Paid family leave ‘one important step’ to addressing equity in health care
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This month, we focus on the struggle within health care to adjust to the “tectonic shift” in paid family leave.
Paid family leave in the health care sector is as much about the humanity of those who work within that sector as it is about equity — equity for those who bear children, equity for all who parent children, and equity in the outcomes, compensation and career advancement of all involved. The recent shifts in designating paid family leave for employees recognizes the important impact of this protected time for parent and newborn.
As stated in this month’s cover story, featuring Orli Cotel; Rita Hamad, MD, PhD; Isabel Huang, MD; Shikha Jain, MD; Santina Wheat, MD, PhD; and Deborah F. Weinstein, MD; there are clear benefits to the child, the parent and the employer.
In some countries, 6 to 12 months of paid family leave is standard, while in the United States 12 weeks is considered customary. This time is essential for the physical and emotional health of the mother, the bonding of the newborn to their parent(s), and the establishment of the newly formed family unit. I still recall the physical, emotional, intellectual and familial adjustments required with the birth of each of my children. The time spent together during those early days is crucial to the wellbeing of the family.
We are taught to advocate for our patients, but this must extend to when we, the health care providers, become the patient.
Paid family leave sits within the broader discussion of equity for those who choose to have or parent children. For too long, the work of childbearing, and child rearing, has been shouldered by the mother, and the ramifications extend beyond the post-partum period. The “cost” of lost time due to illness, schooling and the extra-curricular activity of the child is additive and often persistent.
This broader discussion of equity must be addressed, as the negative consequences for women in medicine can persist for a lifetime and throughout their career. The well-documented drop-off among women in higher positions of leadership is often tagged to “her time away to raise children,” or the idea that she might take time off to have children. The economic consequence is experienced by many as the “gender pay gap,” and adds to the career consequence of the “glass ceiling.”
Correcting this requires structural change on multiple levels but normalizing paid family leave is one step towards reducing this inequity.
Paternal leave is a more recent acknowledgment of the rights and desires of the non-childbearing parent to participate in the care of their child. As Dr. Weinstein so aptly stated, “Parental leave needs to apply to all parents, regardless of gender and whether or not a parent is the primary caregiver, for all of the reasons that parental leave is important.”
Normalizing paternal leave has major potential impacts on many levels: Removing gender bias in childcare, erasing the stigma of paid time after childbirth, and closing the gap in promotions driven by the biases surrounding childbearing, to name a few.
However, equitable outcomes also require that paths are created to incorporate the individual following their paid family leave. Trainees need to “catch up” on learning, and junior faculty may need assistance re-entering the clinical and research promotion tracks. Private practice practitioners may face economic burdens created by accrued overhead costs during the time away, which must be proactively managed.
Failure to do so runs the risk of making paid family leave an unattainable reality for many who have dedicated their lives to caring for others, but are then unable to care for themselves and their offspring, when they most need it.
The COVID-19 pandemic has highlighted the fact that inequity comes in many shapes and forms. Recognizing the humanity within our health care heroes is the first step toward addressing the bias experienced by many in health care, from student to retiree. Paid family leave is one important step forward on this path to equity.
- For more information:
- Grace C. Wright, MD, PhD, is a member of the Healio Rheumatology peer perspective board, founder and president of the Association of Women in Rheumatology, and owner and president of Grace C. Wright, MD, PC.
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