Winning at parenting without losing yourself [PODCAST]

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“As working women, we have an opportunity to be an example of living with passion and priorities, of working hard, of staying committed, not necessarily to work itself but to the priorities we set around our work and our personal lives. When we work and parent simultaneously, we have a chance to teach our kids resilience — letting our kids see that even if they struggle with something they can handle it and get stronger from it — and to embrace a village mentality, not in a better way than stay-at-home moms can but in a very different way.

Above all, we have the unique pleasure of encouraging our own kids to find real balance and real joy as they live their lives and as they go on to work and parent the next generation.”

Whitney Casares is a pediatrician and author of The Working Mom Blueprint: Winning at Parenting Without Losing Yourself.

She shares her story and discusses her KevinMD article, “Winning at parenting without losing yourself.”

This episode is sponsored by the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Would you like to help communities recover from the opioid epidemic? If you said yes, and you are a behavioral health professional or paraprofessional, then I have great news for you. Receive up to $250,000 in student loan repayment in exchange for service in a community disproportionately affected by the opioid crisis. Learn more and apply to join STAR LRP, the Substance Use Disorder Treatment and Recovery Loan Repayment Program. Applications close on July 22.

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Hosted by Kevin Pho, MD, The Podcast by KevinMD shares the stories of the many who intersect with our health care system but are rarely heard from.

Transcript

Kevin Pho: Hi, and welcome to the show, where we share the stories of the many who intersect with our health care system but are rarely heard from. My name is Kevin Pho, founder and editor of KevinMD. Here on the show we have Whitney Casares. She is a pediatrician, and she wrote the book The Working Mom Blueprint: Winning at Parenting Without Losing Yourself. Whitney, welcome to the show.

Whitney Casares: Thank you so much for having me. It’s a pleasure to be here.

Kevin Pho: So we’ll get into your excerpt and book in a little bit, but first off, can you share your story and journey to where you are today?

Whitney Casares: I have wanted to be a doctor for as long as I can remember because, of course, like many of you all, I love science. I love all the nerdy aspects of it, and I also just love helping people. Originally, I thought that was going to be really helping children themselves to have the best health possible, and that is still my mission. But over time, I found that the moms I was interacting with in my pediatrics clinic actually needed help too.

I think, as we’re all discovering within medicine, when families thrive, and particularly when moms thrive, there’s this trickle-down effect to their kids, and we know that really impacts the social-emotional development of kids. So I started diving into that and thinking about how I can help moms to feel like they’re winning at parenting without losing themselves. It led to one book with the American Academy of Pediatrics about helping moms in that newborn period to care for themselves, and then the second book that just came out, which is about working moms and helping them to avoid burnout and to find purpose and intention, not live in that place of chronic stress.

Kevin Pho: Great. So let’s talk about that book. It’s titled The Working Mom Blueprint: Winning at Parenting Without Losing Yourself. Before you talk about the book, can you share some stories that you’ve experienced, either from your colleagues or friends, or what you’ve seen, that really were the impetus for your writing?

Whitney Casares: Yeah, absolutely. So I have a physician mom friend and colleague who’s an infectious disease specialist. She’s very highly trained, has a great reputation, and does amazing clinical work. She was telling me a couple of years ago about how she was part of this physician engagement event that was put on by her organization, and the event happened at seven o’clock in the morning, when she was trying to make toast and get her kid off to school. She said, “Gosh, they want me to be engaged and to provide great customer service for my patients and to be really mindful when I’m there in the clinic or when I’m thinking about my work, and the thing they should do is realize, first and foremost, I’m a person too. I’m a mom too, and I have all these different parts and pieces that I’m trying to balance at exactly the same time.”

And so, gosh, I felt like if someone like that, someone who really seems like they have it all together and can do all this juggling, is struggling, there must be tons of other moms out there who are doing the same. Time after time, I have moms in my clinic who tell me, “I feel like, yes, I’m able to burn the candle at both ends. I’m able to do that juggling act like a Jedi. But when it comes down to it, inside I feel like I am just a ball of anxiety. I feel like I’m chronically tired. I feel like I’m really not enjoying much of my motherhood experience.”

Kevin Pho: And tell me not only how that affects the clinician herself, but how does it affect patient care as well?

Whitney Casares: I mean, the thing is, when we’re burned out, we know that means we’re not going to be as focused in clinic. We’re not going to be able to be thinking about our patients and their needs in a way that is creative, in a way that really is super mindful. We know that our ability to care about what’s going on for that patient is diminished. We know that our patients are able to see really clearly. We can put on a mask for so long, but they can see over time, “Man, this person doesn’t really care about me. They might just be checking off boxes.” And so it makes it so that the patients can see that they’re less engaged, and it makes it so that they feel less satisfied in their work at the end of the day.

Kevin Pho: All right. So you wrote a book addressing this, The Working Mom Blueprint: Winning at Parenting Without Losing Yourself. Now, for those who didn’t get a chance to read that excerpt, tell us a little about the book.

Whitney Casares: So the book is really about strategies for mom herself in terms of taking care of herself. We know that a lot of times, organizations for physicians or clinicians will talk about, “OK, here are the things you need to do if you have a patient that’s troublesome, if you have maybe an angry parent that comes into clinic, if you have an angry patient. Here are the ways you can kind of mitigate that really high-stress situation.” But they don’t talk about the root of the problem, which is making sure you’re taking care of yourself so you’re not at that edge where you’re more likely to engage in maybe a more tenuous situation or not be able to navigate that more clearly.

And so the book talks about ways that moms, and working moms in particular, and physicians are like the perfect audience for this, can actually take care of themselves in a sustainable way. Then it also talks, because it’s written with the American Academy of Pediatrics, about ways to take care of our kids. So it talks about: How do we streamline meal prep for our kids? How do we deal with school obligations that come up? How do we deal with screen time for our kids? Because a lot of us, especially this year with COVID, found, “Man, if we’re working from home, we have to distract our kids somehow.” So how do we deal with that, working at home alongside our kids?

And then it also talks about behavioral issues with kids. What are the root causes? What are the things that we as moms, as parents, can control? And then what are the things we need to think about that aren’t about maybe the basics, like sleep and exercise, but more about our connection with our kids? How can we build special relationships with the people that we love the most, even if we might not have that huge quantity of time that other people have?

Kevin Pho: So of course, during the pandemic, there’s been tremendous pressure and stress on physician parents, not only from the clinical side but, as you said, at home as well. Now, from your book, what are some of the biggest actionable tips that you could share with the physician parents who may be listening to this?

Whitney Casares: So number one is to parent out loud in your clinical practice or within your clinical system, right? If you are a parent, male or female, make sure that you’re not quiet about the obligations that you face with your family at home. Because the more that we all parent out loud, especially those of us in senior leadership positions, and I’m on the executive committee within my organization, the more that normalizes it, and the more it makes people aware that that seven o’clock meeting actually doesn’t fit for about half of the population. That creates culture change and policy change. It helps to move things forward.

The second is, of course, to give yourself tons of grace and to practice mindful self-compassion. So this idea of when we get to be that harsh critic, which a lot of us as clinicians are very well trained to be, and we practice that in our minds, if we’re maybe not able to spend as much time with our kids or feel like we’re kind of not doing everything well while we try to do everything: being that good, positive inner coach versus the person who is super mean and harsh with ourselves.

And then the third is making sure that you’re setting aside time for yourself and with your children that are about not having performance things, that are about, “OK, what’s the thing that I love to do?” Even if it’s five minutes in the car before I go into my house, right? I’m a Justin Bieber fan. I’m a believer. So me listening to five minutes of Justin Bieber in the car, that gets me in that good, healthy spot mentally before I go into my house with my kids. Instead of adding on that fifth or sixth extracurricular activity, take a pause and say, “You know, maybe it’s better if we just spent a moment cuddling up on the couch and reading a good book.” So take time throughout the day, and then also take those times to pause and reflect and say, “What’s the thing that actually is going to serve me and serve my family and then, in the end, serve my patients in my clinical practice?”

Kevin Pho: So I want to follow up on that first tip that you said, parent out loud. I have two teenage daughters. I have a high school daughter, and I think that what you said makes complete sense in terms of managing both my home life and my clinical life as well. But there’s a perception out there that physicians should only focus on patients and what goes on in the clinic or in the hospital, and that causes a lot of doctors to be a little bit tentative to, as you say, parent out loud, because they fear that administration is going to think that their priorities are misplaced. Now, what kind of tips can you give to physicians to help them parent out loud?

Whitney Casares: Well, I think number one is, if you are not in a position of leadership yourself, aligning yourself with people who are in positions of leadership, who are parents as well, and who share your similar commitments. So for example, there are plenty of junior partners within my practice who wouldn’t feel comfortable raising a hand to say, “I can’t do that because I have a child care need,” or would feel like they’re being seen as a lifestyle doctor if they were the one to say, “I need to leave at five to go pick my child up from child care.” But I’ve been there for 11, 12 years, and so as a senior leader within my organization, if that person comes to me and tells me what their struggle is, I can advocate for them, I can start to talk about my own times of conflict that I have, and I can be a voice at those top senior meetings. So I think that’s number one.

Number two is developing a culture of having someone like an HR representative that can work alongside you, where you can go to someone who is trusted and isn’t going to be someone who will potentially be looking at you in a way that is negative or saying, “I guess we should pass that person up for opportunities.”

I think the third is, as physicians and as clinicians, I’ve always been thinking: Yes, it’s true that we fear kind of retribution, maybe from our colleagues or from administration. But I always want to stop, to pause, and say, “You know, I am someone who is highly educated. I’m someone who works hard. There’s no reason that it should be that I work and pretend like I’m not a parent there, and I parent and pretend that I’m not someone who works. And so I deserve, actually, to have my voice heard. Someone who’s an administrator, though they’re awesome and lovely, I’m just as valuable as they are, and my voice matters just as much as theirs does.” And it won’t change until we start raising our voice a bit, being a bit louder, even in small, incremental ways.

But I totally get it. I’ve been there as a junior partner myself, or not even as a partner, just as an employee, to say, “I don’t want to say something. I think maybe they’ll look at me in a negative light.” And so if you’re in that position, I would say align yourself with someone who is more of a senior leader and has taken steps before you.

Kevin Pho: So let’s say a physician does all the actionable tips that you previously gave, yet still feels that they can’t handle both the home and professional aspects of their lives. At what point should they consider cutting down hours clinically, going part-time? Because I feel a lot of physicians think that leaving medicine altogether is their only choice. So tell me about some of the incremental steps in between.

Whitney Casares: The signs that maybe you need to take a break and take a step back, maybe not fully leaving medicine but at least giving yourself a little break from the daily grind, are when you’re with your patients and they’re talking, and you’re feeling like, “You could just keep on talking, but I don’t really care.” If you are having more altercations with patients than you’re used to having, if all of a sudden you’re getting complaints when usually you would never get complaints, if you’re finding yourself on your edge all the time with your clinical staff or with your partners or with your patients, you feel like, “I’m just on the edge of kind of anger or about to explode.” So those are the signs.

And then a few things you can do is to decide, “OK, I’m going to take some time for myself, where maybe I’m going to have an alternate schedule. What’s the most stressful time in the morning for me, for my kids?” I decided this past year with the pandemic that it doesn’t work as well for me to leave early at the end of the day, for obvious reasons, right? People don’t usually like it if you’re the one who leaves early. But it did work for me to start later. And so what I would do is, on two days a week, say, “OK, I’m going to start at nine o’clock instead of eight o’clock, and I’ll work until six o’clock on those days.” So making an alternative schedule made it so that I could be with my children in the morning. I could get them to school. I had a little bit more time in those hours.

The other is, if there is something that you’re passionate about that’s outside of medicine, or kind of quasi-medicine, to spend some time pursuing those passions. I know for me, Modern Mommy Doc gave me so much more energy when I did my clinical work. When I was feeling burned out, to have this other project I was working on that really mattered to me, I felt like it was my vision for my life and really fit with my mission and purpose. And then, as that got going, I actually cut down on my clinical hours. I went from working four days a week in the clinic to three days of work in the clinic, and that really gave me the space that I needed to feel like, “OK, now when I’m in clinic seeing patients, or at the hospital seeing babies, I’m all in,” because I had this other time to work on the parts and pieces of me that I really care about.

Kevin Pho: I talk to a lot of doctors, and, you know, you mentioned a side gig or an interest outside of clinical medicine, and paradoxically, that actually made them more committed to what they were doing in the exam room. Now, I feel all the doctors still feel a little hesitant doing that side gig. You know, they think that physicians should be seeing patients pretty much all the time while they’re working. Now, tell me some steps that you took to really kind of take that step back and really blend what you did outside of the clinic and what you did inside the clinic.

Whitney Casares: At Modern Mommy Doc, we talk about this concept of the centered life blueprint. The basics are, basically, if you and your life, the things you care about the most, are a circle, there are all these things outside the circle that have to get done that don’t really matter, right? Like your social obligations and the laundry and maybe being on that fourth committee at work that you don’t really care about. And then in the circle, it’s kind of your centered vision for your life: When I’m 80 years old and I look back on what I want people to say about me and the things that I spent time and energy on, what would those be? And for me, those five things include patient care, but they also include contribution to women in general and helping moms to thrive. And so there’s nothing wrong with me having those two parts of me be directions that I’m working on over time.

I think, you know, we do have to flip the script mentally, and I had to work alongside a life coach, alongside a therapist, to be able to kind of redirect my thinking, or re-analyze why I was so hung up on just the physician part. But there’s absolutely nothing wrong with us as physicians having additional parts of our lives that matter to us. I think there’s this old-school philosophy and kind of teaching that because you were privileged enough to be given the position of being a physician, then you should be 100 percent with your patients.

But the reality is, for me, financially, the compensation at my pediatrics practice is good, but it’s not actually even as good as some of the other parts and pieces that I do outside of that. The student loan debt that I accumulated from going to medical school, that was a heavy burden. So while it’s absolutely my privilege that I get to be in a room and that people trust me with their deepest secrets and their biggest problems and their heaviest burdens with their children, I do not have to be a martyr for them, because my life is mine. And at the end of the day, when you’re 80 years old, you are the only person who’s accountable for how you spent those years. You let the pressures of the world, or a society, or the, you know, kind of medical construct tell you how you’re going to live your life, gosh, you’re going to be disappointed at the end.

Kevin Pho: We’re talking to Whitney Casares. She is a pediatrician, and she’s the author of the book The Working Mom Blueprint: Winning at Parenting Without Losing Yourself. Whitney, my final question: What’s your take-home message that you want to leave with the KevinMD audience?

Whitney Casares: As working moms, as working parents, as physicians and clinicians in general, you cannot decide all the things that come at you. We know that, especially in medicine. We can’t control the patients that come in. We can’t control the problems that come our way in our personal lives. But we can decide, in the big picture, where we want to place our time and our energy. And when we do that, and take control of how we want to expend all those precious resources that we have and only we can control, we can honestly change the world in big ways, in ways that do not burn us out and make us feel like, “What’s the point?”

Kevin Pho: Well, thank you so much for sharing your time and insight, and thanks again for being on the show.

Whitney Casares: Thank you for having me.

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