The Work, Life, Schedules, and Challenges of Husband-Wife ER Docs

Yana Duncan and her three kids, who made her her breakfast on Mother’s Day this past May.

There is no doubt that working in emergency medicine can make for unique scheduling challenges, especially when you have young children at home. It’s not uncommon to rely on one’s spouse to maintain a more normal 9-5 schedule and take on primary responsibility for kids. But what if you and your partner are both emergency medicine docs?

That is the situation with Drs. Yana and Brannon Duncan, from Austin, Texas, as well as Drs. Jenny and Jim McQuiston, from Clarksburg, Maryland. Both are husband-wife emergency medicine physicians. Both couples have young kids at home. And each has creatively arranged very different strategies for both working in the ER and raising their kids.

Their strategies for managing both work and home may be fundamentally different, but Yana and Brannon and Jenny and Jim have at least one story in common: the way each met their future spouse.

Rotating Through

“It was Grey’s Anatomy kind of thing,” said Jenny, talking about when she met Jim. She was in medical school on rotation into the ER where Jim was chief resident. “At first I was like, whatever, I don’t like this guy. There was a trail of nurses throwing their number at him. So it was a 3-month period of me not giving him the time of day.”

But Jim soon began to win her over. “First of all, he’s an extremely good doctor. He’s very, very smart, and he was amazing with patients.” Jenny remembers one patient encounter in particular with an elderly woman who came to the ER very sick. She was Greek and did not speak any English. “Jim went up to her, and held her hand, and whispered something in her ear. She was smiling and so happy, and I was watching from the doorway. I was still trying to not give him any attention. But when he was done I asked what he’d said to her.”

Jim told her that he’d said he’d traveled to Greece, so he spoke a little Greek, and he said what he knew to her, which, translated, meant: “You’ll be Ok my darling.” It was at that point that Jenny’s armor began to seriously crack. “I was like, ‘oh my God, this guy is a really sweet guy, a really nice guy.'”

Yana and Brannon also met while Yana was a medical student rotating through Brannon’s Emergency Department. As Brannon recalls, the hospital he most wanted to go work after residency had told him that they only hired chief residents, so he was taking on as many responsibilities as he could. “It was his way of using chief resident as kind of a filter system. So I offered to take any grunt work they would throw at me.”

That included training all the medical students who rotated through. Most days he felt like he was spoon-feeding the basics of emergency medicine to “students who had no idea whatsoever.” The work was tedious, Brannon recalled. “But, one day the most beautiful girl I’d ever seen came in.”

Yana and her parents escaped the Soviet Union as “Refuseniks” when she was a little girl, just before the Berlin Wall came down. They arrived in the U.S. with nothing, and Yana worked her way through college and med school at her own expense, as did Brannon. As he recalled their courtship: “Despite my being an exhausted intern in a residency packed with competition, the beauty still chose to honor me with her affection.” Brannon added, “Not a day goes by that I don’t tell her how grateful I am for her choice.”

For Hire: Two Emergency Physicians

The McQuistons and the Duncans may have had similar courtship stories, but after that the similarities end. As Yana was finishing her residency in Michigan, Brannon said they kept hearing about how cool Austin was. But when they traveled there to interview, “we didn’t have the first idea of how to see the city,” he said. Brannon was a musician, and he had heard about Austin’s bustling music scene. Not to mention, he and Yana both had a love of wakeboarding, and they’d heard Lake Austin was an “epic” place to ride. They were excited to check it out.

But they made some key mistakes booking their travel. To begin with, they arrived two days after a music festival had wrapped up, leaving most of the music venues closed. Meanwhile it turned out the hotel they booked was in Austin’s only bad area. Plus, Brannon said they were a bit naïve about how sought-after Austin jobs were. They didn’t realize how unusual it was to even get an interview that trip.

They interviewed with one of the directors at ESP, a USACS founding partner, but they were full at the time. Still, three months later there was an opening. Yana and Brannon’s second trip to Austin was magical, Brannon said. “We drove into the city, this time over the ‘Bat Bridge’ just at dusk, and millions of Austin’s trademark bats flew out from under the bridge in waves all around us. Every music venue on every corner had the doors open with the most amazing music flowing out. ESP put us up in the coolest hotel looking out over Lake Austin, and we had the perfect weather for renting a boat and boarding up and down the river. We were smitten, and had to laugh at how poorly we had planned the trip the first time.”

One of the physicians had decided to leave to become a missionary, and Brannon got the call to come interview at Seton Main Hospital in Austin. Meanwhile, Yana interviewed with the director at Seton Southwest. Drs. Sam Roberts and Bruce Moscow offered them the jobs. It was a good fit for both of them. “Looking back, I can’t express how grateful I am that they gave us that opportunity when so many other great docs were also trying for the spots,” Brannon said.

Meanwhile, Jenny and Jim had a very different job search experience.

After Jenny finished residency, the two decided to take an epic road trip, starting in Florida and driving up the entire east coast to Maine (Jim recounted the road trip in a 2015 blog post). While the Duncans may have done everything wrong, Jenny recalls that during the road trip she and Jim became accomplished interviewers in their own right, learning to spot signs of a troubled department and discern when something just wasn’t right.

“It was like the tables were turned,” Jenny said. “We just knew what to ask.” Or, as Jim wrote in his post: “By the end of our road trip, we were pros. The usual nervousness that accompanies an interview was only a distant memory.”

They did 30 interviews and got 30 job offers, ultimately ending their road trip when they got to Maryland and interviewed with directors from MEP Health, another USACS founding partner. Jenny said MEP was the first group to actually interview them separately and treat them as individuals rather than a two for one. Besides that, they just clicked with the leadership. “It just felt different,” Jenny said.

As Jim wrote: “It was immediately clear that this group was different than all the others that we had interviewed with. Many companies have developed ‘Mission Statements’ and ‘Core Values.’ Sometimes they’ll put them on a wall or in an advertising pamphlet. But these guys just exuded excellence, compassion, integrity and trust. It wasn’t something they strived for; it was who they were.”

Juggling Work and Family

Right away Jenny and Jim set on a strategy of divide and conquer. Jim launched into leadership roles and took on a lot of administrative work. As a member of the MEP executive team, his responsibilities included frequent travel to fill shifts at hospitals throughout Maryland. Meanwhile, Jenny focused on the kids. “It was clear that one of us had to be the primary kid person, and one of us had to be the focus on partnership and career advancement person,” she said. “I was like, I just want to be an ER doctor, keep up my skills taking care of critically ill people, while also spending as much time as possible with the kids.”

Her typical day includes driving her two sons, 7 and 8 years old, to soccer, baseball, Cub Scouts, Summer swim teams, karate, and more. “The Summers are just crazy,” she said. The McQuistons have part-time help from someone who has known the boys since they were babies. She comes during school days to help with meals and cleaning. But Jenny does all the driving.

Jenny works approximately two shifts a week on Tuesdays and Thursdays, and they coordinate their schedules so that Jim doesn’t work either of those days and can fill in on driving and parenting duties. The whole juggling act only works, Jenny said, because of an “amazing” woman at USACS named Margaret Estep. Margaret schedules their shifts. “She has day by day managed both our schedules together to a T,” Jenny said, with fewer mess-ups in seven years than she can count on one hand.

While Jenny and Jim divide responsibilities, Yana and Brannon have hit on a completely different solution: coordinated night shifts.

“With emergency medicine, you can either be a dedicated overnight doc, or you can be on a rotating schedule,” Brannon said. “And trying to schedule any kind of childcare around that is kind of hard. We realized when we started doing overnights, scheduling with the kids got way easier.”

The Duncans have a full-time nanny with a somewhat non-traditional schedule. The nanny comes to the house after the Duncan’s have had dinner, bathed the kids and put them in their PJs for the night. Then, Yana and Brannon leave for shifts at their respective hospitals in Austin. Between the two of them, they see 7,000 patients a year all between the hours of 8pm and 6am.

While they work, the nanny puts their three kids to bed. The Duncans have twin three-year-old boys and a six-year-old daughter. While they work, the nanny sleeps at the house, wakes up with the kids, and takes them to school. That allows the Duncans to sleep through the afternoon after their shifts. When they wake up, they can pick up their kids from school and spend the afternoon and evening with them.

“We get all our evenings and afternoons with our kids,” Brannon said. “On days off, we switch to a human schedule,” which can be a little jarring he admits. “We’ve tried to ask our kids to sleep until 3pm but they wouldn’t do it.”

He says the schedule can be trying, but ultimately it works. He once ran into a neighbor in their downtown Austin apartment who called them “the bleary-eyed family,” a label they’ve always joked about since.

Like the McQuistons, Brannon credits the schedulers with making it all possible.

Impossible But Not Impossible

Brannon said the support from ESP, and now USACS, has always been there for making their careers work with young kids. “USACS does an amazing job of helping our full-time parents work around raising families,” he said. “Everyone has needs, and it’s nice to be part of a group that tries to anticipate families’ needs and be ahead of the curve on making sure they are supporting them.”

For her part, Jenny said her life is “crazy and amazing,” but not difficult. “A lot of people think having kids and mixing dual ER schedules together is impossible, but it’s not impossible,” Jenny said. “Jim is very happy. We have lots of time left over to be active, go on vacations, go to the gym. I am not crazy stressed. I work two days a week. I am with the kids a lot, which I love… I am very happy.”