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Editor’s note: This is part one of a two-part series examining the ways physicians prepare for and manage parental leave.
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March 2017It’s logical to conclude that medical personnel enjoy the gold standard in employee healthcare benefits. That can be a risky assumption, however, especially for residents in their childbearing years. It isn’t unusual for young physicians planning a family to discover—sometimes too late—that their health benefits fall short of the minimum guidelines recommended by the American Congress of Obstetricians and Gynecologists to ensure a healthy pregnancy (available at acog.org).
Other countries provide more benefits than the United States (see “Paid Parental Leave by Country”). This is especially true with maternity leave, as many healthcare employers have struggled to keep up with the growing status of women in the medical community.
According to data derived from the Association of American Medical Colleges (AAMC) Data Warehouse, only 6.9% of medical school graduates in 1966 were women. By 1981, that number had risen to 24.9% and, in 2014, women comprised approximately 47.5% of all medical school graduates. Moreover, the American Medical Women’s Association (AMWA) reports that 50% of female physicians have their first baby during residency training. All of this amounts to dramatically increased numbers of women physicians growing their families and developing their careers simultaneously.
Medical residents are subject to the same challenges as employees in other professions. Meeting these challenges requires the cooperation of healthcare employers and employees in finding ways to ensure that adequate time and space is allotted to welcome new arrivals into the world, and doing so without jeopardizing the careers into which physicians have invested so much.
Best-Laid Plans
When Gayle Woodson, MD, an otolaryngologist at Ear, Nose, Throat, and Plastic Surgery Associates in Winter Park, Fla., entered the field in 1976, she was one of only 12 female otolaryngologists in the country. Dr. Woodson vividly recalls being asked during her medical school interview, “What will you do about children?” Taken by surprise, she replied, “Well, I guess I won’t have any.” She didn’t take herself at her word, however, and did indeed get pregnant during her fellowship. She went on to start her job during her eighth month of pregnancy and waded her way through a system that was not necessarily ideal for female physicians who wished to have children.
Dr. Woodson knows she was one of the lucky ones. “My boss was very progressive, and colleagues were protective of me, but I had a good friend at the time who was also pregnant and in private practice. Her group felt that she should pay for a locum tenens to cover for her [while she was out of the office], because it was unthinkable at the time, not only for a woman to be a surgeon, but for a woman surgeon to have a baby. Just unthinkable.”
“A lot depends on the kind of group you’re in. You hope that they’ll give you time off without call if you need it in late pregnancy, and that you can have enough time after the birth to stay at home without any clinical obligation. Some women want to come back and work part-time and some really want to go full force. You have to know what works for you and negotiate for it.” —Gayle Woodson, MD
Although female surgeons are no longer a rarity, it’s still not unusual for pregnant physicians to encounter obstacles as they navigate the logistics of maternity-related leave and scheduling adjustments. Often, the first hurdle comes when they have to interpret their program’s maternity benefits, said Kim Templeton, MD, president of the AMWA. “Not all employment contracts are the same, and physicians need to read them carefully to see if parental leave is included. If it isn’t, then that should be discussed prior to signing,” Dr. Templeton added. “Otherwise, these benefits are handled by federal law, which is written for everyone and doesn’t take into account issues of those in specific professions, such as medicine.”