Missing prescription: The case for extended paternal leave in medicine

Franklyn Rocha Cabrero M.D. , a neurohospitalist and clinical neurophysiologist, recently appeared on The Podcast by KevinMD to discuss his article, "Missing prescription: Long-term parental leave for fathers in medicine."

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Inspired by the book "The Expectant Father" and his own experience taking parental leave, Franklyn's article highlights the significant disparity in parental leave opportunities for fathers in medicine and advocates for a cultural shift to support greater paternal involvement in early childhood.

Startling statistics and a pervasive culture

Franklyn was startled by statistics revealing that most fathers take little to no parental leave, with those who do typically taking only about two weeks. He attributes this to a deeply ingrained culture where fathers are expected to return to work immediately after the birth of a child. The United States' lack of mandated paid parental leave (both maternity and paternity) further exacerbates this issue, leaving parental leave policies largely at the discretion of employers.

The benefits of paternal involvement

Franklyn emphasizes the well-documented benefits of fathers taking extended parental leave:

• Stronger parent-child bonding: Increased father-child interaction during infancy leads to stronger bonds.
• Improved spousal relationships: Fathers' active participation in childcare supports mothers and strengthens the couple's relationship.
• Better child development outcomes: Research indicates positive developmental outcomes for children with involved fathers.
• Physician well-being.

Personal experience and professional pressures

Franklyn shares his personal experience taking three months of parental leave, made possible by his self-employed status as a locum tenens physician. He contrasts this with the challenges faced by employed physicians, who often encounter pressure to return to work quickly, even receiving emails during his own leave inquiring about his return date. He shares anecdotes of colleagues, including a resident who returned to work just days after his child's birth and a newly employed physician denied any leave whatsoever.

The disparity between maternal and paternal leave

Franklyn underscores the significant disparity between maternity and paternity leave, with mothers often receiving substantially more time off. He argues that while recognizing the mother's crucial role in early infant care, fathers also deserve extended leave to bond with their children and support their partners. He advocates for closing this gap, aligning with modern ideals of equality. He cites that the first 3 months, known as the "fourth trimester," is especially difficult, demanding almost constant attention.

Changing the culture: Advocacy and individual action

Franklyn proposes several steps to change the culture surrounding paternal leave in medicine:

1. Open dialogue: Encouraging open conversations about parental leave, as exemplified by the podcast discussion.
2. Policy changes: Advocating for changes in employer policies to provide more generous and equitable parental leave for fathers. Including it in contract negotiations.
3. Advocacy efforts: Supporting advocacy at the state and federal levels for mandated paid parental leave.
4. Challenging the culture of overwork: Rethinking the ingrained medical culture that prioritizes productivity over personal and family well-being.

The self-employment solution

Franklyn advocates for self-employment, specifically locum tenens work, as a way for physicians to gain greater control over their schedules and take extended parental leave. He shares his own positive experience, emphasizing the enhanced work-life balance and the ability to prioritize family.

Take-home message:

Franklyn promotes a change in the culture of medicine, where many providers feel obligated to put work above all. This impacts patient care. Increased access to longer-term paternal leave will increase provider mental health. He encourages physicians who may feel trapped by the current medical model to try entrepreneurship and take control of their schedules.