March 3, 2023
In 2020, roughly 42% of practicing Family Physicians were women -- up almost 8% from 2010. While this increase is promising and expected to continue, it also clearly shows the need for employers and decision-makers to formulate workplace policies and strategies that promote professional growth alongside parental respsonsibility for female physicians. Balancing practice and motherhood should be a celebrated feat, not a tolerated one. While parenthood is not unique to female physicians, there are unique burdens and pressures that regularly fall on mothers.
We interviewed five of our members to hear their perspectives on being Moms in Family Medicine: Dr. Jessica Triche, Dr. Vickie Fowler, Dr. Kelley Lawrence, Dr. Jackée Clement, and Dr. Liz Baltaro. We'd like to thank them again for sharing their guidance, successes, and challenges.
Back in February we shared their input through the podcast episode "Mothers in Medicine, in Their Own Words." But today we share their full comments on navigating those challenges, whom they look to for guidance, and how being a mom has shaped them into the successful family physicians they are today!
Jessica Triche, MD: My residency classmates. Four of us had kids. We leaned on each other. My youngest had neonatal jaundice. My classmate helped me not panic (it was during Christmas holiday and the clinic was closed) and even came over to reassure me. Later, as my kids aged and I became involved in leadership, I talked to Shannon Dowler. She had 2 boys as well, and her kids are amazing. She told me I could be a great mom and a great leader.
Vickie Fowler, MD: I looked to my female friends, colleagues, and mentors. I recall during a particularly challenging time with my teenage daughter that Dr. Sue Slatkoff gave me guidance and support to feel empowered to ask for time to be present for my teenage daughter, just as I had needed to feel empowered to be home with my younger children.
Kelley Lawrence, MD: Good question. I don’t think there was one person, so I will name a few that were impactful for each of my pregnancies — some female and having traveled the same physiologic paths before me, some male and having an understanding and empathy that was profound: my mom (Jean Vance, who was a full-time teacher and mother), Dr. Teresa Terezis, Dr. Amy Weil, Dr. Charlie Baker, Amelia Henning, CNM, Dr. Wendy Barr, Dr. Kay Nordling, Dr. Mark Higdon, Dr. Jennifer Higdon, Dr. Heather Doty, and Lauren Penwell-Waines, PhD.
Jackée Clement, MD: I was fortunate to have a faculty team leader and mentor in Dr. Kelley Lawrence. She was such an advocate for me to do what was best for my family while maintaining a career in family medicine. I appreciated hearing her stories of having children in residency. In addition, she is a lactation specialist. I definitely used my phone-a-friend privileges often in that department.
Liz Baltaro, MD: I absorbed narratives from physician moms long before I was a mom myself — from the very start of medical school. I had so many sources of inspiration — my parents, my residency program director and advisors, colleagues, faith-based community, our local Moms of Multiples chapter, and non-medical family and friends. More recently, I have enjoyed listening to “Dr. Mama Podcast” created by a family physician, Dr. Alice Kaufman, and found inspiration in JAMA's "A Piece of My Mind" column, and the novel “We Are All Perfectly Fine” by a Canadian Internist Dr. Jillian Horton.
JT: Use available resources! If you don't have family close by, work out things with your kids’ friends' parents. Shared rides, alternating practice attendance, etc. Family should come first but, as you will learn, you are pulled in the other direction. At times, you may need to take a step back and really focus on family. It's ok to miss work for your family. You don't want regrets. When interviewing, see if you can gauge how family friendly the practice or organization is.
VF: It is important to reset your expectations of yourself, such as what you can accomplish or perhaps should aim to accomplish. The early years are magical and go by very quickly.
KL: My career has had stops and starts that many of my colleagues — who were not physically growing children inside (and outside) of their bodies — did not have. I worried a lot about what that different path would mean for me as a physician; I worried too much. My career has brought me much joy and fulfillment, and my family has even more so. I’m very grateful to have spent the time I did nourishing my children — and I still try to keep that in mind, because my children only have one mom, but others can fill in as docs to my patients or teachers to my medical learners if or when needed.
JC: My advice for young parents who are trying to balance their careers with increasing their family size is that you definitely need to have a plan for what is going to take priority in your life and for how long. When I was taking care of my newborn baby, that was my focus. And I was fortunate enough to not have work interfere with that time. Make sure you know your job’s policy regarding maternity leave. Will you need to go on disability? Will the leave be paid or unpaid? If you are a medical student reading this, please be courageous and ask about these policies. Only in this way will other programs realize that they need to take a second look at their policies if they want to remain competitive.
LB: Medicine in general still feels set up like most doctors have a stay-at-home partner and no caregiving or reproductive needs themselves. Women and mothers who are working in a system like this are bound to face many challenges — these are systemic problems, not personal failings. I still remember a sign on the office of an attending physician mother during my third-year clerkship which said, "You can have it all. You can't have it all at once." Now I deeply understand the hardship of combining a caregiving profession with the demands of motherhood. I acknowledge that both medicine and parenting are individualized experiences — unpredictable, uncontrollable with many transitions that require reprioritizing, tough decisions, and sacrifices.
JT: It has helped me care for my pediatric population! Easier to reassure parents about "normal" development, or let a mom know that an adolescent attitude is normal! I think having kids keeps me grounded. I put artwork and schoolwork up in my exam rooms, and my patients always ask about my kids. I think this makes me more relatable. I then tell the kids about the compliments, and they like that. Sometimes patients will see us in public and tell them how great their artwork is. They love it!
VF: As with all skills, firsthand experience is the best instructor! As a family physician who cared for obstetrical and pediatric patients during much of my career, I became a much more knowledgeable and empathetic physician due to my own experiences. I can relate much better to my patients who are parents as to their joys and their concerns. Also motherhood gives my life so much more meaning and ensures that I do not lose myself in my work.
KL: Being a mother has given me a visceral understanding of the vulnerability and fear that accompanies any pregnancy problem, any childhood sniffle or cough. It has helped me better communicate with all that in mind with parents and their children of all ages. It has also fulfilled a deep desire to nurture and love that I didn’t even realize I had prior to being a mother.
JC: Overall, being a mother has had a positive impact on my role as a physician, because I am able to provide not only medical knowledge but also first-hand experience with my patients and their families. There are certain things about parenting and caring for another person that you just do not learn from a textbook. And at the very least, getting to see it on a day-to-day basis just helps reinforce what I’ve already learned. There are some negatives to becoming a parent as a resident. Obviously, I was not able to see as many patients as my colleagues while I was on leave. I am still working to catch up on my patient count. I do feel I was not able to study anything else during my months away, and I did have to use an elective while I was raising my child. Lastly, becoming a mother during training really forced me to narrow down my interests and say no to extraneous projects that would not help me meet my goals as a mother and physician.
LB: I am a more compassionate and better leader — willing to let go of expectations and agendas, embrace imperfections, and understand others. I feel less in a rush to get through my "doctor checklist" and more interested in listening and shared decision-making. And I am much more in tune with the social challenges to women's health, especially Black women's health.
JT: Make time for your family. Bring your kids to events such as conferences. Let your patients know about your family. When you are overwhelmed, call your colleague friends. I have Tamieka, Shannon, and Talia — they all helped me!
VF: What is an important thing you can do to succeed as a parent and physician? Set boundaries!!!! Family time is sacred. Protect it.
KL: Take time off with your kids when they have school breaks — do things with them, and try to consciously put the Mom before the MD.
JC: I think it’s important to realize that trying to be the perfect parent or physician is a recipe for disaster. There are too many unknown variables that can upend whatever plan you had for that day, so it’s best to remain flexible.
LB: Outsource, hire, and accept help. Let colleagues cover your inbox and patients. Use your paid time off. Challenge the status quo that doctors don't take sick or personal time. You can set a positive example for others that way. Plan time for self-care, especially restorative creative experiences. Get a therapist. Do all this without guilt.
JT: The specialty practices what we do as moms. We care for our kids from newborns through their lives. Illnesses, development, mental health issues, sports, and more. Your experience as a physician will help you as a mom, and your experience as a mom will help you practice family medicine.
VF: Family Medicine is an amazing specialty in that it allows a physician to change practice scope during the various stages of their careers and lives. You are also more likely than many other specialties to find yourself surrounded by empathetic and compassionate individuals who understand the importance of family.
KL: Because for the most part, we get it. We understand growing families from pregnancies through old age. Family docs can be some of the most supportive colleagues to have on your side! Also, we can go through different seasons as family docs — part-time, full-time, broad-scope, limited-scope as needed for our families to function well.
JC: Family Medicine is a good specialty for those who wish to have a family, because we are at the forefront of trying to change medical education and make it more family friendly. Of course, there’s the added benefit that you will learn not only about pediatrics, but also obstetrics. Essentially, you will be as prepared as you can be to become a parent if you choose Family Medicine as your specialty. And then you will be able to take those skills that you’ve acquired from your training and personal experience in service of your patients of all ages.
LB: There is joy in being professionally grounded in a discipline that promotes family. A career in Family Medicine has more freedom than most jobs — it allows pivots to complement phases of life and motherhood, including geographic pivots, new focus areas, teaching, leadership, research all practice types, and either full- or part-time.
A version of this interview appeared in the Winter 2023 Issue of The North Carolina Family Doctor.