Industry changes are making it easier for cardiologists to start families

"I think cardiology is thought to be a very family-unfriendly field, but we need to change that. It's really amazing that the ACC is actually incorporating sessions like this into their program, because I think we need to change the feeling that you can't have a family and also be a cardiologist. We want individuals who have well-rounded lives and we also want more women in cardiology, and women have historically only represented 15% of all cardiologists," Scott explained. 

Timing for children and concerns about infertility if you wait too long

Scott highlighted the challenges associated with the timing of parenthood. Each person's experience is different based on individual circumstances, including available support systems and career trajectories. While some may opt for parenthood during residency before really launching into their careers, others may find it more feasible during their early years as attending physicians. However, Scott also underscored the reality of infertility, particularly for women in cardiology, which can further complicate the timing of parenthood and add emotional stress to the journey.

"Infertility is real. There are so many women who feel like now is the right time, but then they can't get pregnant. And then infertility also brings up years of delay and stress, and medical therapies also add stress to the whole situation. There also is a high risk of pregnancy complications in women who are in medicine," Scott said. 

Support systems for child care are needed

Support systems emerged as a recurring theme in Scott's insights. Whether through professional assistance such as nannies or family support, having a robust network is essential for navigating the demands of both career and parenthood. 

"You also need to give yourself grace. You can't envision yourself as this perfect parent and perfect doctor. You do your best that you can. For me as a parent, it's always been about being very present when I'm with my children so that when I'm with them, I'm not thinking about my phone, my patients, what next thing I have to do," Scott explained. 

She encouraged individuals to embrace flexibility and acknowledge that perfection is unattainable.

Another challenge many cardiologists face is stress in a marriage when kids are added to the equation. She said having a partner who is flexible and understands the demands of clinical work can make a big impact.

"I had a partner who was very flexible and he was able to always take second to my position. A lot of physicians are married to other physicians or have partners who are physicians, so that makes it even more challenging. So one nanny, two nannies, a lot of them have also had family members who come live with them. I think that is a great way to help raise families, because you always have someone who's a family member home with the children," she said. 

But without a strong support network, it can be a lot like a house of cards. She said it just takes one little card to come down and the whole system topples. She said a sick child who cannot go to school, for example, can disrupt the schedule and you need to know what your plan B is ahead of time. 

"You just have to be very well organized and you have to have a village of people behind you to help make this happen," Scott explained. 

Institutional support for parents within healthcare

Hospitals are increasingly recognizing the importance of accommodating the needs of young families, offering amenities such as pumping rooms, mentoring programs and daycare facilities. These initiatives aim to ease the transition back into work after parental leave and foster a supportive environment for healthcare professionals. There is also recognition that many cardiologists want more of a work-life balance, which can help decrease feelings of burnout.

Scott shared optimism about the evolving landscape of cardiology, where a better work-life balance is now being recognized as essential. She encouraged aspiring cardiologists to explore the diverse opportunities within the field and reiterated that parenthood and a fulfilling career in cardiology are not mutually exclusive.

"At Mass General Hospital, we have pumping rooms, we have support structures where the early parents can have mentoring ... I think it's really hard for people to come back to work after any parental leave, so just trying to ease that transition as much as possible helps," Scott said.

Mass General has a backup daycare system to support its staff with children and reduce unexpected days parents would otherwise need to take off. Scott said she has used this daycare on many occasions. 

"It's actually wonderful. You can call in the morning if your backup system A, B, C, D didn't work. Choice E was the Mass General Hospital daycare. You drop your kids and then pick them up at the end of the day. They also had extended hours, since we don't always work 9:00 a.m. to 5:00 p.m. It's actually really heartening to see that the healthcare world has realized that we need to accommodate parents," She said.

COVID-19 also showed hospitals and doctors a new way to work at home that can still be productive. After the pandemic, many clinical staff still wanted to maintain the ability to work from home on occasion because they found it helped a lot with that work-life balance,

"I think there are a lot of reasons why there's not enough healthcare providers, including burnout. COVID was really hard on the healthcare community and a lot of people realizing that maybe working from home is actually conducive to having a healthy work-life balance. I absolutely think the hospitals need to pivot and need to realize that they need to meet the needs of their workforce and provide the support so that their workforce comes back to work, feels supported and wants to continue working," she said.  

Feelings of a delayed career with children in medicine

While many cardiologists want to build a family, there sometimes is the feeling that having kids may hold back their careers for several years when they are young and require a lot of attention. 

"I think that there is a certain delay in your career. I think no matter how much of a superstar you are and your best of intentions, there is something that does take a pause, especially when you have young children," Scott said.

When her kids will little, for example, Scott did not attend ACC annual meetings for years because she felt she needed to be at home. 

"My children are teenagers now, so I feel like I've emerged from this world where I can now go to meetings. I can FaceTime them and still connect with them, but it's much harder when they're younger" she said. 

Overall, she said there are many ways today to find more of a work-life balance. Scott does encourage young doctors to pursue cardiology as a speciality.

"I think it is really becoming a field where you can have a family, have amazing work, and have a balance of it all," she said.