COVID-19 was particularly cruel to two communities: caregivers, and
Healthcare workers who serve as caregivers for their families have found themselves short-staffed as they face hundreds of thousands hospitalized with COVID and nearly one million dead — but women and men are not experiencing these burdens at the same rate. A 2020 survey from medical resource site Medscape found that 51% of women physicians reported burnout compared to 36% of men, pointing to a discrepancy in pressure within the healthcare industry. For Dr. Erica Kaye, a Memphis-based physician and scientist specializing in pediatric oncology as well as hospice and palliative medicine, this pressure, in part, stems from how the professional and personal collide for female caregivers in
“We need a cultural revolution in our country to reimagine how we support caregivers,” says Dr. Kaye, who’s mom to a two-year-old and a six-year-old. “I’ve been fortunate to work with organizations with a lot of humanity and compassion, but that’s not always normalized in these spaces.”
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Dr. Christina Yannetsos, a Denver-based physician specializing in emergency medicine, had twin boys four months ago, and knows all too well how much empathy is needed within her field.
“As someone who is returning to the workforce, it’s been extremely difficult,” says Dr. Yannetsos. “Luckily, I have very supportive colleagues and leaders who believe family comes first and provides resources and accommodations like a place to pump so I can breastfeed my kids.”
But should the treatment of working moms depend on luck? EBN spoke with Dr. Kaye, Dr. Yannetsos and Dr. Eliza Chin, a San Francisco-based physician specializing in internal medicine and the executive director of the American Medical Women's Association, to better understand the challenges they faced as working moms in healthcare, and what needs to change for the next generation of female doctors. Here’s how each woman responded.
Looking towards the start of your journey as a mother, what was it like to step away from work to deliver and recover?
Dr. Chin: When I had my first child, I had six weeks of paid maternity leave. For my second child, I actually took time off for a number of years. My husband was moving jobs at the time, and the hurdles of child care and starting a new job were too much. I put my career on hold and didn’t set any huge aspirations because it was important to me that I was able to raise my kids. That was a personal choice and everyone makes different personal choices, but it's interesting as I reflect back on what big factors guided my career path.
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Dr. Yannetsos: I was out for about five months. I had to leave [work] a little early because I had preeclampsia, and that took up a few weeks of my sick time. My delivery was also a C-section, so I utilized more of my sick time and short-term disability, which covered up to eight weeks. Then I used a month of paid parental leave, with one month of unpaid leave. My family needed that five months to adjust to the point where one person could take care of these two little boys. In other countries, parents get yearlong paid leave, but we are behind in the United States.
Dr. Kaye: There are institutions in the United States that get a gold star for giving more maternity and paternity leave compared to their peer organizations. Yet most institutions in the U.S. are still profoundly behind other countries that standardly offer 12 months of leave to ensure optimal care and bonding within that family.
I was grateful to have 16 weeks through the Family and Medical Leave Act. I know that many people aren't able to do that. I stored a lot of sick and vacation leave, which I used up during my maternity leave, so my leave was mostly paid. People who aren’t able to save up weeks of sick and vacation leave would have unpaid maternity leave for any time beyond 6 weeks. I was grateful to my supervisor for normalizing taking four months off, as many employers don’t. I wish the status quo was to encourage mothers to take up to a year to bond with a new child — particularly given that securing affordable, safe child care is so difficult to navigate for working parents.
Speaking of child care, what has been your experience with accessing care for your kids?
Dr. Yannetsos: In healthcare, we work all hours. I could be working the day shift, afternoon shift or night shift, while my husband has a 9-to-5. On top of that, child care is extremely expensive — so expensive that most people find it more beneficial for one of the parents to stay home.
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My husband has his master's and a PhD, and he has considered staying home because it's not cost-effective for him to work and pay for a nanny, which would cost around $65,000 a year. As of now, we decided to split shifts: my husband will work during the day, and I will go in to work in the afternoon or overnight. If I have to work during the day, we have a nanny. But finding a nanny in COVID is incredibly difficult, and most people do not want to send their kids to daycare because of COVID. That’s why a workplace daycare would be hugely beneficial for healthcare workers, because it’s difficult to find care with that type of flexibility.
Dr. Kaye: We've used daycares extensively throughout the last six years, and when COVID hit, that system was suddenly no longer feasible. So we cobbled together babysitters as best we could in real-time. We tried multiple times to hire part-time nannies, but that yielded a revolving door of students who would commit and then rescind their commitments a month or two later. At the same time, you're supposed to be performing at a high level professionally, as if a global crisis were not unfolding. It was an indescribably stressful time.
Dr. Chin: When I had my first child, I dropped my fellowship to get a job because I knew we couldn’t pay the rent and child care expenses on two doctor trainees' salaries. Eventually, I ended up carving out a schedule where I could drop the kids off at school, go to work for a number of hours and then be there for pickup — but obviously the jobs I chose depended on child care decisions.
Now that my kids are grown adults, I have immersed myself in work. Sometimes I'm surprised that I ended up in a wonderful place and gained leadership experience.
Is there stigma surrounding doctors who also choose to be mothers?
Dr. Kaye: In every profession, there is stigma against women who try to “have it all.” I think medicine in particular is an environment in which women have been told, directly and indirectly, that they cannot be leaders in science and medicine while also being mothers. I don't mean to minimize how difficult it is to balance motherhood and career. But I think that the concept of work-life balance is a false dichotomy that sets people up to fail. In any one given moment, no one can balance multiple hugely important things at the same time. Day by day, you have to make choices.
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For example, today I am prioritizing my children, and that means some work things are not going to happen as quickly as I would like them to. And on other days I prioritize my work because there's a deadline or a patient I need to pour into. That means my family may make some sacrifices. This framework – that we can be great at many different things, just not at the exact same time – helps me to feel like I'm doing the best I can in a given situation.
What needs to change in the healthcare industry so women do not feel forced to choose between their kids and career?
Dr. Chin: I was lucky that my division chief was very understanding about the challenges I was facing after my first child — his wife is also a mother and physician. He was incredibly generous, not only to take me on and hire me, but to allow me to work 75% of the time. So as a new mother, I took home a smaller paycheck proportionally, but I had the flexibility to not be at work from 8-to-5 every single day at the beginning of my career. Things like that make a world of difference. Unless people understand the challenges of what it's like to be a caregiver in this space, things won’t change.
Dr. Kaye: That’s why we have to prioritize supporting and advancing women into leadership positions in science and medicine. We need more women who have had the lived experience of juggling complexities like pregnancy, pregnancy loss, traumatic delivery, postpartum anxiety and depression, maternity leave, and navigating the profound stressors related to securing and maintaining child care.
That’s why I talk openly about being a working parent, particularly in this environment, both to normalize it and to raise awareness.
If we could have better representation of women who have had those lived experiences in leadership roles, the culture of medicine would meaningfully and sustainably begin to evolve, translating into kinder policies for balancing parenthood and success in the workplace. Looking back across the pandemic, I'm hopeful that we have learned some lessons and can maintain and build upon flexible, compassionate policies that benefit working parents in the future.
