Deep-seated gender norm expectations add another layer of complexity. Across cultures, women in medicine often feel pressure to “do it all,” balancing physician and caregiver roles.⁵ This is only exacerbated by the disparities in gender representation and the responsibilities of domestic care, with two out of every three caregivers being female; this added pressure makes life even more difficult for female emergency physicians, and it leads to higher attrition rates among women in the workplace.⁶ This raises the importance of health care organizations focusing on multi-layered support systems that recognize these distinctive pressures to create a healthier work-life balance for all sandwich-generation emergency physicians.⁷

Solutions

Emergency physicians in the sandwich generation can use different coping strategies and solutions to help navigate the complexities of balancing work and home life. Time management and prioritizing are critical skills that help these physicians create a more manageable schedule. It is also essential to set clear boundaries between work and home life for quality time with their children and aging parents without feeling overwhelmed.^8,9 Finally, creating a solid social support system is critical, as your family, friends, and peers can offer emotional and practical support. Professional resources, including mentorship, counseling, and even executive coaching, can also guide stress and wellness management.^8,10

On a broader scale, health care organizations can support emergency physicians in excelling at work and feeling satisfied with their lives outside of work by creating a culture that understands the sandwich generation.⁸ In August 2024, U.S. Surgeon General Dr. Vivek Murthy released an advisory highlighting parents’ and caregivers’ mental health and well-being. In the report, he noted that this group is “struggling” and called for workplace policy improvements and employer programs that support caregivers.¹¹

One suggestion is to have employers offer “paid parental, medical, and sick leave, flexible and equitable work schedules, and access to childcare (either in the community or onsite)” for their employees. Additionally, Dr. Murthy recommended that employers implement training programs for managers focusing on stress management and work-life balance. This training should help managers recognize indications of stress and mental health challenges among caregivers and provide strategies for promoting work-life integration.¹¹

Other ways to create a supportive organizational culture would be offering comprehensive and affordable mental health resources such as therapy and support groups, providing financial planning assistance, and training emergency department chairs and directors to understand the unique needs of these physicians.^8,11