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Neurohospitalist and clinical neurophysiologist Franklyn Rocha Cabrero discusses the article, “Missing prescription: long-term parental leave for fathers in medicine.” In this episode, Franklyn delves into the systemic and societal barriers that hinder male physicians from taking full advantage of parental leave, explores the benefits of longer leave on family well being, and highlights actionable strategies for balancing demanding medical careers with family responsibilities in the field of health care. Drawing from personal experiences as a self-employed practitioner, Franklyn offers practical insights for aspiring fathers in medicine who seek to prioritize family without sacrificing career advancement.
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today we welcome Franklyn Rocha. He is a neurohospitalist and clinical neurophysiologist. Today’s KevinMD article is “Missing prescription, long-term parental leave for fathers in medicine.” Franklyn, welcome to the show.
Franklyn Rocha: Hi Kevin. Thank you for inviting me.
Kevin Pho: Alright, so tell us what led you to write this article on KevinMD in the first place?
Franklyn Rocha: I got inspired by this book, The Expectant Father, so a colleague of mine actually recommended it, and I started reading a few of the pages, and I was really, really startled by the statistics about how very few men take parental leave. And I then decided to go to my mentor, and it’s like, has anybody written about this?
And I did a search. Nobody had written about it. And I decided, since I was in parental leave, that I wanted to, you know, kind of talk about this topic.
Kevin Pho: Alright, so tell us about the article itself, for those who didn’t get a chance to read it.
Franklyn Rocha: Yeah, so I kind of start off providing some statistics about how many dads and fathers take parental leave. And I was surprised to see that most people don’t take any leave at all. Or if they do, it’s about two weeks. And as, I don’t know, a lot of the audience—those who have had children—two weeks is definitely not enough to take care of a newborn, especially if you want to be a supportive spouse. So, I, you know, I delve into it, and a lot of it had to do with the fact that there’s just this culture where fathers or dads, you know, are supposed to go back to work immediately after they have their children. And as many of you know, the United States is one of the few countries that doesn’t provide paid maternity leave or paternity leave. It’s really up to the employer. And, you know, I delved into it even more. And even if parental leave is offered, a lot of fathers decide not to take it because of that culture of, you have to go back to work and be productive. And, you know, the problem with that is that the children really feel the effect. The research really shows that fathers who are more available and spend more time with their children, there’s more bonding. And also there’s a better relationship with the spouse because mom is really appreciative when dad is involved. So I was like, yeah, I really need to talk about this.
And then I kind of took those statistics and then applied it to my own personal experience. As I was going through my training and residency and fellowship, and I noticed that a lot of dads didn’t have a lot of time off to take care of their newborn even when they requested it in advance. So I just thought, you know, I need to speak about this. I think this topic is very important. And then, you know, my mentor, Dr. Willner—Andrew Willner—told me, yeah, I actually was thinking about writing an article about that years ago, so I’m glad you’re taking this over. And he suggested that I submit this to you, to KevinMD, and to the audience, and that it would be well received by a lot of the physicians who will be listening to this podcast.
Kevin Pho: Alright. So, yes, I know Andrew Willner well. He’s appeared on the podcast multiple times. So thank you so much for sharing your story. You mentioned that you yourself were on parental leave. Now, did you run into some of those obstacles when you were requesting your own parental leave?
Franklyn Rocha: So, I’m in a different situation because I’m actually 100 percent self employed, so I’m not really particularly employed full time by any hospital system or office. So, a little background about myself, I finished my fellowship training in 2022, and just seeing my own supervisors and my colleagues who work full time, I really didn’t want to practice medicine the way that it’s practiced now, which is you get employed and then they give you as many patients as possible to see in very little time and with a lot of administrative burdens and just really no control of your time. You just have your PTO, which is your vacation, X amount of time a year. And I just wanted to practice differently. I want to control my schedule.
So one of the benefits of me doing locum tenens slash clinical neurophysiology slash, you know, some teaching gigs here and there, is that I get to control my schedule. So, I decided, I put my vacation settings on my email, and I said, I’m leaving from this date to this date, and that’s it. I’m having my first child, and I need that protected time. So, I actually designed my schedule in a way that I was able to take three months off from work and make sure everything was tidied up before I leave and make sure that I had enough savings to be able to go through this with no problem.
So it required a little bit of planning, but I was able to circumvent all these challenges. If I was an employed physician, I would think I would have the same problems, where probably they would tell me to come back to work or pressure me to come back to work as soon as possible. And I do have to say something really interesting is that I have been pressured by my contracts, the hospital system that I contract with, to come back to work. They’ve been sending emails since January. Now I’m getting, like, nope, I’m holding off. I’m not coming back till March. So the pressure is there. It’s just that I decided I wasn’t going to give in and that I was going to prioritize my son, you know, being that he’s the most important thing right now for me, besides my wife, of course, supporting my wife. But it’s important that we obviously prioritize what’s important for us. And, you know, the work is going to be there two months down the line, three months down the line. Clinical medicine is exhausting, it’s challenging. So, I thought, you know, for me, this is important. So, I, yeah, I did the schedule, and I’m really happy. Honestly, this is the best thing I could have done.
Kevin Pho: So, you mentioned that some of your contracts are pressuring you via emails. Just give us a gist of what they are saying. How are they pressuring you?
Franklyn Rocha: Well, some of them are saying, are you, like, going to come back to work with us? Are you ever going to come back? I’m like, yes, I’m preparing to leave. I haven’t emailed you back. It’s because I’m still taking my time. I’m like, oh, it’s OK. Just, just wanted to make sure. And then some of them would be like, oh, we’re ready to put new cases on your log, Dr. Rocha. When are you expected to come back? Those are some of the emails I’ve received. But of course, you have to just not give in to the temptation of rushing back to work and just remembering why I did this in the first place.
Kevin Pho: Now, just to be clear, in most employed settings, if a father wants to take that parental time off, normally it comes out of their PTO, their paid time off. Is that your understanding as well?
Franklyn Rocha: Yes. Or even worse, for some institutions, because if you haven’t been working for more than a certain amount of time—let’s say like a year or two years—in some institutions if you just recently switched jobs, you actually would have to take unpaid time off because they’d be like, oh, you haven’t been with us more than 12 months or 24 months. And so a lot of families actually have to take unpaid time off, which is unfortunate, right? Because, you know, we give all this time to this career. We give our years of our life to train, and you would expect at one point the system has your back. But what I found is that, you know, at the end of the day, they just care about covering their shifts. So it’s up to us. We really have to just empower ourselves to be really like, no, I need this time. Like, you know, you have to give me this time because this is important for me, this is important for my family. And it’s also a thing about mental health, right? If you don’t have that time off to take care of your child, then you’re going to feel some kind of resentment towards your job. So, it’s a dynamic, it’s a conversation that I think people just have to have with their employers if they’re employed, and if they’re self employed like me, then, you know, setting those boundaries is very important.
Kevin Pho: You mentioned earlier that when you were talking to some of your colleagues, even if they requested that parental time off in advance, they ended up not getting it. Tell us about some of the stories that you’re hearing about fathers in medicine in employed settings not getting that time off at all and some of the pushback that they’re getting from their employers.
Franklyn Rocha: Yeah, actually, you know, I was talking to one of my other friends in Texas. I’m not going to disclose who the employer is, but he was telling me that he wanted to take time off. He had just had a little girl, and he couldn’t because he had just started at that job very, very recently. So they told him that he actually couldn’t take a single day off unless he wanted to take unpaid leave. And he honestly gave in to the pressure of just continuing to work. His daughter was born on a Friday, and he went back to work on a Monday. And I just felt really bad because I was like, this is just not fair. You’re a first-time father, and, you know, he’s kind of on the older side, older than me, and I’m not going to say my age here, but he’s a first-time father, and I just feel bad that he wasn’t—I mean, he could have put more pushback, of course. I mean, that’s always an option, but I think he just went back to work. And then, going back to my experiences as a trainee, when I was a resident, I had a junior resident who also had a baby, and I believe they gave him two weeks for paternity. And he was in one of the toughest years—PGY2, PGY3—where you’re doing a lot of call, a lot of consults, so he had to do two weeks and then go back to work. And his wife was also a resident in internal medicine, and she got six months—six months or three months? No, I don’t remember. I don’t think it was six months, actually, probably like three months. She got three months. But that’s the thing that I kind of want to highlight in this article, is that there’s this real disparity between the type of leave that a father gets versus a mother gets, right? And of course we understand that the mother is very important. She’s the one that’s feeding the baby, and she’s probably the one that’s spending more time with the baby. What I’m saying in this article, my message is we really need to close that gap of the time that’s given to dads versus moms. I mean, we live in an era of equality, right, of trying to close the gap in different aspects of society, including women’s pay, so we need to close that gap. But, I mean, this is the point I wanted to bring up, that fathers and dads deserve time off too, more time off than two weeks, because the newborn, the most challenging phase I found—and my son is three months old right now, and February 24th is going to be three months—is these first three months are very challenging because it’s known as the fourth trimester. The baby is coming out and still thinks it’s in the uterus. They cry a lot, they feed a lot, they need a lot of stimulation, so it’s a full-time job, and it’s not a one-person job. Even a two-person job—my wife and I are both on leave, and we’re around the clock busy during the day, because it does take a lot of time and dedication to take care of a baby in an appropriate way, right?
Kevin Pho: So, what are some ideas that you have to maybe change that culture of medicine to be more accepting and embrace paternal leave?
Franklyn Rocha: I mean, I think first of all, we have the conversation that we’re having today, and that’s why I decided to write about it and see if people are willing to comment about this and see what dads think about this, what moms think about this, to have a conversation in a safe space. And then, second of all, we might just change a little bit the policies and procedures of some of these employers and make sure that parental leave for fathers is—you know, the time is extended a little bit more. Maybe a conversation can happen that we include those in contract benefits and non-salary benefits and make sure that parental leave is emphasized. Of course, at the federal and state level, you can do advocacy efforts, although that’s a little bit more difficult, of course. But, you know, the United States is still one of the few nations that doesn’t give paid parental leave guaranteed as a right, while other countries do. And, you know, from their side, they can be like, oh, well, we can’t afford you being on leave, but on the flip side, you say, well, the research is really clear that, you know, happy couples who have children, if they take that time off, they’re more productive when they come back, they’re more refreshed, whatever you want to call it. So, from a business perspective, it ends up making sense to change those policies and procedures. And then, I guess, the third thing is that we have to go back in the training and the culture of medicine, and we need to change that mindset that we need to sacrifice ourselves and put ourselves last, when really, the research and anecdotes out there show that this modern culture of medicine is not good for patients. If the doctor is not happy, if the doctor feels resentful, they’re not going to provide good patient care. So we really need to rethink this culture of medicine of productivity and think about, well, how is that going to impact my work with patients? And if I’m not happy, I won’t be able to—how am I going to be able to deliver good patient care? So at the end of the day, it’s a win-win situation for everybody if we give parental leave to men and women equally.
Kevin Pho: We’re talking to Franklyn Rocha. He’s a neurohospitalist and clinical neurophysiologist. Today’s KevinMD article is “Missing prescription, long-term parental leave for fathers in medicine.” Franklyn, let’s end with some take-home messages that you want to leave with the KevinMD audience.
Franklyn Rocha: Well, the take-home message is I do recommend for all the trainees out there, or anybody who’s considering switching things up, is just become self employed, become an independent contractor, open your own S-corp, your own small business, become an entrepreneur. I say this because that was the only way I was able to schedule these three months of parental leave. So, if you’re kind of tired of the day-to-day routine and feel like you’re in this rat race, I mean, just take a risk and decide that you want to work for yourself. There’s a lot of side gigs now with technology. I think it’s an excellent way to make your own schedule and break away from this culture of medicine that you have to just work yourself to the ground. You know, since I decided to be self employed and do this, I’ve never been happier. So, if anybody has any questions, of course Kevin can pass my email. If you have a question about my career track or trajectory, I did it straight out of fellowship. I don’t think everybody has to do it that way, but I can at least give some tips on how I was able to do it.
Kevin Pho: Franklyn, thank you so much for sharing your story, time, and insight. And thanks again for coming on the show.
Franklyn Rocha: Thank you. Thank you, Kevin.
