Spouses and Relationships

[F0017S0]

You may think it's a choice. To others it isn't. People who want to be parents and that influences their well being. And it gets very stressful as the reproductive clock starts ro run out. Do you know someone who has gone through infertility treatments? It's so so hard.
And regarding choice, when does that argument end? The lung cancer patient had a choice to not smoke, the person who went skiing and broke their leg did too, the colleague who had a stroke or MI but was obese, not exercisi g etc etc ... Why should any of us as a society pay for the poir choices of others??

Tim, just because that was your daughter's experience it doesn't mean its like that everywhere. In fact when we had sick people out, everyone shared the extra work single/married/with kids. I had kids and yet was assigned to work during the Christmas/NY holidays while all my single friends were off traveling. Your daughters program sounds like a more family friendly one. I come from a punitive program. So your comments and those of others here remind me of how I was treated for choosing to have children because God forbid anyone is inconvenienced by "women issues". It's misogyny no matter how you it's disguised!

Having kids today just doesn't sound enjoyable at all: I interview as an alum for the Ivy I attended and both the kids and parents are wrecks. But they made that choice to bring kids into this crazy world. And yes, there are elements of choice in all of the scenarios you outlined above. But a kid situation is far more significant becasue it directly impacts others, say Tim's daughter negatively.

[matia]

It doesn’t sound like Tim’s daughter’s program was “family friendly” if she was lower on the totem pole to spend Christmas with her family just because she didn’t have children.

Family friendly are called the programs that make "accommodations" for those with kids whether that is holiday call, maternity leaves, breastfeeding etc.

I think programs should have accommoaccommodations for residents in need period. Too many go through mental health crises, depression, take their own lives and can't figure out if there is help or where to get help. This is really a medicine problem not just a residency problem. We need to be more "employee colleague" friendly, period.

[matia]

Having kids today just doesn't sound enjoyable at all: I interview as an alum for the Ivy I attended and both the kids and parents are wrecks. But they made that choice to bring kids into this crazy world. And yes, there are elements of choice in all of the scenarios you outlined above. But a kid situation is far more significant becasue it directly impacts others, say Tim's daughter negatively.

I mean seriously?? Cause the smoker colleague or the one who broke a leg skiing who takes fmla for their treatments does not impact everyone directly, those single and not single?? This is bias you have there and you might want to recognize that.
You guys act like you are never "inconvenienced" at work except for pregnany/mat leaves. And wanting to treat that leave different from other leaves or "work burdens" is based on bias against people reproducing.
We just had a couple of attendings leave at the same time, who do you think had to take over and overbook their schedule, take more call etc etc once they left? For no extra pay too. Sure we grumble but everyone shares that "burden" and we move on. And we don't hold a grudge for those that found a better fit for them. Yet if this had to happen for a pregnant woman to cover her 3 month mat leave (which is much less onerous btw because most women docs plan for mat leave and front load call and it's for a limited time too) most colleagues are more emotional as though the pregnancy was done to "harm" them, it's just made more personal. It's a bias solidly supported by a misogynistic society. Thankfully things are changing even in medicine just not fast enough!

Personally, my opinion is life happens and no matter the cause if someone needs fmla/time off for their personal reason, should have it and we should be supportive. I am inconvenienced for a short time but the greater good that's done all around negates that. And hopefully that environment makes for a longer and happier career for those colleagues in need.

PS. My kids are my life and having them has made me a happier and better person/doctor. We try to do our best but t's never easy though, I don't think it's supposed to be.

[Tim]

Family friendly are the programs that make "accommodations" for those with kids whether that is holiday call, maternity leaves, breastfeeding.

I think programs should have accommoaccommodations for residents in need period. Too many go through mental health crises, depression, take their own lives and can't figure out if there is help or where to get help. This is really a medicine problem not just a residency problem. We need to be more "employee colleague" friendly, period.

100% agree that it is a medical problem.
If a person is needed to provide services (yes they contribute), do you shut down services when they are out? If there are 5 residents in a program, how is it feasible? Can’t borrow from the other 5 programs..
Identifying an issue is one thing, but what is the solution?

[matia]

100% agree that it is a medical problem.
If a person is needed to provide services (yes they contribute), do you shut down services when they are out? If there are 5 residents in a program, how is it feasible? Can’t borrow from the other 5 programs..
Identifying an issue is one thing, but what is the solution?

It's a job, even residency. It should be handled like any other shirt term leave in any job. You try to find a temp who can do some of the duties/responsibilities and/or you pay the existing workforce more for the extra work they do during that time. Of course the latter doesn't happen in residency or attending hood because admin look to save $$ not to be fair. So as I said, it's an administration issue not a "colleague" issue. We are not reinventing the wheel here. In other countries doctors/residents have 1+ year leaves.

I am going to get off my soapbox now. I think I have said enough.

[Tim]

It's a job, even residency. It should be handled like any other shirt term leave in any job. You try to find a temp who can do some of the duties/responsibilities and/or you pay the existing workforce more for the extra work they do during that time. Of course the latter doesn't happen in residency or attending hood because admin look to save $$ not to be fair. So as I said, it's an administration issue not a "colleague" issue. We are not reinventing the wheel here. In other countries doctors/residents have 1+ year leaves.

“You try to find a temp who can do some of the duties/responsibilities and/or you pay the existing workforce more for the extra work they do during that time.

”You try to find a temp who can do some of the duties/responsibilities and/or you pay the existing workforce more for the extra work they do during that time.

5 residents:, one goes down increases the work load by 25% on the remaining. Extended time leaves the PD with a rotation problem. The 4 remaining have required rotations. How do you split the assigned rotation, 25% to each for each? There is no “temp” available and residency involves highly educated and top 1% workers. These are cream of the crop employees that even finding one resident is a long demanding and expensive process.

I am open for solutions. This is not any other job.
The remaining 4 have their own struggles as well.
Don’t push them over the edge. They are comrades in arms, protect their backs. Days off can be covered, part of the job.
The resident will be viewed on whether they showed up, reliable or not.

[Anne]

Family friendly are called the programs that make "accommodations" for those with kids whether that is holiday call, maternity leaves, breastfeeding etc.

I think programs should have accommoaccommodations for residents in need period. Too many go through mental health crises, depression, take their own lives and can't figure out if there is help or where to get help. This is really a medicine problem not just a residency problem. We need to be more "employee colleague" friendly, period.

Yes, I’m aware what the euphemism “family friendly” means. My point is that single people without children also have families and expecting them to always work holidays like Christmas and Thanksgiving so that those with children don’t have to work then is unfair and inappropriate. As a child whose mother worked at least every third Thanksgiving and every third Christmas when I was growing up, I can tell you that kids do just fine if their parents have to work some holidays. If you chose a profession where people work holidays, you should expect to work them some but not every year, regardless of your personal situation.

[F0017S0]

I mean seriously?? Cause the smoker colleague or the one who broke a leg skiing who takes fmla for their treatments does not impact everyone directly, those single and not single?? This is bias you have there and you might want to recognize that.
You guys act like you are never "inconvenienced" at work except for pregnany/mat leaves. And wanting to treat that leave different from other leaves or "work burdens" is based on bias against people reproducing.
We just had a couple of attendings leave at the same time, who do you think had to take over and overbook their schedule, take more call etc etc once they left? For no extra pay too. Sure we grumble but everyone shares that "burden" and we move on. And we don't hold a grudge for those that found a better fit for them. Yet if this had to happen for a pregnant woman to cover her 3 month mat leave (which is much less onerous btw because most women docs plan for mat leave and front load call and it's for a limited time too) most colleagues are more emotional as though the pregnancy was done to "harm" them, it's just made more personal. It's a bias solidly supported by a misogynistic society. Thankfully things are changing even in medicine just not fast enough!

Personally, my opinion is life happens and no matter the cause if someone needs fmla/time off for their personal reason, should have it and we should be supportive. I am inconvenienced for a short time but the greater good that's done all around negates that. And hopefully that environment makes for a longer and happier career for those colleagues in need.

PS. My kids are my life and having them has made me a happier and better person/doctor. We try to do our best but t's never easy though, I don't think it's supposed to be.

You don’t necessarily need to take leave from work to tend to a broken bone from a skiing accident. And I also do not feel as if there was any malicious intent on the part of a pregnant colleague to torpedo my work days.

That said: a baby isn’t an accident, like a broken arm. Assuming a non complex fracture, that arm will likely heal just fine with proper care in several weeks. As others have said, there’s the leave that compounds from time for prenatal care into time for infant care into time for all sorts of other activities associated with children. A colleague having a child is essentially a future ask of colleagues to “step up when [the parent] steps back.” Where’s the line? Am I expected to step up for recitals? Parent-teacher conferences? Pediatrician visits? It’s the postnatal after-the-fact asks for flexibility that start to wear thin.

For the record, I don’t hate kids, nor do I hate parents of kids. If/when I go to medical school, a pediatric subspecialty would be of interest to me. I enjoyed working with the kids in my studies at my old job. I’m happy for you that you were able to balance all of your responsibilities as a doc and mom, nor so I mean to say “you are a bad mom.” If my statements were construed that way, I am sorry. That said, modern parenting in a persistently shaky economic reality is not something I (personally) would endeavor to willingly endure.

[matia]

Yes, I’m aware what the euphemism “family friendly” means. My point is that single people without children also have families and expecting them to always work holidays like Christmas and Thanksgiving so that those with children don’t have to work then is unfair and inappropriate. As a child whose mother worked at least every third Thanksgiving and every third Christmas when I was growing up, I can tell you that kids do just fine if their parents have to work some holidays. If you chose a profession where people work holidays, you should expect to work them some but not every year, regardless of your personal situation.

So I thought I was done with this subject, but where did I endorse that it's ok for those with kids to take less call or not be on call for the holidays? I am not sure where you guys practice, but in my experience it works by seniority who takes the $$Itty call, not by who has most children. Maybe I should move to where you'll are?

Rather I am advocating that while I need the support for my mat leave that single person will need the support later for whatever else happens in their life sickness of themselves or family members. We have seen it over and over play out with Covid and quarantines. It's a 2-way street. And just because most in residency are single without kids, it doesn't give them a right to single out those who need the support to have a family.

[Lordosis]

In my experience people without kids miss just as many days as people with kids just for different reasons.

[StarTrekDoc]

In my experience people without kids miss just as many days as people with kids just for different reasons.

Yes, that's true. Along with Family care bonding - the amount of time needing coverage is not insignificant and typically during the building ones practice too, the coverage is a bit more complicated and extended too.

I'm all for family bonding. During our residency guys got 24 hours; at best 3 days. Gals got 2 weeks. -SMH. Duing my career I've covered boxes 10+ for fellow colleagues taking extended maternity. All good. Love their kids. It is uneven? sure. Life is uneven. Rolling with it.

[Jenn]

Like the FB meme when you are shorthanded it's a failure of administration to staff adequately for known and expected and likely surprise shortages. And it isn't something you should fix by working harder and longer overtime, but us docs are working stiffs without the protections many laborers have. Except when you are the owners; in which case hope you like the cross coverage policies you created both when you are out and when your colleague is out- and if you don't, vote for a change.

However I'm sure that if my residency had an extra person in each year we'd all say "yeah 11 people split the workload" and be mad when it was only 9 or 10 instead of being happy it's rarely below 8. And we need paternity leave in parity with maternity or at least approaching it.

BTW when the US Army was younger (and when I researched the issue for a talk in the '90s) there was more time/soldier missed for alcohol abuse issues (including MVAs) amongst men than maternity issues amongst women soldiers. Of course back then and earlier fewer women (than now) planned a family if they were soldiers.

[F0017S0]

In my experience people without kids miss just as many days as people with kids just for different reasons.

Really? Parents have both kid duties and the usual missed days that everyone else has. The signletons only have the missed days that everyone else has (all of this is on the aggregate average)...

[Lordosis]

Really? Parents have both kid duties and the usual missed days that everyone else has. The signletons only have the missed days that everyone else has (all of this is on the aggregate average)...

At least in my experience which I admit is limited.

During residency I had a kid my last year and I was not out any more than anyone else. My wife worked full time as well. There were a couple other residents who had kids and they were not the people I think of for being out. We had a few people who would call off for various reasons regularly and they did not have kids. Most commonly it was for "mental health days"

In my current job my partner and I with kids are by far the most consistent. It is the other people I work with either never had kids or grown adult kids who are out way more frequently. Usually health problems or issues with pets.

There are a lot of reasons to miss work. Kids are just one of them. But a good employee will be a good employee if they have kids or not.

[F0017S0]

At least in my experience which I admit is limited.

During residency I had a kid my last year and I was not out any more than anyone else. My wife worked full time as well. There were a couple other residents who had kids and they were not the people I think of for being out. We had a few people who would call off for various reasons regularly and they did not have kids. Most commonly it was for "mental health days"

In my current job my partner and I with kids are by far the most consistent. It is the other people I work with either never had kids or grown adult kids who are out way more frequently. Usually health problems or issues with pets.

There are a lot of reasons to miss work. Kids are just one of them. But a good employee will be a good employee if they have kids or not.

Fair enough; I am not intending on coming across as demeaning. My experience is also limited to me, and just don’t miss work really at all. So my perception is skewed as well…