 2005, I've never worked more than three days a week since I finished residency five years ago.
You might assume that if I've maintained the same pattern for years, I must have found the perfect balance, requiring little review.
But a typical week of end-of-day comments to Pete looks like this:
  • Monday: "I've been thinking of doing another residency. What would you think of staying home for three years?"
  • Tuesday: "Let's move to the Island and take up organic goat farming. Think how much the kids would love it."
  • Wednesday: "Work's been great lately. Maybe we should pick up another day of daycare and increase my work to three days a week. We could use the extra cash to pay for a cleaner and meals."
  • Thursday: "I've been thinking maybe I should be home full-time while the kids are this young. These years will be done before we know it."
  • Friday: "Why don't you apply to medical school? You could go into family medicine, and we could share a practice. One of us could always be home with the kids."
  • Saturday: "I'd love to throw myself into work full-time, even just for a year or two."
  • Sunday: "Our current arrangement really is ideal. I'm so grateful that I get to spend this much time with the kids. What other career would offer this flexibility?"
These suggestions, and many others, are never offered out of dissatisfaction, but out of creative optimism. An afternoon seeing prenatal patients makes me want to return to the clinic the next morning. But a morning spent hunting for crabs at the beach with the kids makes me wish for a long, uninterrupted string of just such days.
I don't consider the constant consideration of alternatives pathological. For one thing, when you're a physician mother, being yanked in several directions is the norm. For another, I think it's healthy to live with intention, frequently reviewing one's choices.
Before getting a new haircut, my personal rule is that I must want that cut for seven consecutive days. I apply the same basic principle to life changes. When rapidly cycling through ideas, best to sit tight with the status quo, unless an option eventually emerges as the better one.
My fantasy pendulum swings equally in both directions - increasing time at home and at work. The average of all ideas I toy with is exactly what I'm doing now.
Looks like for the foreseeable future I'll continue seeing patients on Tuesdays and Fridays, and spending the rest of the week sharpening pencil crayons and picking berries in the woods.