Anna Gilley, MD, often worries about what would happen if her toddler got seriously sick while she was at work and the nanny didn’t know what to do. Working mothers in other professions might be able to leave their job at a moment’s notice, but Dr. Gilley says she doesn’t have that ability as a pediatric hospitalist at Hendricks Regional Health in Danville, Ind.
“Being a hospitalist, when I’m at work, I’m definitely at work. I cannot leave,” she says. “I have patients to look after who depend on me.”
So far, her daughter, who turned 1 last month, has been healthy. But the possibility of not being home if her little girl gets sick or injured weighs on Dr. Gilley’s mind.
With HM still a young medical profession and hospitalists with small children common, Dr. Gilley is not alone in her concerns. They range from the issues working mothers across professions experience (fatigue, time constraints, work-motherhood balance, breast-pumping) to such challenges as nontraditional work schedules and patient obligations that are unique to physicians.
“Sometimes you feel like you are the only person in the world who is going through this, but obviously you’re not,” Dr. Gilley says. “There is always a benefit to having people who have gone through the same thing you are going through.”
Pregnancy and Maternity Leave
When Jane Yeh, MD, a hospitalist at Overlake Hospital in Bellevue, Wash., was pregnant with the first of her two children, she often would seek advice from a colleague who had given birth two years before. The guidance she received then is something Dr. Yeh, who has sons ages 2 and 4, now passes along to hospitalists who are expecting.
“Keep an open mind and don’t put yourself into a corner that you can’t back out of,” she says.
Having a baby completely changes a person’s life, so when hospitalists speak with their group directors about work after maternity leave, they should avoid committing to a full-time contract and fixed start date, and instead talk about opportunities for flexibility, Dr. Yeh says.
Upon giving birth to her first son, Dr. Yeh’s initial thought was to take three months’ maternity leave and go back to work on a 0.6 FTE basis. Eventually, she returned to the job after four months and gradually added shifts over the next four to eight weeks to reach 60% working time. “It was the whole first-time mother thing,” she says, adding hospitalists on maternity leave should openly and honestly communicate their work intentions with their director.
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Plan on taking as much maternity leave as possible under the law and workplace policy, counsels Roberta Chinsky Matuson, who has advised scores of pregnant women across professions about work-related topics as president of Northampton, Mass.-based Human Resources Solutions. “You can always come back early,” Matuson says.
While Hendricks Regional Health allows a maximum of 12 weeks of maternity leave, Dr. Gilley took 10 weeks. Under her seven-on/seven-off schedule, she works one week of day shift followed by one week off, and one week of night shift followed by one week off. “I think if I were working every day, I would have taken advantage of the full 12 weeks off, but 10 weeks was good enough for me,” she says.
Full Time Vs. Part Time
Carolyn McHugh, MD, MPH, who was hired by Overlake Hospital when she was pregnant and finishing her residency, always planned to go back to work after giving birth to her daughter, but on a part-time basis. “I had to work pretty hard to find part-time work,” she says.
Aside from a few months of working full time while she was pregnant with her second child and her husband was out of work, Dr. McHugh continues to work part-time. She gets paid a little more per shift but doesn’t have benefits. When she was out on maternity leave, it was unpaid leave.
Her boss will frequently ask if she wants to switch to full time, but Dr. McHugh, who has a 3 1/2-year-old daughter and a 16-month-old son, is content to decline. There are days now when she doesn’t see her children at all due to work, and her daughter’s cooperative preschool requires considerable hands-on involvement from parents.
“Maybe when my kids are in school, I’ll do it, but really, I don’t know,” she says. “I feel like I’m really lucky where I’m at. I have an employer who is concerned about my well-being, and the opportunity exists to move to full time.”
The decision about whether to work full time or part time must start with finances, explains Jennifer Owens, director of the Working Mother Research Institute in New York City. If a working mom can afford to work fewer hours, there are a number of factors that should go into the decision, including:
- Level of involvement with children;
- Impact on earning potential;
- Prospects for promotions and other career opportunities;
- Effect on relationship with spouse;
- Ability to switch to full-time work down the road;
- Level of support from family and spouse; and
- Impact on health benefits.
“It’s just a cost-benefit analysis where the costs and the benefits involve your baby,” Owens says. “You know the work environment that you’re in; you know the family environment. … Only you know all the factors.”
From the start of her pregnancy, Dr. Gilley knew she would be returning to work full time. “My husband is still a resident and that made a big impact on my decision. I work two weeks out of the month and that makes a big difference, too,” she says. “If my husband was out of residency and if we were a little more stable, I think I could have chosen part time.”
A self-described Type A personality, Dr. Gilley said she also chose full time because she needs to be doing something at all times.
“On my weeks off, I love it and I enjoy being with my daughter, but sometimes I’m ready to go back to work,” she says.
Back to Work
Dr. Gilley didn’t ease back into work. She jumped right in.
“I was ready to see patients and get back to work to do what I was actually trained to do,” she says. “It was hard mentally and emotionally, but once I was there, I was like, ‘I like this and I can keep doing this.’ ”
It helps that she has a nanny she loves and trusts with watching her child. “I called several times the first couple of days, but after I knew my daughter was fine, I didn’t call as much,” she says.
Nevertheless, Dr. Gilley often asks herself if she is spending too much time at work and not enough time at home.
Hospitalists with babies face many of the same challenges as other working parents returning to the job after maternity leave, Owens says. They have to contend with competing responsibilities, lack of personal time, and separation guilt and anxiety, to name just a few issues.
“The first thing is take it easy,” she says. “Returning from maternity leave and back into your work life can sometimes feel like you’re diving into the deep end of a pool.”
Matuson says hospitalist moms have to be realistic and accept that balancing motherhood and medicine is going to be difficult. “They are going to be totally exhausted, so they have to learn to not take on more projects,” she says. “They have to learn to say no.”
Also, be prepared to feel guilty about being at the hospital and understand there is going to be a lot of making the best of a less-than-ideal situation, Dr. Yeh says. She breastfed her sons and can remember feelings of frustration with the breast-pumping, even though she used a hands-free pump that allowed her to read labs and answer pages. On one hand, she was providing her baby with breast milk but spending less time at home. On the other hand, if she skipped the breast-pumping to get home earlier, her baby didn’t get breast milk.
“There are a lot of different things that make up who we are. We are not just a physician and we are not just a mother,” Dr. Yeh says. “It’s really important to figure out your own balance.” TH
Lisa Ryan is a freelance writer based in New Jersey.