By Douglas Riddle, Curriculum Director of The Carol Emmott Foundation

Among the things the pandemic upended, family organization took a dusting from uncertain work settings, increased remote work, and the dissolving of clear time boundaries among different parts of our lives. The pandemic, though extensive in its impact on our world, was only one of the drivers of the changes in how we do “family”—its responsibilities and opportunities.

Emerging research has focused on how Gen Z is organizing work and parenting, but the impacts go beyond generational differences. A few conversations with Carol Emmott community members in heterosexual married relationships, parenting children reveal that a rich pragmatism is affecting family organization more than cultural traditions or societal expectations. Future explorations may sample a more diverse set of patterns beyond these.

The Gen Z focused research has identified several emergent characteristics shaping family organization:

1. A desire for flexible work arrangements, often taking advantage of hybrid work schedules.
2. More fluid understandings of role obligations, less tied to gender, more often negotiated in response to the unique family situations.
3. Greater responsibility across generations for care, affecting choices about work.
4. A move toward flexible, situational parenting, recognizing the differences between children in the same family.
5. Parenting that is attentive to the emotional management within the family.
6. High reliance on technology to manage communication and coordination of family activities.

Conversations with Carol Emmott fellows illustrate the range of responses to the persistent challenges driven by tectonic changes in our social, economic, and vocational worlds.

The changing nature of family organization became prominent in our thinking with the Symposium presentation of Dr. Vanessa Walker at The Carol Emmott Foundation 2026 annual meeting. Vanessa (Fellowship Class of 2025) described how her spouse, Robert, and she made the choice to customize their family organization around key shared values. From the time their daughter was born, they decided that having a constant, stable figure at home was a top priority. She and Robert decided that Robert should be that figure. “I never experienced the fragmentation of conflicting roles,” she said. “I was free to take on roles that required late nights or early mornings. I could work on building systems instead of reacting to things at home.” The positive benefits of this choice have become visible in a variety of ways, one of which surfaced when the parents heard their 6-year old boy and 9-year old girl arguing: “Would you tell Salem that boys can be doctors too!”

Cultural factors play a role in shaping fellows’ responses to changing circumstances and their demands. They expand the range of options available to a family. Dr. Irene Kim (Fellowship Class of 2020), Director of Transplant Surgery at Cedars Sinai Medical Center is married to a technical consulting professional. When their daughter was one year old, her parents moved in with them. They also found it helpful to have a live-in nanny. Irene says this pattern is not uncommon in Korean families where the nanny provides dependable care and the grandparents can fill in wherever there are gaps. This also makes it possible for Irene to prioritize education. She is able to work an hour each week with each child, as does her husband, Tom.

Dr. Rahma Warsame (Fellowship Class of 2022) is an Associate Professor of Medicine and Oncology at the Mayo Clinic. Her husband is also a full-time worker, but he works from home, and that flexibility allows him to take a sick day, pick up their children, or go to swim lessons. Her much-less-consistent schedule and necessary travel has mandated pragmatism with respect to household tasks. She says, “He cooks, I clean.” They employ a housekeeper every two weeks for help, but she adds, “Mostly, I do all of it.” That includes the laundry with the help of her 8-year old daughter whose job is to fold and put everything away as well as take care of her own bedroom and the mud room. Otherwise, Rahma and her husband, David, share the parenting responsibilities. She takes them to doctors’ appointments. He takes them to sports, swimming, rock climbing, and so on. He shops and does the cooking. They made a decision not to engage a nanny because, “I want to do as much parenting as I can because I’m pulled away so much.” She admits that the pragmatic approach was hard won over time because they both come from backgrounds with more rigid gender roles for the household, but the benefits of each of them having significant parenting time are incalculable.

The Chief Strategy Officer of the Duke University Health System, Morgan Jones (Fellowship Class of 2020), and her husband, Brent, have a full house with 5 daughters and one son (6 months old as of this publication). When they married in 2023, they recognized that stability and emotional support were going to be particularly important because all their daughters had experienced loss of a parent. When Brent concluded his traveling consulting project, they made the tough decision to prioritize consistency at home and focus on stability for their family, instead of two incomes. Given Morgan’s more predictable work schedule, it made the most sense for Brent to take on the role at home. He manages the day-to-day—shopping, cleaning, laundry, cooking—and together they coordinate each week to keep everything running. Morgan shares that the shift in parental roles requires constant communication and flexibility. “I appreciate Brent so much as a girl (and now boy) dad—he’s showing our kids every day that both moms and dads can work inside or outside the home. There’s no one ‘right’ role, just what works for your family.”  Morgan admits that the changed parental roles demand continual adaptation and everything requires negotiation. They’ve found that a standing Sunday planning meeting helps them stay aligned for the week ahead, reducing stress and making sure no one falls through the cracks. The family has also built intentional rituals to create structure and connection—Sunday afternoons often include tennis or pickleball followed by dinner out, and they prioritize sitting down together for dinner as a family each weeknight.

There are as many emergent patterns of family organization among fellows as there are fellows, but even these few examples provide some lessons about emerging trends. We chose fellows within a fairly narrow range drawn from heterosexual married couples, but the range of family structures is much wider than sampled for this article. What we are seeing is:

1. Fellows are committed to finding pragmatic solutions to the complexity of family life. The changing demands require new solutions that eschew dependence on gendered expectations.
2. Culture and family history can be both constraining and resourceful. Especially for men, the easy familiarity of gendered expectations can take significant mental and emotional work to release. The benefits of freedom from those expectations emerge over time but are not always easy to predict in advance. It often falls to the woman to insist on the changes that are needed to ensure reasonable loads and shared household leadership.
3. Every family’s solution is going to be particular to that family. In a chaotic world without the ready infrastructure of a more stable society, individual solutions become the norm. Among healthcare leaders especially, the complexity of demands means that there will be few established resources a family can take advantage of. Basically, “you have to invent it yourself” is the message.

We suspect that the emergence of new family organizational structures is likely to accelerate for the near future. Social and economic uncertainty mean that the work of The Carol Emmott Foundation, and others committed to liberating all the resources available, becomes more and more important. Flexibility and range of choices depend on having enough support and safe places to explore alternative approaches. The Carol Emmott community has been designed to provide that encouragement for both practical reasons and to move toward greater justice in family life. The better we do that work, the more creative alternatives will emerge to shape the fulfilling family patterns of the future.