Maternity leave - need advice for high income docs in private practice

[CordMcNally]

I still think you're looking at two separate issues here. You mention the military mantra that leaders eat last. What happens when everyone is a leader (owner)? What about when the leader (owner) doesn't show up to eat (work)? They're not going to get any food (money). As an owner, you can and should plan for these things. Someone in a high paying specialty shouldn't have an issue making this work. As I've said, I think maternity leave for low paid hourly workers is a different story (and the one that I think you're mostly talking about although isn't the one that applies in this situation). Some practices can continue on with the same patient load/surgery schedule being an owner down for 12 weeks. Even a well run 3 owner practice with no other employed docs won't be able to hold the fort down by each of the other owners taking on 50% more clinic patients and surgeries. That's not to mention they won't be getting the increased compensation since it'll go to her. Let's say they continue to pay her her normal compensation while she's gone for 12 weeks and then another partner says they want to take a 12 week paid sabbatical as soon as she gets back from her maternity leave and expects her to cover their clinic load and surgery load, again, without increased compensation to her. Deep down, she won't feel like that's fair. With owners, fairness is getting paid when you work and bring in revenue and then not getting paid when you don't.

[HikingDO]

I can't tell if this is a deliberate misreading of what I wrote. I said PP is male-dominated, as the majority of PP places are run by men. The exception would be OBGYN and Peds, but in the total world of PP, it's male-dominated owners. Nowhere did I say men shouldn't get the time off like women do. Men should get the time, just as women do. Interesting too that you have a dismissive attitude of the time parents have with newborns. I suppose the basic position should be that women were put on this earth to have children, and if they choose to work as well, they should pop that baby out and if healthy, back in the office within 24-48 hours. Those 24-48 hours off should also be used as their vacation time. Get back to work and make the owner some money!

Now I’m not sure if this is a deliberate misreading of what I wrote. At what point did I say that women were put on this Earth just to have children? My point is that it’s not someone else’s responsibility to pay for your choices, it’s my general libertarian view of the world. I’m 100% certain that our political views are polar opposite, so I’m going to leave it at that and not comment any more before I get this thread locked.

[JBME]

Let's say they continue to pay her her normal compensation while she's gone for 12 weeks and then another partner says they want to take a 12 week paid sabbatical as soon as she gets back from her maternity leave and expects her to cover their clinic load and surgery load, again, without increased compensation to her. Deep down, she won't feel like that's fair. With owners, fairness is getting paid when you work and bring in revenue and then not getting paid when you don't.

While I think both sides have very valid points and evidence to support their position, I would genuinely be curious to know how often this hypothetical you wrote actually happens. I haven't been in this situation working in a small group but I've been around plenty of office pregnancies and leaves, and I've never, ever witnessed someone coming back from leave and another person on the team says they want to take a leave since the woman just got a childcare leave. Of course that person would naturally come across as an a-hole. That person thinks it's only fair. As for children being a choice, that's only true around 50% of the time. The other 50% of births are either unplanned or mis-timed. In the end no minds will get changed here. But if there was a standard leave policy (for both men and women equally) but small groups did not have to participate, those small groups probably would not participate but they could either lose a lot of talent or have a problem with recruitment. As Tim said some benefits are more advantageous than others and so individuals will evaluate all of these things when or before working

[CordMcNally]

While I think both sides have very valid points and evidence to support their position, I would genuinely be curious to know how often this hypothetical you wrote actually happens. I haven't been in this situation working in a small group but I've been around plenty of office pregnancies and leaves, and I've never, ever witnessed someone coming back from leave and another person on the team says they want to take a leave since the woman just got a childcare leave. Of course that person would naturally come across as an a-hole. That person thinks it's only fair. As for children being a choice, that's only true around 50% of the time. The other 50% of births are either unplanned or mis-timed. In the end no minds will get changed here. But if there was a standard leave policy (for both men and women equally) but small groups did not have to participate, those small groups probably would not participate but they could either lose a lot of talent or have a problem with recruitment. As Tim said some benefits are more advantageous than others and so individuals will evaluate all of these things when or before working

That's because all of your scenarios (and your personal experiences from what I can tell from your posts) have involved employees and not owners. That's my biggest argument is that this is an entirely different scenario for employees vs. owners. I believe someone asked if any private practice owners with predominantly female owners how this is handled but I don't think we've gotten a response yet.

[Lordosis]

If someone has a death in the family or an ill parent that they need to take time away from work for is that every covered with pay? Maybe it is a benefit at some places but I have not seen it before. FMLA will protect your job but no one is going to pay you.

[JBME]

If someone has a death in the family or an ill parent that they need to take time away from work for is that every covered with pay? Maybe it is a benefit at some places but I have not seen it before. FMLA will protect your job but no one is going to pay you.

lot of places offer bereavement (a lot of places also do not offer bereavement)

I too would be extremely interested in a study of PP female owners and how they address this issue. It would be supremely interesting to me. My hypothesis would be that they have such a leave policy, and if they don't it's because the female owners are at least 50 years old or don't have children or they weren't in PP in their child-bearing years

[tylerjw12]

My wife just started this week back to work after a 6-week maternity leave. She a partner in her OB/GYN group. She requested more time off, but her partners said no. She is forced to use allotted vacation time, but is not getting a 'normal paycheck' for being on leave. One may say it really isn't "leave" as she's simply taking her vacation days all at once. She had a prior maternity leave while an employee in same PP. It was also capped at 6 weeks, 4 weeks paid vacation and 2 weeks unpaid. OB/GYN doesn't mean family friendly. I've heard an attending at an OB residency is known to say 'You can be a good doctor, or you can be a good mom. Not both.' I want to be clear I am not badmouthing her practice or her partners. They have rules and certainly reasons behind them, which are followed.

I believe in granting more parental leave. I don't necessarily think her partners should pay her for a 12-week (or longer) maternity, but she should be allowed to take more unpaid time. Her office is not under FMLA, but I would say it's reasonable for most employers to accommodate a 12-week time off. It's not like a delivery comes as a surprise, so employers have plenty of time to prep. I can think of many other co-worker archetypes I'd much less prefer versus a female who may take 10 weeks or more for maternity leave 1-4 times over a decade-long period.

To the OP, I think this is just one part of your pros/cons list you consider while searching for jobs. My wife was certainly open about her plans to grow our family at interviews. This particular PP hit pretty much every other box in our checklist. Though the maternity leave was worse than other positions available, she decided it fit our other goals for her career. Maybe one day she can change the rules and allow for more maternity for other physicians down the road. Yes, meaning granting other people benefits she didn't get herself.

To the discussion on fairness... fairness is just a red herring. It's more about what one values. You don't talk about fairness when a surgeon injures a hand playing softball and can't operate for 6 weeks. You don't talk fairness when someone is out for weeks for weeks after a car accident leads to a serious back injury. It's not unfair for someone to need to take time off work for chemotherapy treatments. No one says "Well I don't play, or rock climb, or have cancer, or have debilitating migraines, so I'm entitled to the same amount of paid leave."
Women are shamed for being SAHMs. Women are shamed for working and sticking their kids in daycare. Women are shamed for listening to instinct, wanting to spend more time at home with a newborn. Posts on this thread shamed the OP for wanting to get something for more than absolutely necessary, something that another gender doesn't get. I can understand the sentiment that society/culture can create obstacles to have children, which was a side bar to OPs question about which position offered a financially better maternity policy.

[NumberWhizMD]

Employed, so maybe the feeling would be different if I were in PP.

I'm in a small group (total of 3). My partner was out last year for 6 months with a complicated pregnancy (did virtual while she could, but out of commission for 6 months total). Knew it might affect my salary slightly, which was a little hard. However, covered for her and was probably more productive during that time to make up for her being out. Thing is, I know she would do the same for me in a heartbeat.

As employees, we can "buy in" to short term disability. I know others who have spread out their salary and taken less over 6-12 months so they don't have a few months with no pay.

The other option is to have kids in training. Both of mine I had during training (one in med school, one in residency). Returned back at 4 and 5 weeks so that I could graduate on time. That was a bigger priority to me, and I was young and had the stamina to do so.

If we ever had another, I would likely take more time, knowing that it would be a financial "hit" for the time off. However, I also know I wouldn't get paid during that time. It sucks, but it is what it is. And that money does have to come from somewhere.

[Tim]

Europe is a completely different animal. One can say what they want about private companies. Much different regulations for each country.

"Employers must offer at least 4 months (16 weeks) of parental leave during the first 8 years of a child's life. The E.U. doesn't mandate that the leave be paid, although many countries offer at least partial pay. And countries decide whether to grant the time and the money to individual parents or to their family as a unit."

"Compare those statistics to paid family leave plans worldwide and it’s clear that the United States has a long way to go. The countries of Finland, Hungary, Poland, and Slovakia offer two years or more of maternity leave. Canada, Denmark and Germany hover around 52 weeks. Even Mexico offers 12 weeks of paid leave."

Might as well take two years off. Much of the family leave has been driven by political leanings rather than demographics or a sense of social norms. By that I mean those in power make laws. It has not been from the altruism of the companies.

[Anne]

Women are shamed for being SAHMs. Women are shamed for working and sticking their kids in daycare. Women are shamed for listening to instinct, wanting to spend more time at home with a newborn.

You forgot some. Women are shamed for choosing not to have children. Women are shamed for not being able to have children. Women are shamed for staying single out of choice. Women are shamed for being single despite wanting to be partnered because they couldn’t find a good match. Women are shamed for having children when they are too young. Women are shamed for having children when they are too old. Women are shamed for having children without being married. Women are shamed for having children without involvement of a male partner. Women are shamed for marrying someone who makes a lot of money (gold digger, trophy wife). Women are shamed for marrying someone who makes less than them (couldn’t do better, who wears the pants).

Just wanted to make sure we had all our bases covered.

[billy]

If someone has a death in the family or an ill parent that they need to take time away from work for is that every covered with pay? Maybe it is a benefit at some places but I have not seen it before. FMLA will protect your job but no one is going to pay you.

I've had to take fmla for my wife twice as an employee. And no, it was not paid. But I also didn't expect to be paid for it. Some places will let you use your PTO for it concurrently until you run out of PTO. Partners at my old group had to cover my calls, but I didn't feel bad bc they are owners/partners- they take that risk by being an owner. They also got the benefit of profiting off my work when I did work. If any partner at that group had to take leave, they would not be getting paid either. Partners eat last means they dont get to eat when not working.

FWIW, NJ offers some paid leave benefits that you pay into with your paychecks. Of course it tops out at ~900/week, which the OP can make in her first week of attending salary (900x12) and can save for on her own. I did not receive any benefits while on FMLA yet still pay into the system.

Totally different for low income workers/employees, but we are talking about a high income individual who might end up being a partner.