Women Retina. Achieving a Work-life Balance. Feature Story. With Carol L. Shields, MD; Kimberly Drenser, MD, PhD; and Anne E.

Transcription

1 Feature Story Women Achieving a Work-life Balance With Carol L. Shields, MD; Kimberly Drenser, MD, PhD; and Anne E. Fung, MD Any woman who chooses to embark on motherhood while staying on the career track faces challenges unique to her gender. There has been a dramatic shift over the last several decades from 1 philosophy that the woman should stay in the home to care for the children and manage the household to now, when many couples share financial and household responsibilities. From childbirth to early childhood, however, the mother often remains the primary caregiver regardless of her role outside the home. Recognizing that retina specialists not only go through medical school and residency, but also devote 1-2 years to a fellowship program that can entail spending countless hours in the OR and/or on research projects, I wondered how women who have chosen this subspecialty simultaneously manage a family life and a career. With this in mind, I interviewed 3 retina specialists in 3 different stages of their careers and family life to find out how they maintain a work-life balance and what advice they might have to offer others in a similar position. Carol L. Shields, MD, is the Co-director of the Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University in Philadelphia. Kimberly Drenser, MD, PhD, practices at Associated Consultants and is the Director of the Pediatric l Disease Molecular Genetics Laboratory and Director of Ophthalmic Research at Beaumont Eye Institute in Royal Oak, MI. Anne E. Fung, MD, is a partner specializing in medical retina and Director of Ophthalmic Research at Pacific Eye Associates in San Francisco. In the course of speaking with Dr. Shields, Dr. Drenser, and Dr. Fung, and putting together these interviews, I learned quite a lot. I thought about my own work-life balance and the importance of prioritizing and planning to help simultaneously maintain a robust career and a healthy, happy family life. I am grateful for the time and insight that these 3 truly impressive and inspiring women offered to help me produce this article. - Rachel M. Renshaw, Editor-in-Chief 14 NEW RETINA MD. WINTER/SPRING 2012

2 What stage in your career were you when you started your family? Carol L. Shields, MD: I was married in my second year of residency and at that time, I didn t have a conscious plan to have a family. Both Jerry (Jerry Shields, MD) and I came from large families we both had 7 siblings in our families and so we knew that we could handle a large family of our own. Our first child was born 1 week before my written boards, so I literally went to my boards with my post-ceasarian section staples in place. Our second child was born 2 weeks before my oral boards. I remember going to my oral boards and people would say, Oh, I hear you just had a baby, which would trigger an emotion that immediately caused lactation to start. It can be crazy how these things happen, but it all works out in the long run. Kimberly Drenser, MD, PhD: I had my first child after my first year of fellowship, so by the time I was an attending, I was still a new mother. I now have a 6-year-old and a 2-yearold. I work full-time in private practice, and I also perform research and am Director of 2 research labs. Anne E. Fung, MD: Since 2005, I have been working to establish an active research program and build my private practice patient base. In the summer of 2011, my first child was born. My first challenge was to figure out how long I wanted to take for maternity leave. Many of my patients with age-related macular degeneration require near monthly injections. My patients are somewhat reluctant to have other MDs do their injection, so I decided to come back after 2 weeks of full-time leave and do injections 2 half-days a week. I went back to a fulltime schedule at 3 months. How did you determine who would take care of your children when you returned to work? My preference is that when I am home I am just mom. Dr. Shields Dr. Shields: Once you decide that you want to have a family, an important consideration is how you will manage your home. Do you plan to have your children in daycare, which sometimes doesn t open until 7:00 or 8:00 am? Would you rather have a caregiver that comes to your home or a live-in nanny? Daycare was not an option for us because of the limitations on timing, but the idea of a livein nanny also did not appeal to me as I felt it would, to a certain extent, cramp our family life to have someone living with us. You can also have a nanny come into your house during work hours or even share a nanny with someone else and have your children go to another person s home during the day. We chose the option to have someone come in to our home to care for our children during working hours, but even this is not perfect because there are times when a car won t start or an illness prevents the nanny from coming. Although no option is without flaws, this was what we felt worked for us. Regardless of which option you choose, it is important to understand that childcare is an important job and so whomever you choose must be reliable, and you should be prepared to pay this person well. Dr. Drenser: I was fortunate because my husband has his own business and so his hours are very flexible; however, because we live in Michigan and most if not all of his business comes from California, he does have to travel a good bit of the time. We knew early on that we would some sort of full-time help. We went through what seemed like 1000 interviews through an agency and took recommendations from friends to find both a suitable nanny and cleaning service. For a short time after both of my children were born, we also hired a chef to prepare 3 weeks to a month of meals to make things easier. Dr. Fung: When I first went back to work for the few half days, my mom, who lives about 1 mile from the office, was able to watch my daughter. I was able to schedule 20-minute breaks to pump because I was breastfeeding, and I made my lunch hour a bit longer so I could go home and feed my daughter. For long-term childcare, we started looking about 6 months before our daughter was born. We hoped to and were lucky to find a wonderful nanny who started first as a once-a-week housekeeper while we became familiar with one another, then transitioned to an overnight helper 5 nights a week after my daughter was born, then again transitioned to three 10-hour days a week when I returned to work full-time much longer than a regular work day. My mom helps out the other 2 days that I work. How do you organize your workday so that you can separate work and home life? Dr. Shields: My preference is that when I am home I am just mom. In order to make this possible, I try to be as efficient as possible when seeing patients. Additionally, I have found it helpful to carve out time during the workweek when I am not available for any interruptions. During this time, I am able to complete research tasks and other paperwork so that I am able to devote my time at home to my family. WINTER/SPRING NEW RETINA MD 15

3 One of my priorities is to have dinner together as a family. Dr. Drenser Dr. Drenser: In general, I am not a morning person, but I have found it helpful to get up early and go to work as early as possible. In those early hours before I start seeing patients, I write up my research projects and complete administrative tasks or grant applications anything that is not patient-care related. When I am done seeing patients, I can go home, eat dinner with my family, and then if I have any work that needs to be completed that night or any conference calls, I schedule these tasks at 9 pm, after my kids are in bed. Dr. Fung: What has been most challenging to me is the time pressure getting everything done in the office and getting home in time to feed my baby or let the nanny go home. I am continually trying to maximize my efficiency. As she gets older and as I am getting used to the balance, I do find that being more efficient with patients and delegating tasks at work are helping me get home earlier. Once home, the focus turns to my husband and daughter. I keep lists at home of work tasks to do when I arrive and vice versa. How do you prioritize in regard to work and family to create a situation that is manageable for you? Dr. Shields: You have to learn to say no. That meeting for the OR doctors that is going to be held at 6 or 7 pm? Forget it. Go home and be with your family. None of those meetings after office hours ever amount to anything more important than your family. I have priorities that I have always aimed to maintain in my life. My first priority is peace and happiness; my second is my family; my third is my clinical work; and my fourth is my research. I m not saying this is the right order for everyone, but it is the order I have always sought to maintain. Dr. Drenser: I think the most important thing is being honest with yourself and being realistic. You are not going to be able to simultaneously be the do-it-all mom and the most productive, hardest working partner. It s not physically possible. You have to ask yourself, What is the most important thing to me, and what am I willing to give up? I knew that I wanted to have the same career that I would have with or without children. I didn t want to work part-time; it just seemed a bit silly to me to have gone through all that training and not work full-time. This point was particularly important to me because I have 2 daughters, and I feel that I would be giving them the wrong message: that your job is to work really hard until you have kids and then you have to sacrifice by not working and not using your talents and the skills in which you were trained. I don t try to do it all; rather, I learned to delegate at home. For example, I don t do a lot of homework with my older daughter unless she specifically needs my help for a science project or something similar. The nanny or my husband will take on this task. One of my priorities, however, is to have dinner together as a family. I grew up in a family where at least 5 nights a week we had dinner together I think that it s an important component to the family unit. It is very important for me to come home at a reasonable time to be able to sit down and eat dinner, then spend a few hours with my daughters before they go to bed. Dr. Shields: As my children grew up, the older kids would help the younger children with homework and other things around the house as soon as they got home from school, so that by the time Jerry and I returned home from work around 5:30 or 6:00 pm, it was nearly all completed. I could then cook dinner, and we could eat together as a family. I agree that having dinner together as a family is critical to unity. It makes me cringe when my kids go over and visit friends, and I hear that they ended up ordering Chinese food to eat in front of the TV because the family never eats dinner together. Dr. Fung: I have definitely gotten much better at compartmentalizing my life than I was before my daughter arrived. I used to stay at the office until 7:00 or 9:00 pm on a regular basis to finish up patient paperwork and work on research projects. Now, I am much better at finishing seeing my patients, dashing off a couple of items, and then putting things down and going home by 5:00 or 6:00 pm. It is still hard, however, because this approach means that certain things don t get done on time. But it s a compromise that I m willing to make because my daughter and husband are my priority. I don t want to let anyone down, but I am learning to say no. I can t say that I have figured all of this out yet. It is important to note that my husband has played a significant role. Even though he is a colon and rectal surgeon covering general surgery call, he has made it a priority to be at home with our family in the evenings. Our partnership of understanding and support for one another s time away from home plays a crucial role in the degree to which we can pursue each of our careers. 16 NEW RETINA MD. WINTER/SPRING 2012

4 Dr. Shields, you work closely with your husband and have worked with your children, and Dr. Fung, you work with your father, who founded your practice. What is your advice to others regarding working with a family member? Dr. Shields: Whether you are working with a spouse, child, or parent, there are several benefits and risks. The benefits include that, in all likelihood, your family member truly cares about the practice. The risks include irrelevant problems at home that can affect how smoothly things go at work or vice versa. Additionally, you must be extra sensitive so that it doesn t appear that you are favoring family member over the entire staff. It s almost like reverse discrimination because the family member often takes a back seat out of respect to other office members. Dr. Fung: One of the most special aspects of working with my father is being able to say Good morning, Dad each day to him after being away over a decade for training. He has been incredibly supportive as I started practice (sharing patients, being available for second opinions when I m stuck), but I try to always remind myself to make special time to have lunch with him once a month so that we can talk about him. We now travel to retina meetings together I take care of the hotel and travel arrangements so that he can just enjoy the meeting. Dr. Fung, because you had been in private practice for a time before having your daughter, did you feel that you had to prepare your colleagues for your new role as not only a doctor, but also as a new mother? Dr. Fung: I talked to my partners early on in my pregnancy, and they were very supportive. They were happy to take over my patients during the time that I was away, but I also tried to ensure that I tied up as many loose ends as possible. In fact, I think they all thought I was a little crazy to come back so soon so I could perform injections. Our practice is very open and sharing one of the other partners is also a mom, and we just had a new associate that joined the practice who is also a mom. How do you handle things at home when you must travel to clinical meetings or other speaking engagements? Dr. Drenser: My family is pretty well acclimated with my frequent travel to meetings. I usually Skype frequently with my husband and the kids so we can talk about their days. We have had a great nanny for the past 3 years. If I give her enough notice, we just go through my schedule and increase her hours so that, along with my husband, we can have coverage for the time that I am away. One of the most special aspects of working with my father is being able to say Good morning, Dad. Dr. Fung I usually don t bring my family because unless it s a familyfriendly meeting; it is not enjoyable for anyone because I am not available for most of the time. Dr. Fung: Deciding how to balance travel/speaking engagements is definitely important. My mom has committed to traveling with me for multiple day meetings, my nanny comes for short meetings, and if I arrange in advance, my husband will cover too. This will clearly get easier once I finish breastfeeding, but it is a serious consideration! What other recommendations do you have for balancing responsibilities inherent with children and your professional career? Dr. Shields: My associates would likely agree that I am a dedicated, diligent, and loyal worker. Better stated, I am a hard worker. I have tried to minimize absent days due to kids problems or illnesses. As much as possible, I have tried to be pitching in at the office. Another important issue is the caregiver this person has to be reliable and trustworthy. This will make your home and office life much more pleasant. Dr. Drenser: For precisely this reason, I would err on the side of too much help rather than not enough help. We had a nanny at one point who was very good, but sometimes she would be late or call and say she was not feeling well at the last minute if my husband was out of town, this would cause me an enormous amount of anxiety. So, in my opinion, it s always good to have a back-up plan. I try very hard not to cancel at the last minute on my patients. Many of them have to arrange transportation or are children whose parents have taken off work for their appointments. I probably underutilized help with my first child, but I learned to have enough help by the time I had my second child. What additional tips do you have for other women who are starting out in their careers in retina and who have or may be considering having children? Dr. Shields: When your kids are small, there may be little time for yourself. Sometimes there s not even time to use the restroom alone! That said, on the weekends, I try to make time WINTER/SPRING NEW RETINA MD 17

5 to continue my interest in sports. Every Saturday and Sunday I play exhilarating tennis with a coach. Now that the children are older, they play tennis with us on the weekends also. In fact, they are all much better tennis players than Jerry and I could ever dream of. It s important to carve out time for exercise I also make sure that I get enough sleep. I am always ready for bed by 9:30 or 10:00 pm every night. Another important point is to know your child s schedule and attend every event possible. We commonly shape our daily office schedule around the lacrosse, basketball, and tennis seasons so that we can attend our children s sporting events. They find us sitting on the bleachers, pacing the sidelines, or taking photos. That 1 hour of dedicated time at a lacrosse game could shape the confidence of a son or daughter. Lastly, remember that life rotates around your relationships with others. Take care of others before yourself, whether it is your patients, your kids, your husband, or your colleagues and office staff. That is the best attitude to have. Dr. Drenser: Once I realized I would never have the quantity of time with my kids that some other mothers did because of my work schedule, I was determined that the time I do have with them is quality. I try to do something special with each of my daughters every week for a few hours on the weekend when I am not at a meeting or on call. We call it our date time. My oldest daughter said that this time is one of her favorite things and that she really looks forward it. It is nice to know that I can give this time to her and that it s special. Dr. Fung: When you are a resident or a fellow, you don t have as much control over your schedule and tend to be less financially comfortable, so having a baby may not seem ideal. When you are established in a practice, you have more control over your schedule, you are in a better place financially, but it may be harder to become pregnant. I would caution any woman who is in a position to start a family but who wants to put it on hold that she talk with her OB/GYN about fertility issues and be aware that becoming pregnant can get more difficult over time. And even though we have all been through med school, I found this book really helpful for family planning: Taking Charge of Your Fertility by Toni Weschler, MPH. This book is available through the author s website: Dr. Shields: The first rule of having kids and a career is that there is never a good time to have a child because either you are scheduled to be at a meeting, you have surgery that day, or you have to take your board exams. Instead of trying to schedule it down to the 9 months that would be a sensible time for your schedule, just relax and do it the old-fashioned way! n Carol L. Shields, MD, is the Co-director of the Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University in Philadelphia. Dr. Shields can be reached at ; fax: ; or via at carol.shields@shieldsoncology.com. Kimberly Drenser, MD, PhD, practices at Associated Consultants and is the Director of the Pediatric l Disease Molecular Genetics Laboratory and Director of Ophthalmic Research at Beaumont Eye Institute in Royal Oak, MI. Dr. Drenser can be reached at kimber@pol.net. Anne E. Fung, MD, is a partner specializing in medical retina and Director of Ophthalmic Research at Pacific Eye Associates in San Francisco. Dr. Fung can be reached at ; fax: ; or via at annefungmd@yahoo.com. 18 NEW RETINA MD. WINTER/SPRING 2012