Child care stress can add to burnout. How can physicians manage it?


One in five health care workers experiences stress related to child care, a problem that was exacerbated by the pandemic, according to a 2022 study.

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Elizabeth Harry, MD, the lead author of the study and senior medical director of well-being at University of Colorado Health in Denver, appeared on an episode of “AMA Update” to offer some insight on the topic and how it can adversely affect physicians’ well-being.

Child care is a topic of universal concern. Physicians and other health professionals, however, have unique specifications when it comes securing child care arrangements, Dr. Harry said.

“The hours that we work are so different than your standard child care hours ... so it's often difficult to find a facility or a child care worker that is able to work those hours.”

Then comes “the cost of child care, particularly in some of our high-cost-of-living areas and particularly for trainees,” she added. “As we have more trainees joining the field at later stages in their life and they've already started families, a lot of them have a difficult time moving into those high-cost-of-living areas and paying for child care.”

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Dr. Harry’s study found that 21% of health care workers experience child care stress. And that proportion didn’t factor in the many health professionals without children. Demographically, nonwhite respondents had higher child care stress, as did women compared with men.

“We looked at, what was the relationship between having high child care stress and reporting either burnout or anxiety and depression or intent to leave and reduce hours,” Dr. Harry said. “And we found that if people were experiencing high child care stress, they were actually 115% more likely to report anxiety and depression.”

In addition, these health professionals “had an 80% higher odds of reporting burnout, a 91% higher odds in intending to reduce their hours in the next two years, which is very important when we think about our health care worker shortages and then about a 28% increased odds in leaving health care altogether in the next two years,” Dr. Harry said.

Learn how the AMA is working to find new ways to help medical students and residents get child care.

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As a mother of two with a physician spouse, Kavita Shah Arora, MD, can speak to the pandemic’s impact on child care stress. She and her husband were in separate cities at the time—he was in Chicago completing a fellowship, while she was in Cleveland. The family had a nanny to help ease the burden.

“Solo parenting with our closest family eight hours away was emotionally hard,” said Dr. Arora, professor of obstetrics and gynecology at The University of North Carolina-Chapel Hill. “I didn't know who would watch the kids if I became sick—or what we would do if our nanny became sick. The guilt of bringing something home to my kids or nanny was immense. We were incredibly lucky, having had full-time pre-arranged care meant we could pivot to remote school for our son and other pandemic-related changes with minimal impact on my ability to work.”

Even as the pandemic has moved to a less dire phase thanks to safe and effective vaccines, child care remains a major stressor, Dr. Arora said. Understanding that your child care arrangement is unique to your needs is paramount.

“Whichever route you go, it will have pros and cons,” she said. “Pick the option that works best for your life, and that may change over time. Most important, shed the guilt. If your children are safe, fed and loved, they will thrive.”

As you continue the journey to being a young physician, the AMA Transition to Practice series has guidance and resources on deciding where to practice, negotiating an employment contract, managing work-life balance and other essential tips about starting in practice.