FEATURE ›› REAL-WORLD RETINA

BALANCING Family & Career

BY ERIN MURPHY, CONTRIBUTING EDITOR

New retina specialists put in long hours, and often aren’t in a position to dictate their schedules. If you factor in academic work or the dual demands of a two-physician household, where do you find the time for family?

If you have children, you already know a bit about the “balancing act.” If you’re thinking of starting a family soon, you might be wondering where you’ll find the “extra time” in your over-packed schedule to be the kind of parent you want to be.

Rest assured, others have been in your place. Read on to learn how some of your colleagues manage — and love — balancing career and family.

CAROL SHIELDS, MD, AND JERRY A. SHIELDS, MD

Career: Drs. Carol and Jerry Shields are Co-Directors of the Oncology Service at Wills Eye Hospital and Professors of Ophthalmology at Thomas Jefferson University in Philadelphia. Dr. Jerry Shields, founder of the Oncology Service at Wills Eye, is receiving the 2014 Laureate Recognition Award from the American Academy of Ophthalmology for exceptional contributions to ophthalmology. This is the Academy’s single highest honor. Dr. Carol Shields has received the American Academy of Ophthalmology Life Achievement Honor Award for significant contributions to the field of ophthalmology and is the current President of the International Society of Ocular Oncology.

Family: The Shields have been married for nearly 30 years and have seven children who range in age from 14 to 26.

THE SHIELDS’ STORY

“If someone had told me 30 years ago that I’d have seven kids, build a busy practice at a large hospital and write a steady stream of papers and textbooks, I would not have believed it,” says Dr. Carol Shields.

In college, Dr. Shields worried about whether medical school was a good idea. As a physician, would she have enough time for a family? But the draw of her chosen field was very strong.

“Jerry and I were married when I was entering my 30s, and I wondered if I’d be able to maintain a career and have a family. I had no clue what it would require to take care of kids, and I didn’t know if I’d have no kids or one or more. I took it one day at a time, and when it seemed right, we started a family,” she says. “We had our first three children in 1988, 1989 and 1990, and a total of four more every few years after that.”

Dr. Shields is grateful she chose to build her career and a large family. “I’m so satisfied with my choices. I don’t think having a family has hurt my career, and my career has still allowed me to have a close marriage and family. I’d never change a thing about my job or my family — both are treasures to me.”

CREATING A CAREER-FRIENDLY HOME LIFE

To have a home life that supports a large family and provides ample time for high-level careers in medicine, the Shields have followed strict schedules for decades.

“Our days are organized so Jerry and I can be home for dinner every night, and we’ve all had dinner together 99% of the time, 7 days a week,” says Dr. Shields. “I get to work at 6:30, and finish clinic by 2:30 or 3:00, so I can attend the kids’ games. If I’m not needed at home, I may stay at work a few hours longer, before heading home to cook dinner. Monday through Thursday are booked solid, and Friday is a research day, but I can also use it for a child’s medical appointment or parent-teacher meeting.”

Dinner is big at the Shields’ house, where candlelight, conversation and real food take precedence over TV, texting and takeout. The Shields also make it a priority to attend their children’s games and other events, and the family routinely plays tennis and skis together.

Of course, being home early is only part of balancing work and family.

“I think the most important part of balancing home and career is to have someone really good and reliable at home — someone you trust, who is good to your kids and gives them the attention they need,” Dr. Shields says. “We liked using a good daycare with our first and second kids. It was so predictable — drop off, pick up, stop by at lunch. If you have a few kids and you have a friend or family member lined up if they get sick, then I like that route.”

As the Shields welcomed more children to their family, they decided to finish an apartment over their garage and hired a husband and wife as a live-in nanny and housekeeping team. The team cared for the children, drove the kids to school, handled the laundry, cleaning and household repairs. Today, with just two kids left at home, the Shields have a part-time nanny and someone who does handy work and shopping.

“When daycare isn’t enough, live-in child care might be necessary and it’s not cheap,” explains Dr. Shields. “This is a real job — maybe the most important. We want people who are really good, and we don’t hesitate to pay them top dollar. Often the best and most professional people command top pay, and it’s worth the money. If we weren’t completely confident and happy with our childcare, we couldn’t have the careers that we have. The dedicated people who have cared for our family for many years are part of our success and happiness.”

BUILDING A FAMILY-FRIENDLY CAREER

“What more satisfying career could you have?” asks Dr. Shields. On a typical day at the clinic, she might see three to five new infants with retinoblastoma. “Working with these families is very meaningful for me. To help another family in need, particularly with a young infant facing cancer and blindness, and know that we can make a huge impact on this child’s life and vision, is amazing. I’m so proud to be able to do what I’m doing.”

Dr. Shields also has what she calls a “quirky, nerdy academic side” that pushes her not only to excel in her field, but also to work in academia and continue to publish. Her husband is equally busy. It’s a lot of work for the parents of seven children.

“In every decision, our children were first and work was second,” she recalls. “When they were little, I did all my research at work, not at home. I hardly went to any meetings. I could do more as they got older, but it has always required a high level of organization.”

When Dr. Shields goes to a meeting, she makes a calendar of all the tennis lessons, lacrosse practices and other engagements for the caregiver to follow with the children each day. She even plans meals so the caregiver isn’t overworked. And she has help staying organized.

“To keep my sanity, I’ve always had an office assistant, who helps with both office and home scheduling,” she says. “For example, she’ll help me schedule the kids’ dental or medical appointments, fill out forms for summer camp or arrange for someone to fix our furnace.”

ADVICE TO NEW PHYSICIANS FROM DR. CAROL SHIELDS

“Don’t worry about the big picture. Don’t make grandiose plans. You don’t know what the future holds, so just take it one day at a time.”

“You need to know your priorities. What kind of career do you want? How much time do you want to spend with family? To do well and enjoy either one, you have to really want it because it’s hard work.”

“There’s no perfect time to have a family. If you want children and you’re ready, just do it and enjoy it every step of the way.”

“When the kids are young, your house will never be as clean as you want it to be. You won’t have a nice car because the kids will trash it. Fancy food won’t go over as well as simple, healthy food. But you can have all those high-end things later.”

COLIN A. MCCANNEL, MD AND TARA MCCANNEL, MD

Careers: Retina specialists Drs. Colin and Tara McCannel have been in practice for more than 10 years. They have practices based at the Jules Stein Eye Institute at UCLA and work at satellite hospitals as well. Dr. Colin McCannel is a Professor of Clinical Ophthalmology at UCLA, while Dr. Tara McCannel is Director of the Ophthalmic Oncology Center.

Family: The McCannels have been married for 6 years and have three children ranging in age from 10 months to 3 ½ years.

THE MCCANNELS’ STORY

Drs. Colin and Tara McCannel didn’t have children when their careers began. Instead, the couple had already established themselves before adding children to the mix. When they felt the time was right, the McCannels had three children in less than 3 years.

“Things change a great deal with kids in the picture. Suddenly, child care and family time become very high priorities,” says Dr. Tara McCannel. Careers remain essential to the couple as well. “We both love what we do. We’re very passionate and it defines us. Turning that off, although it would result in more time with our kids, would be more harmful than beneficial, I think.”

She believes it helps to have a spouse who is similarly career-minded. “We both know what it means to have a career and work in academia. We’re a pair, and we both have to be successful to make things work.”

Dr. Colin McCannel advises, “All prospective parents should be comfortable with the fact that kids will change your life dramatically. You’re starting a new life that is dictated by their needs to varying degrees.” He’s confident that his family — and yours — will rise to the occasion. “Many busy couples in our specialty have children. If you want a family, it would be a shame to forego it because of a busy career. It’s challenging, but we humans have a tremendous ability to rise to challenges and make things work.”

CREATING A CAREER-FRIENDLY HOME LIFE

The McCannels are full-time surgeons, so childcare is key and allows them to focus on work.

“UCLA has a daycare facility for employees and it’s an outstanding environment for infants and children. Our older two children are there, and the third will be going soon. They love it at daycare, and I’m happy about them being nearby on campus,” says Dr. Tara McCannel. “The little one is at home with a nanny, who also serves as our backup if one of the kids is sick and can’t attend daycare.”

The McCannels’ nanny also does cleaning and laundry, helps get everyone out the door in the morning and often prepares dinner at night. She leaves when the doctors arrive home from work and doesn’t work weekends.

“A live-in nanny would give us more flexibility, but we’ve made the conscious choice that being hands-on parents is what’s important to us. When we’re home with our children, we want to be focused on family,” Dr. Colin McCannel says. “We do sneak in some work during naps and after bedtime. If we have an occasional deadline, one of us will watch the kids all day so the other can work, but generally when we’re home and the kids are awake, it’s all about them — we don’t even talk about work.”

BUILDING A FAMILY-FRIENDLY CAREER

One of the pillars of the McCannels’ successful balance is to focus fully at home and focus fully at work.

“I frequently wish I had more time for work, particularly my academic work, because I love it. But paperwork doesn’t scream at you like kids do!” Dr. Colin McCannel says. “I focus on the kids at home and focus on getting work done during work hours.”

As their family has grown, both doctors have been able to maintain a presence in the academic world, serve on committees, belong to journal clubs and attend conferences. They just need to be a little more selective.

Dr. Tara McCannel explains, “We look ahead at the year and plan days when one of us might go to a conference alone while the other stays home with the kids. When we’ll both be out of town, we invite family to stay with the kids while we’re gone. We’ve taken our kids and a nanny to conferences, but the family approach is better.”

When unexpected demands arise at work, the McCannels have become experts at trading off responsibilities.

“It certainly is challenging with clinical practices and especially academic work. There are times when we have two or three commitments at once, and it seems impossible to find the time,” says Dr. Tara McCannel. “That’s when the other one steps in and helps, whether it’s taking the kids for a few hours on the weekend or handling the bedtime routine to provide some extra time for the other person. It can feel chaotic, but it works out.”

ADVICE TO NEW PHYSICIANS FROM DRS. COLIN AND TARA MCCANNEL

Tara: “For young people starting careers, especially young women, it can be intimidating to have career success and also have a family. There are challenges, but you can make it happen.”

Tara: “The ways we achieve balance are constantly evolving. Is the current arrangement the best it can be? Do we have enough time for activities with the kids, for friends, for each other as a couple? You have to consciously consider those things. That said, you can’t plan for everything, so try to go with the flow instead of getting frustrated. As long as we’re all happy and healthy, the big picture looks good.”

Colin: “Pay someone to do the cooking, cleaning and laundry. If we didn’t do that, the house would be a mess.”

TWO-PHYSICIAN HOUSEHOLDS CAN WORK

Virtually all parents have anxieties about how to balance work and family, no matter what kind of work they do. Retina specialists aren’t unique in that sense. The families featured in this article have managed to pull it off and they’re happy with their choices. And when you’re ready to begin your own balancing act, you can probably get even more great advice and stories from the physicians you work with every day. NRP

TIPS FOR NEW PARENTS

Retina specialist Sophie J. Bakri, MD, has practiced at the Mayo Clinic in Rochester, Minn., for nearly 10 years as a vitreoretinal surgeon. She and her husband, an orthopedic surgeon at the Mayo Clinic, have a 1-year-old boy and another baby on the way.

She offers these tips for retina specialists starting their families.

›› “When you’re at work, be at work. When you’re home, be at home. You should plan to be really efficient at work, and then go home and forget about work while you spend time with your baby.”

›› “Decide what’s important and remove tasks that don’t add value. If it isn’t childcare or patient care, does it have value to you? For example, I outsource housework, so when I’m at home, I’m spending time with my baby.”

›› “Research good child care. We started with grandparents early on, but once he started daycare, I was very happy with that, too. Having a nanny at home is an option for some, but she may have days when she’s unable to come to work. My baby is with multiple adults and other kids in a secure, monitored environment at daycare. It gives me peace of mind.”

›› “You’ll need backup childcare sometimes. Think about your network of neighbors, friends, relatives and childcare professionals. I have a lot of people to call if needed, and if the baby gets sick at daycare, I can take him to Mayo Clinic’s sick baby daycare. I couldn’t get by without backup.”

›› “Conferences are still possible. I traveled to conferences often with my son in the first year, along with my husband or mother to care for him. It was nice to see him during breaks, rather than going for a few days without seeing him. Once you have more than one child, it’s easier to travel alone and keep the children home with your spouse or another family member. When my son is older, however, I’d like to take him along again because I’d like him to see what we do as physicians.”