Remote Learning Strains Medical Workers And Their Employers

Dr. Maria Diaz, a primary care physician in Lawrence, thinks she has a plan that will allow her to keep working this fall. Her kindergartener has a full day, in-person option through his pre school. Her second grader will go live with in-laws in Sharon for the three weekdays when her public school is remote. On the two days when the second grade classes are in person, Diaz hopes to be able to work from home.

This is all still preliminary. Diaz hasn’t confirmed anything with the clinic or hospital where she works because she still doesn’t have all the details from her daughter’s school.

And the plan could crash if Diaz’s in-laws get sick or either of the children’s schools goes fully remote. For Diaz to keep doing essential medical work in Lawrence, one of the hardest hit cities in Massachusetts, pretty much everything has to go right.

“It is very scary because I want my daughter to excel in school. I also want to be able to see my patients and to follow all my commitments,” Diaz says. “So I feel very stressed.”

For Liz, who runs diagnostic tests from 9-5 at a hospital in western Massachusetts, quitting looks like her only option right now.

“With the hospital, it’s those set hours, during school hours. There’s no way around that,” she says. We’re only using Liz’s first name because she hasn’t told her employer there’s a good chance she’ll leave soon, so she can supervise school work for her young son.

Liz does some telemedicine as a side job now, monitoring tests remotely, which she may be able to expand in lieu of the hospital job.

“I’m kinda bummed about it, but I think most people are probably in the same boat, at least if they have children,” she says.

Hospitals, clinics and doctor’s offices across the state are scrambling to deal with this latest COVID-19 curveball and figure out how remote schooling might affect operations this fall, with flu season coming and fears of another surge on the horizon.

An internal survey at the largest hospital network in Massachusetts gives the problems some concrete dimensions. More than half of 6,000 respondents say they may talk to their supervisor about rearranging their work schedule as many schools go remote. Thirty-five percent are considering working fewer hours, 25% may take a leave of absence and just over 20% may quit to supervise children at home.

The results reveal a number of problems.

“Even if we have none of our folks taking any action to change their schedule or take a leave or leave the workforce, it’s of course a concern to have a workforce that’s under this much stress and anxiety,” says Matt Badger, a Mass General Brigham Senior Vice President for Human Resources.

Badger lists some of the support Mass General Brigham has put in place: day care and nanny discounts, back-up in-home day care, six day care centers run by MGB, access to tutoring assistance and help creating learning pods. Even with discounts, Badger knows lower-wage employees won’t be able to afford additional babysitting expenses.

And many health care workers, along with other parents, are finding that babysitters can’t summon the authority of a parent or teacher. Dr. Leena Mittal, chief of the division of women’s mental health at Brigham and Women’s, learned that last spring. She and her husband would agree on tasks with their son each day, but then he’d refuse to do them with the babysitter.

“It became this constant struggle and tug of war with my son,” Mittal says.

So this fall, Mittal and her husband plan to shift their schedules so that one of them supervises the school hours. Mittal hasn’t set that up yet because she doesn’t have the final arrangements from her son’s school.

All of the possible workforce changes raise questions about whether hospitals will be able to run at their full and possibly surge capacity.

“it does of course create concerns related to the operation of our hospitals,” Badger says. “I don’t think at this point we see enough indication that it will impair our ability to serve the communities that we operate in.”

Other hospital systems are looking at similar staffing issues and talking about boosting per diem work, more flexible scheduling and work from home options — anything to avoid limits on hospital hours or service.

“That’s what we want to avoid like the plague, says Bart Metzger, chief of human resources at UMass Memorial Health Care.”Our entire emphasis as we’ve come out of the first wave of the pandemic has been in recovery. And we actually have made very significant strides in terms of recovering lost volume. I’d hate to do anything and frankly would be surprised if we did anything that was counter to that.”

Metzger expects to present a range of employee accommodations to his bosses in the coming week or two.

“We have a long history of erring on the side of what I call the people quotient,” he says. “There’s no way that we’re going to meet the full array of our employee’s needs, but every little bit helps.”

And it is needed right now, say hospital employees. Sherrel Cooley, a medical secretary at a UMass Memorial psychiatry clinic, is still waiting for officials approval, but heard on Saturday that she can start working from home Tuesday. That is also the first day of remote school for her two children in 2nd and 8th grade.

“They both have learning disabilities so I couldn’t just, you know, set them in front of the computer and good-bye, I’m going to work,” Cooley says.

UMass, Mass General Brigham and Atrius Health are among the health care systems that have already extended work from home, where appropriate, to June of 2021. That will help, but not solve the dilemma for many parents.

Cooley says she’s worried: Will she be able to keep everything on track for her clinic’s psych patients while making sure a 7 and 14-year-old pay attention to a math lesson on their computer?

“Every other parent is trying to find other ways of trying to do this as well. It’s just very difficult,” she says.

The Baker administration says it's paying close attention to staffing levels at all health care facilities and will increase support if needed, although it didn’t say how.

Mittal says hospitals and clinics need to understand there’s no one size fits all answer to this problem for parents because there’s no uniform situation among families. She, for example, feels “out of her depth” when it comes to early education.

“So the more flexibility people can have, the better,” she says, in terms of “hours, working from home and the expectations.”