Throughout this series there’s been a recurring theme: a lack of data and research around mental health and private practice ownership. We have established that the role of a private practice owner is unique from that of an associate due to the many practice management roles an owner needs to fill. The challenge, often, is that the work does not end just because the office closes for the day, which can potentially blur the lines between work and home responsibilities. The burden on physician-mothers is even greater.

It is well-established in most societies that women assume more responsibilities in the home in a traditional family unit; these responsibilities only expand as a private practice owner. In fact, a study comparing the domestic roles of female and male surgeons found that females assume more parenting and domestic responsibilities, potentially negatively affecting their career advancement.¹ This article focuses on motherhood, medicine, and private practice ownership, and offers real-life advice from a licensed psychotherapist.

ADDING CHILDREN TO THE LIFE EQUATION

A national retrospective, systematic review from 2020² highlights the challenges women in medicine face and assesses how their career paths may change when deciding to have children. According to one study, 64% of female physicians delay having children to prioritize their career³; another found that 82% of women decide to have a smaller family due to the challenges of being employed in the medical workforce.⁴

The COVID-19 pandemic evened the playing field for all physician-mothers across various practice settings with one common denominator: challenges finding childcare. Gender disparities were further highlighted during this challenging time, with more physician-mothers voluntarily reducing their work hours compared with physician-fathers to stay at home with their children.⁵

IS PRIVATE PRACTICE THE ANSWER?

Challenges not only arise from finding an appropriate blend of work and home, but also from a lack of resources to assist mothers in achieving a balance in both.²The question again arises: Is private practice ownership the answer to the challenges that physician-mothers face, given its flexibility? I asked several female colleagues who are owners of private optometry practices to share their best coping skills for managing their practices.

“Relinquish the expectation that everything needs to be done today,” advises Jen Wademan, OD, owner of Bidwell Optometry in Folsom, California, and mother of two girls.

Amrita Kataria, LPCC, LMHC, MA, a licensed psychotherapist in California, says work-life balance is impossible, so prioritize what is important to your family. “Everything else comes in second, third, etc.” She coaches her clients to implement prioritization techniques (see Helpful Prioritization Techniques). Specifically, Amrita recommends private practice owners stratify their to-do list in the Eisenhower Prioritization Matrix, which can help strategize productivity in a finite amount of time. She recommends modifying this matrix as tasks are completed. Additionally, “Grouping similar tasks together is especially important for managing stress and reducing cognitive load,” Amrita offers. “For example, self-care and family activities should be blocked out together, even within one section of the matrix, alongside work-related activities in the same matrix.”

YOU CAN ONLY DO SO MUCH YOURSELF

The concepts of delegation and outsourcing have come up in other facets of practice management, and they seem to work in motherhood, too. Dr. Wademan admits that after too many ruined vacations, she now delegates staff calls and requests to her capable office manager.

Amrita considers outsourcing an important tool in delegating home-related tasks. She recommends delegating easy, time-consuming tasks, such as grocery shopping and housekeeping, first. In their search for these local resources, her clients are also successful in finding support groups of working mothers who share recommendations and organize activities. This not only benefits the children, but also the mothers. Embracing technology can also facilitate appropriate time management through the use of calendars and automated reminders.

That said, sometimes work emergencies do take priority. Inna Lazar, OD, mother and founder of Greenwich Eye Care in Greenwich, Connecticut, and the Dry Eye Institute in Darien, Connecticut, says enlisting the support and understanding of her family unit makes it easier to prioritize work emergencies during family time. “They recognize the demands of my job and the importance of being available to those in need, even if it means our time together is occasionally interrupted. Admitting that my work often takes priority is difficult.”

Mother of three Jalene Haynes, OD, owns and manages three large practices in Florida, where she oversees more than 30 employees. She describes an unfortunate but common scenario from a recent Monday morning: “It’s barely 7am, and I am focused on making sure my three children are ready for school. Do they have lunch, backpacks, and brushed teeth? At the same moment, I receive a message from an employee that their child is ill, and they can’t make it to work. Instead of being able to fully focus on my children, I am forced to drop my role as a mother and assume my practice owner role, making urgent last-minute decisions. I handle the urgencies as they come, but otherwise, practice matters can wait during family time.”

MAKE FAMILY TIME MEANINGFUL

Amrita states that the power of setting realistic expectations and practicing self-compassion is undermined. She recommends that if there is a known stressor (ie, a period without adequate employees or the launch of a new product), doctors write down specific self-positive statements about what they have achieved and practice self-compassion. Oftentimes, physicians must accept that managing work and life responsibilities will have seasons.

Upon opening her cold start practice, Jennifer Shaba, OD, owner of the Dry Eye Healing Institute in West Bloomfield, Michigan, says, “It was challenging not being home a lot in the beginning, but you have to be patient with yourself. It’s easy to feel guilty about not spending enough time with your kids, but it’s quality over quantity.” Amrita believes this is a great example of self-compassion—allowing flexibility and understanding that the priority is quality time spent with your children rather than the quantity of time.

There is something to be said about motherly guilt. After 14 years of private practice ownership and motherhood, Janelle Davison, OD, owner and CEO of Brilliant Eyes Vision Center in Smyrna, Georgia, says, “I grappled with the reality that I couldn’t be present for every moment, but I made those moments when I was present count. Gradually, my guilt waned, fueling my pursuit to be the best version of myself as a professional and a mom.”

Amrita dissects this idea further. “Creating routines and rituals for growing children reinforces connection not only for the children, but also for the working mom. Routines create predictability and stability, which reduces stress for both children and parents.” Examples of this are family dinner routines.⁶

STRATEGIZE YOUR ROLES

Private practice ownership is certainly not the answer for managing motherly guilt and work-related stress. Although the flexibility to set your own hours can undoubtedly improve quality of life, there are many added responsibilities that managing a practice brings about. Implementing techniques such as time blocking, delegating tasks, practicing self-compassion, and creating a stable home environment for children can all facilitate a more positive blend between motherhood and private practice ownership.