How clinicians are facing pandemic childcare challenges

COVID-19 has upended the lives of countless people around the world. Even while cases are down from past peak surges, finding reliable childcare is a near-constant challenge—particularly for clinicians who must balance competing responsibilities for their patients and their children.

Childcare concerns are a common call to the peer-to-peer Physician Support Line, according to Mona Masood, DO, founder and chief organizer of the hotline staffed by approximately 700 volunteer psychiatrists. “Our profession is very much about our patients,” she said in an exclusive interview with MDLinx, “and it really hurts doctors to think that they have to cancel an appointment or a day's worth of patients who have been waiting to see them, perhaps for months" for childcare reasons.

US childcare struggles

The US Census Bureau’s Week 41 Household Pulse Survey for December 29, 2021 to January 10, 2022, painted a more detailed picture of the nation’s pandemic childcare woes. During that time period, 26.7% of children under the age of 5 were unable to attend daycare or another childcare arrangement due to safety concerns.

Fortunately, the scenario is improving as vaccination efforts continue. However, children still do get quarantined because of COVID-19 or due to exposure to it. 

In that case, as Masood explained, physician-parents may be out of luck finding someone to take care of their child. Even their regular caretakers may not want to risk exposure themselves, and Masood points out that the physician-parent doesn't want to expose somebody else to the illness, because then “that's almost counterintuitive to what we're doing, which is trying to prevent illness.”

Adding to the problem is the fact that childcare centers have been struggling to find enough workers. A 2021 survey by the National Association for the Education of Young Children (NAEYC) found that four of five childcare centers were understaffed, and that 78% of childcare centers cited low wages as the main reason they had difficulty recruiting workers. 

For understaffed childcare centers, 15% reported “major shortage” issues, meaning they were short by six to 15 workers.

Considering all of this, it is not surprising that, among working parents surveyed by the Pew Research Center article in October 2020, 52% of those with children younger than 12 reported that handling childcare during the pandemic was either somewhat difficult (37%) or very difficult (14%). 

Patients vs childcare

Physician-parents feel torn when pandemic-related childcare issues arise, said Masood, who is also a psychiatrist. “We feel divided in terms of our responsibilities when we have a sick child at home, or if there’s an exposure at their daycare or at their school that requires the child to be in quarantine.” 

The Physician Support Line offers suggestions for physicians who must miss work for childcare reasons. One way to ensure that their patients will still be seen is to ask colleagues to cover for them.

Discussions with the support line can also offer physicians some much-needed perspective.

“It is not a failure as a physician,” Masood says. “Having to choose your own child and caregiving for them does not mean that you have failed your patients.” 

She adds: “What the physicians who are calling [Physician Support Line] really want to hear is permission. Permission to be human and to cancel patients. They need to know that ’Me having to cancel patients tomorrow doesn’t mean that I don’t care about them.’ So, we remind our physician callers that just because you are limited doesn’t mean your heart is limited.” 

Compounding issues

Some of the physicians calling the hotline wonder how much longer they can keep up with the high level of engagement required in being a front-line worker during the pandemic. They are “exhausted from living and working under constant pandemic conditions.”

“Burnout” is a word that Dr. Masood tries to avoid, because it can imply that someone is not cut out to be a doctor. She reminds callers that “we don’t work in a vacuum—we’re working in a greater system.” If the healthcare system does not have the resources, the staff, or the PPE that are needed, this only compounds the problems.

Isolation is another feeling that physicians report, as if they are carrying the weight of the pandemic on their shoulders. Dr. Masood sympathizes, telling them that they are “human beings first and physicians second.” Physicians, too, are vulnerable to the virus and its repercussions for their own health and well-being. 

Single-parent physicians face isolation in their home life, as well. Physicians with spouses or partners can come home to them and get comfort from them. 

“But single parents are definitely going from one shift to second shift,” Dr. Masood says. “‘Second shift syndrome’ is what we're calling it. The burden of responsibility, whether it’s for patients or for your children, falls only on your shoulders.”

Encouraging trends

Daily new cases of the coronavirus appear to be decreasing. The Centers for Disease Control and Prevention (CDC) reported that, as of March 2, 2022, daily new case numbers were down by 28.5% compared with the previous 7 days. If this is sustained, it could potentially lessen many of the issues the pandemic has presented to physicians and their communities.

As for childcare, Masood explains that, in general, when surges decline, “it helps put people’s minds at ease. So, even if there is an exposure to COVID-19 now, non-parents are more willing to take care of the child, as opposed to when numbers are higher.”

Sources: 

1. Centers for Disease Control and Prevention. In Focus: COVID-19 Community Levels. March 4, 2022

2. Igielnik R. A rising share of working parents in the U.S. say it’s been difficult to handle child care during the pandemic. Pew Research Center. January 26, 2021.

3. Physician Support Line. physiciansupportline.com.

4. SURVEY: Four in five child care centers in the U.S. are understaffed [press release]. National Association for the Education of Young Children (NAEYC). July 27, 2021.  

5. U.S. Census Bureau. Week 41 Household Pulse Survey: December 29, 2021 – January 10, 2022. January 19, 2022.