How new physician parents navigate practice

It’s challenging enough to navigate a job search for yourself or with a partner. But add family needs to the hunt or career-building mix, and those challenges expand exponentially. You’re looking at opportunities not just as a skilled physician, but as a concerned parent, too.

So how do you launch or further your career with children in tow? By being strategic, you can achieve both a satisfying job and secure home life. Four physicians share how they’ve handled the challenge—with advice for you.

Priorities, planning, putting family first

Merging careers and children takes more than hoping for a family-friendly culture. Being very specific first about your priorities—planning well in advance and standing firm — can help you find a job that fits your bill.

For instance, long before Ryan Zimmerman, D.O., and Lisa Zimmerman, D.O., settled into their respective roles as internal and family medicine physicians for Tower Health, they determined that marriage and family always would take precedence over career, not the other way around.

So, when Lisa matched at Reading Hospital for a family medicine residency, it was a no-brainer that Ryan would try for internal medicine a year later. “We came as a package deal,” she says, suggesting that if there wasn’t an opening for him, the residency situation wouldn’t work for her.

Their planning paid off, not just because they trained in the same place and could start a family, but because Tower Health, Reading Hospital’s mothership, turned out to be their home for the long term. “We started with priorities that would allow us to participate with our family,” Ryan says, “and then looked for jobs that fit that bill. We were lucky that we just stayed here.”

Culture resonates

What has impressed the couple? Administrators made it clear from the get-go that family was extremely important to the organization. Indeed, Tower Health offered an environment that would support them in welcoming their three sons along the way. Lisa was impressed by the number of female physician leaders who were combining family and medicine successfully, confirming that she could do it, too. Tower also offered parental leave and other features conducive to raising families.

Beyond that, the Zimmermans would benefit from the organization’s tendency to retain residency graduates. By having access to a steady stream of early-career physicians with young children, they wouldn’t just have colleagues—new and near retirement — with whom they could compare case notes. They’d also be surrounded by people who recognize how scary it is when your child spikes a fever in daycare and your appointment book is full. As Ryan notes: “Working with people who are in there with you— and have been there too — creates a lot more stability and support.”

Practical choices

The Zimmermans recognized early on that, as new parents figuring out the nuanced responsibilities of raising children, they wanted to be near relatives. It was also critical to have similar workday and weekend hours, which they’ve finally accomplished by lassoing traditional Monday-through-Friday office schedules.

As a residency faculty member, Ryan enjoys a bit more flexibility during the day while still contending with early-morning conferences and late-evening meetings. Although Lisa has some evening hours, she’s managed to protect her weekends by taking call one week out of each month.

It’s been a great accommodation for someone who chose outpatient medicine so that she wouldn’t be obligated on Saturdays and Sundays. “I work hard during the day, and I’m still doing work at night after the kids go to bed,” Lisa says. “But my weekends are mine. So, we have lots of family time.”

But how has cultivating that time affected their careers? It’s all about priorities and choice. Ryan, for instance, nixed doing a cardiology or pulmonary critical care fellowship after discovering during residency that he loved primary and continuous ambulatory care. But his bigger consideration? “My family life was paramount to any specialty.” So, becoming an academic outpatient internist (who now teaches both residents and medical students) “was a simple, easy and correct decision.”

As for Lisa, when the right opportunity — working with Drexel University College of Medicine students — recently came along, the timing was right to pursue her love of teaching and mentoring. “It’s given me another outlet for career growth, which I was ready for at this point.”

Advice that counts

The Zimmerman’s advice can be summed up simply: Figure out your personal and family priorities first and then find a career that facilitates what you want and need rather than the inverse. “You truly have to think about what is most important to you, and for us, that’s faith and family,” Lisa says. “So how can we make work allow for that?”

Ryan agrees, noting that when his residents mention pursuing another specialty or sub-specialty, he’s quick to remind them that their commitments may interfere with quality family time.

As for discussing your family plans during an interview, you can expect future employers to tread lightly, given that being too inquisitive can be considered illegal. But don’t let it be the elephant in the room, especially if your plans have a direct bearing on your work expectations. Be honest and forthright.

Also, ask for the name of another early-career physician willing to share strategies. “It’s strangely isolating and a little bit intimidating,” Ryan says of starting parenthood while launching your career. “It should be this joyful moment when your family is finally coming together. But it’s stressful just trying to keep the baby alive, let alone navigate HR policies and other intimidating things. It just works better with peer support.”

Flexibility eases the stress

Even with your priorities in tow, merging family and career can still be complicated. Obviously, you want to create the least stressful situation with the most beneficial outcomes for both your family and your career. But achieving those objectives can be tricky, given conflicting factors in play. How can you topple the roadblocks? By adapting quickly and adroitly.

For instance, long before Lauren Nicola, M.D., became the current CEO of Winston-Salem, North Carolina-based Triad Radiology Associates, she was very familiar with the parenting ropes. By the time she accepted her first position — as a pediatric radiologist and Wake Forest University faculty member—she’d already navigated training with two daughters, the firstborn in residency and the second in fellowship. So, when a third daughter arrived during her first year as an attending, Nicola was somewhat of an old hand at blending family and work.

She approached the situation with her general attitude: “Just go with the flow and base your decisions on the cards that you’ve been dealt. Then go for it and make it work.”

So how has she done that? By being flexible in all things. Nicola and her husband, also a radiologist, have modified their approach when necessary, engaging both great daycare teachers and super-helpful sitters along the way plus tweaking the routine when it’s a must.

Although their nanny has been a lifesaver, especially in getting kids to and from activities, Nicola credits a caring and helpful partner in bringing things together daily. “It takes a village obviously,” she says. “But having a spouse who’s supportive around the house, supportive of your career, and supportive of parenting, is key. It just makes a world of difference.”

Career, children flourish

When Nicola was ready to switch from an academic role to private practice, she managed to uncover the perfect opportunity close by. Her chief goal was to find a position better suited to her interests, particularly the chance for an ownership stake.

Yet family and geography were certainly major considerations. She wanted to stay in Winston-Salem, where she not only had deep training roots, but an established family. The community has features that are right down their ally: continued access to good childcare and public schools plus a nice, laidback neighborhood. “I was lucky to have trained in a place that was also a really great place to live.”

Triad Radiology Associates, the group she joined in 2015 and now leads, not only allowed her to continue the next phase of her career but did so in such a way that her very active family, including her three daughters and two stepdaughters, wasn’t disrupted.

More importantly, she feels empowered as a mother because she’s happy as a physician. “At the end of the day, the most important thing is that you feel satisfied and happy with what you’re doing for those eight to 12 hours,” Nicola says. “You’re a better mom when you come home than if you just were trying to sculpt a position by checking off some boxes for whatever your criteria.”

As to their children, they’ve become somewhat independent, learning to make their own lunches and entertain themselves if Mom and/or Dad are tied up with work-related tasks. They also often travel with her when she gives health policy talks on behalf of the American College of Radiology. They may be “bored out of their minds, but they still like seeing what Mom and Dad do at work,” she says. For her part, it’s just satisfying to show them that she’s doing something for the greater good. “You can see that they’re excited about it,” Nicola says. “I really like that facet of it as well.”

Practice pays it forward

As to helping others, Nicola and her colleagues believe in workstyle flexibility, particularly when it involves scheduling and pay. To make good on their word, they’ve established various ways that the practice’s 52 radiologists can control how and how much they work.

For starters, they’ve instituted a “somewhat unique” model that allows physicians, even within the partnership, to cap their work time — and ultimately their salary —based on their needs. They offer a minimum of standard core shifts, including weekends and after hours, to service a mix of outpatient imaging centers and hospitals, six of which are under the umbrella of Triad’s largest partner, Novant Health.

They’ve then paired those shifts with a “ton of moonlighting” opportunities for physicians eager to up their income by simply volunteering. If they still want to maximize their time at home and are OK with “a little bit of a salary cap,” they don’t have to sign up for any extras. “For the most part, that’s worked really well for us,” Nicola says. “People have appreciated the flexibility rather than a one-size-fits-all compensation package and time off.”

As to other features that might free up one’s time, Triad not only offers a variable vacation plan plus tracks for physicians who don’t want to take call or work nights and weekends, but also expanded remote work capabilities. Obviously, the practice still needs radiologists onsite. Yet, there’s a great volume of work that can be done elsewhere, which is good news for employees who relish trading the hubbub of the office for the hubbub of home. In fact, some Triad physicians don’t even live in North Carolina, but still operate full-time from another state. “So, we’re giving people a lot more options,” Nicola says.

Advice that counts

Like her colleagues, Nicola advises new physicians that making a successful career and family decision usually starts with serious soul-searching. You want to focus on what you want, without measuring it against the opinions of others.

Pay attention to the practice environment, particularly those future co-workers you may call colleagues. Having a sense as to who they are—and how helpful they could be in a pinch — can be more important than hearing about work specifics. In fact, too often, Nicola says, physicians are so stuck on the nuances of the job, which admittedly are key, that they ignore the culture of the group.

“If you’re working with bad people, it’s not going to go well,” Nicola says. “So, knowing the team and feeling comfortable with it, is huge.”

Nicola will never forget, for instance, the older partner who stepped up during her first year in private practice to cover Christmas Eve call so that she could be home with her children. It was “breaking my heart,” she says, that she’d miss a visit from Santa, until her colleague—with a family of his own, albeit no small children—offered to work for her. Hearing that she could pay him back later or pay it forward when she’s older, she thought, “Oh my gosh, I just won the lottery.”

Solo shift suits family

Knowing that someone has your back at work is a definite plus when you’re trying to raise a family and take care of patients. You likely have high hopes for colleagues willing to cover for you from the same or a similar boat. But sometimes it takes changing trajectory to have support in the wings.

For instance, when Dana Reddy, M.D., accepted her current San Diego-based role with Bristol Myers Squibb, she finally landed the type of remote hybrid position that would help her blend her experience as a rheumatologist with her commitment as the mother of three.

The best news about her job, which focuses on medically monitoring a lupus trial, is that it draws on her clinical skills and fits her workstyle to a “T.” She’s tethered to an organization that provides the opportunity and support, but also allows her freedom to work from home.

It’s not the first time that Reddy has been autonomous. As a solo practitioner just out of training, she relished working on her own. “I didn’t have a big network to answer to, so I was able to have a variety of experiences,” she says of treating underserved patients, often severely diseased, and even conducting small clinical trials, too. “It was great being alone.”

But with only three weeks of maternity leave, she learned quickly that blending a solo practice and new family duties, even with Mom in the wings, was simply not doable. In fact, “it was horrible,” she says, of caring for a newborn while handling sick patients and clinical trial deadlines. It was so debilitating that one year to the month of her first son’s birth, she handed off the practice to someone else.

Job changes fit family

In finding her way from that point to Bristol Myers Squibb, Reddy took a varied path including positions at both a contract research organization (CRO) and a local biotech firm.

Although neither involved direct patient care, both offered the kind of remote work flexibility that allowed her to do what she wanted to do with time and space for her children.

So, when she sensed that the smattering of CRO business trips she was taking prior to COVID was going to ramp up post-pandemic, she was more than willing to move on. “You don’t really think of that when you don’t have kids,” she says, “but being away from them is not particularly easy.”

Today, Reddy can draw on the patient care skills she’s honed, not just from her solo practice days, but afterward, too. By keeping her foot in the clinical door, including short in-person and telemedicine stints before Bristol Myers Squibb came calling, she increased her usefulness to trial participants. “They don’t want to be talking to somebody,” she says, “who hasn’t seen a patient in a decade and has no clue what they’re talking about.”

Practical solutions work

Even though she still must spend a portion of her time in her company’s San Diego office, Reddy says the “hybrid” portion — working from home — makes caring for her job and her children very doable. Yes, she must be available remotely in-office and remotely. But she’s no longer on the road, finding clinical trials to run. Instead, she’s managing one in-house.

That frees her to do the things that moms do, like taking her son to class two days a week and even sitting in on the activity. To close the childcare loop, Reddy and her husband rely on a full-time nanny. And if there’s ever a gap, she has grandparents on speed dial.

What’s more, her employer offers a variety of family incentives, including a nanny on-call. If their caregiver calls in sick or preschool closes on a random day, she has access to someone else in a pinch. As to engaging trustworthy caregivers: “It’s a very short period of your life when you’re going to have to shell out this much money, but it’s worth it.”

Advice that counts

Whether you’re looking for a first job or advancing your career, Reddy suggests never underestimating your own worth or fear acting on it. Besides being confident in your skills, you want to be bold in saying “No” when it’s necessary, “My plate is full,” when it’s appropriate, or “This is what I need” when it comes to yourself and your family.

You may love your job but don’t underestimate the emotions tied to having a family or the desire to change priorities once you’re parenting. It may be suddenly ok to work three days a week for the next seven or so years and take the financial hit, just to put family first.

Whether or not it’s been difficult to turn your partnership into more than just the two of you, you likely share Reddy’s attitude toward that time. “I don’t want to be away from them,” Reddy says of her children. “I want to be with them.” •