The Needs of Children—and Parents
The classic juggle of work and home life involves the care of young children, although that is only one of the competing personal demands on doctors’ time. As the proportion of women in medicine has grown, employers have been challenged to find ways to accommodate their staffs’ maternity leaves and child-care responsibilities, while working parents seek to accommodate their children’s swimming lessons, ball games, and ballet classes.
The generation that now dominates hospitalist ranks (average age 37, according to SHM’s “Biannual Survey of the Hospital Medicine Movement”) has little taste for the traditional image of the old-fashioned, male family doctor, essentially available to his patients 24/7. Lifestyle issues are important factors in their career choices.
Other working hospitalists want time to travel or to pursue outside interests. Their hours of work may be shorter and more predictable than for other physicians, but the pace can be intense, with life-and-death situations involving critically ill patients occurring every day. Many of today’s hospitalists also belong to the “sandwich generation,” juggling simultaneous caregiving responsibilities for children and aging parents.
Stacy Walton Goldsholl, MD, of Wilmington, N.C., president of the hospital medicine division of TeamHealth, and member of the SHM Board of Directors, faced an extreme version of these competing demands when starting her new managerial position on January 1, 2006. Pregnant with her second child, Richard, who was born in April, she was also caring for her 65-year-old father, who died of cancer in February.
“It was tough watching my dad, formerly a very robust person, truly the motivating force for my professional success, my moral compass, confidant, and advisor, as he got sicker,” says Dr. Goldsholl. “Some days I’d leave my two-year-old, Aiden, with my husband and go care for my dad, giving him his injection of Lovenox [enoxaparin] or replacing his PCA pump. My mom and I were his primary caregivers at home until we physically couldn’t handle it.”
At that point her father was admitted to a hospice inpatient facility, where she would sit by his bedside with a computer in her lap.
Dr. Goldsholl probably would have needed to take a leave of absence if she had been working as a hospitalist, but her new employers at TeamHealth gave her a lot of flexibility, limiting the number of strategic meetings she had to attend. In general, however, she believes hospitalist shift work is more accommodating to family demands than an administrative position. She returned from maternity leave full time on June 1 and now travels every week for her job; her mother, who lives nearby, fills in as her grandchildren’s nanny. But Dr. Goldsholl’s experience has sparked her interest in exploring sustainability issues for other hospitalists.
“TeamHealth’s leaders told me their turnover rate is about 5 percent for hospitalists, versus an industry average of 19 percent,” says Dr. Goldsholl. “I found that hard to believe, but when I interviewed some of our local medical directors, it turned out to be true. They were all extremely positive about their relationship with our operational infrastructure.
“There’s so much to do and so many opportunities out there, but it must be sustainable,” she continues. “In order to sustain a career, you must be fulfilled personally, which is directly related to your work/life balance.”
When she drilled down into the company’s data, trying to find out why TeamHealth is able to retain its doctors, she found that the hours they work average 7.3% less than the industry as a whole, while their compensation is comparable to others.1