Summer Dilemma for Working Moms

Author: Sarah Zaheer, MD

The summer dilemma for working moms is real. With schools no longer in session, a lot of meticulous planning and thought goes into ensuring that children are engaged in meaningful activities while their mothers or primary caregivers work. For a lot of us, this process starts as early as January, when the registration for summer camps opens. Every year, despite extensive plotting there are always last-minute hiccups in the plans. As the children get older and their interests evolve, this process often gets more complicated with multiple pick-ups and drop-offs that need to be coordinated. It is a complex dance, which all parents are familiar with. 

If you have a partner who manages all of this for you and you have no idea what I am talking about, please let them know right now how much you value their efforts. Over and over.

To be fair, this is an issue for most working parents universally. There are lots of proposed systemic solutions and approaches and a whole spectrum of opinions. As a DPC doctor, I feel incredibly privileged with the flexibility my job provides in being able to navigate through this.  

So much so, that it feels surreal at times. Almost 3 years into my DPC practice, I can fully appreciate the autonomy the model offers to adjust my schedule as I see fit. It must work for me, and it must work for my patients. Those are the only rules.   

Being able to fully integrate my caregiving roles and physician identity was a significant factor in becoming a DPC doc, as is the case for a lot of us. Every year I almost forget this, but it is unreal how DPC makes a career in medicine work for me while offering patients superior care. 

I had originally envisioned my children spending time in the office while I saw patients. As well behaved as my children were and as understanding as my patients were, very quickly I realized that is not an ideal setup for me. For me, that is the key point.  I get to decide what works for me and what does not. In DPC, there are many, many ways we can restructure our days.

It is old news that remote care is a vital feature of effective primary care. When the financial incentives are no longer tied to office visits, office visits become more about what is safe, efficient and necessary for the patient.  Having a solid longitudinal relationship with patients, based on mutual trust and respect, allows me to leverage remote care appropriately. This saves patients time and energy but also eliminates the need for back-to-back office visits. Thus, my day is structured very differently from a traditional practice. 

In a fee-for-service set up, the limited time often prompts us to overprescribe and order excessively.  Many times those orders are dictated by insurance reimbursements and not always by what the patient truly needs. The note needs to be closed (for reimbursements) as soon as possible, but there is almost no time to determine if this “perfect on paper” treatment plan is actually going to work for the patient. 

In the DPC model, I have ample time to truly collaborate with the patient toward an effective treatment plan with my patient and then follow up to make sure that there is execution.  I make sure that the diagnostics are done in a timely manner, the medications I prescribe are affordable and accessible for the patient and finally does the plan work or not. If it does not work, we swiftly move on to the next steps. The patient does not have to wait weeks to see me. Through this all, I get a much clearer view of their logistical challenges, their health beliefs, their preferences and health goals.  Appropriate use of asynchronous secure messaging allows me to do all this and to structure my office hours in a way that works for all parties involved. 

All of this to say that there are unlimited ways to make the summer work for me, my kids and my patients. Somedays I am in the office earlier in the day, some days I am there later in the day and some days I am not there at all. Yet, I am more accessible for my patients than I was when I did 40-hour weeks, with standard 8-5ish sessions. I have more time to be present with my children and witness the magical process of them growing up. I am still able to take care of myself and no longer feel like a hypocrite when I counsel my patients on healthy lifestyles. 

Of course, there are hard days because a career in medicine is not roses and rainbows. Of course, a part of me is eagerly waiting for school to reopen like a lot of parents right now. But it is a far cry from the survival mode days that we had accepted to be the norm for primary care. This is what thriving looks like.