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THE EDITOR'S CORNER

THE EDITOR'S CORNER

The Trouble with ''Having It All''

Social changes in recent years have resulted in changes in attitudes about the conditions of employment. Nowhere is this more obvious than in the transformation resulting from the large increase in the number of employed women and the desire on the part of women to "have it all"--a family and a career.

Sixty percent of American workers are reported to have child- or elder-care responsibilities. Women especially are torn between the need to work and the need to attend to many of the traditional female duties, which include not only shopping, cooking, and cleaning, but also taking care of children and elderly parents, taking care of sick family members, and maintaining an interest and participation in children's school work and activities.

The cost and quality of available child day-care facilities is a constant concern of working mothers. A great many day-care centers are managed by people who are untrained or unskilled in caring for children. There are signs that an increasing number of fathers--20% in a recent Census Bureau report--are sharing child-care responsibilities. This is related to male unemployment, the trade-off between the salary from a job a father could get and the cost of day-care, couples working opposite shifts, and part-time employees juggling their schedules.

Still, women today take much more responsibility than men for family care and, therefore, are more often late or absent. Research in industry has confirmed that women with children in day-care are much more likely to be absent than women with no children, and that women with elder-care responsibilities also have increased absenteeism. Absenteeism has been shown to lead to increased turnover, stress on the rest of the workers, staff tension, decreased productivity, and lowered employee morale.

There seems no doubt that family responsibilities create problems in the workplace. At the same time, there is considerable doubt about whether efforts to accommodate to the family needs of employees pay off. Such efforts do not appear to eliminate absenteeism, and effects in areas such as morale, stress, and quality of results are hard to quantify.

Part of the conflict between job and family responsibilities is the difference between the needs of single parents and working mothers and the way most businesses and professional practices operate--regular hours, production schedules, quality standards, and delivery requirements. A large number of American workers have chosen a lifestyle that is incompatible with a structured business or professional system. In a sense, businesses and professional practices are beneficiaries of all the talent of female employees on the one hand, and in conflict with the personal needs of female employees on the other.

The entire structure of work is biased against flexibility. The orthodontic office counts on staff members to service the patients. Lateness or absence may threaten the quality of service and put undue stress on the other employees. Work-at-home options are not possible for operatory personnel or receptionists, who must be present when the patients are. However, a full-time operatory assistant or receptionist might become a part-time worker temporarily or permanently; a bookkeeper might be able to work at home with a computer and a modem.

Flexibility in scheduling-- flextime--appears to reduce lateness and absence, and it helps in recruiting and retaining good employees, but it may be a problem in a small office with a full schedule of patient appointments every day. Also, by being flexible you might get more work and loyalty out of one worker, but the rest of the workers might resent the preferential treatment.

The orthodontic office would seem to be an ideal venue for a battle of the sexes, with most orthodontists being male and most staff members female. However, there is no evidence of such a battle in JCO's opinion survey of work-family conflicts in orthodontic offices, published in this issue. For the most part, the differences between the responses of male orthodontists and female employees were almost solely in the degree of agreement or the degree of disagreement with the statements on the survey questionnaire. Whether women can have it all is still open to question, but at least orthodontists seem willing to recognize the dilemma of balancing family and career and to try to accommodate their staff members to some degree.

EUGENE L. GOTTLIEB, DDS

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