Can a physician work part-time?


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Written by Jesse Lopez MD • in Career Choice

I first asked this question about two years ago after one of the longest days of my life as a practicing physician while on call. To my surprise, yes there are many physicians who have transitioned from full-time to part-time practice. Many of these physicians make up a new trend of socially acceptable behaviors that other physicians once frowned upon in the, not too distant past. Part-time physicians make up approximately 15% of the physician workforce and have helped lessen the growing epidemic of physician burnout which now is estimated to be a whopping 42%!

Many physicians choose part-time work for their careers for several reasons many of which even surprised me. Next, let’s take a look at what this group of physicians look like and explore some of the reasons they have taken this approach while weighing some of the pros and cons to their decision.

Why do physicians go part-time?

There are many reasons both personal, sociological and economical reasons all people, not just physician decide to transition to part-time work. These include:

  • Need time to take care of children or other family members
  • Physical limitations or disability prevent full-time employment
  • Lack of sufficient work to be fully employed
  • Pursuing other interests, careers, hobbies, etc.
  • Achieving financial independence
  • Seek work-life balance
  • Or they are Millenials! Jk

What does the part-time physician look like?

The demographics of part-time physicians are somewhat surprising. As you can see from the table below. both male and female physicians work part-time but from a percentage perspective. 22% versus 12% of women versus men work part-time. However, if you look at the total distribution of approximately 950K physicians, 65% are men. Therefore from a total number perspective, the number of men and women who work part-time are nearly equal at ~75K each.

What is “full-time” physician work?

It is extremely difficult to define part-time without first begin discussing what it means to be full-time. The data is also not based on actual numbers but a statistical sample-based upon several studies and national survey data conducted by companies like Merrit Hawkins.

Hours N = ~15K<2020 to 40>40 to 60>60
Full time
Women1% 8% 53% 39%
Men1%5%48%48%
Part-Time
Women13%57%26%4%
Men 17%51%22%10%

First, examine the average American workweek which is 34.4 hours in 2019 according to the U.S. Bureau of Labor Statistics and not 40 hours which is what everyone assumes. Now, look at physicians.

Everyone knows physicians work long hours as illustrated by the classic article “The Deceptive Income of Physicians“. Prior to 2008 residents had no work hour restrictions and since then have been limited to no more than 80 hours per week with the average between 60-80 hours. Although these restrictions are loosely enforced today, no such restriction exists beyond medical training.

The numbers speak for themselves. Looking at the table above adapted by a decent Journal of Peds article the supermajority work beyond 40 hours a week and a significant number of them work beyond 60 hours a week. I know from experience not to discuss work hours with my surgical colleagues since many of them have 100 hour work weeks.

Therefore it is safe to assume a full-time physician works much greater than 40 hours week. If you look at physician surveys like the one from Medscape greater than 75% spend more than 30 hours of the week in direct patient care and 88% spend greater than 5-9 hours of time on paperwork and administration. Approximately 30% of the respondents also work greater than 46 hours a week on direct patient care 32% on paperwork/administration.

The Physician’s Foundation conducted a demographics survey every other year since 2012. The survey averages over 8000 participants each year and represents all states and all specialties. Based upon self-disclosed results physicians have consistantly averaged 51 hours per week since 2012. Similar to the above Table greater than 78% of respondents work more than 40 hours per week

In conclusion, most full-time physicians work more than 40 hours a week and average around 51 hours per week.

Does specialty affect the number of hours worked?

The data on this topic is lacking and I can see why. It is a very personal subject and difficult to study. Physicians are not hourly employees and almost never “clock in.” Any meaningful way to study this topic would require some type of survey which would be subjective and poorly representative of all possible participants. Especially since the 80+ hour a week doctors would not have enough time to fill it out!

The only decent study comes from Arch Intern Med article in 2011 looking at total annual work hours. It can only be inferred who works the very most and who works the very least based upon a benchmark of total hours worked by Family Practice. Everyone else is somewhere in between.

Works LeastWorks Most
Pediatric EDVascular
OccupationalCritical Care
DermatologyThoracic
Emergency MedSurgical Subspecialties

The range of hours varies considerably as well so I find it very difficult to draw any meaningful conclusions.

The Physicians Foundation in the 2018 Survey of Ameria’s Physicians found very little differences when comparing “Specialists” to “Primary Care” but found a larger difference between younger and older physicians where younger work 5 more hours per week on average.

Procedural based physicians tend to work about the same than non-procedural based in general but may vary greatly if you look at specific specialty type.

How Many hours do part-time physicians work?

It is really hard to know how many hours a part-time physician works based upon the studies since it does not have any real definition. In most corporations, it is determined to be less than 32 hours a week or less than 80%. My current job defines it as less than 78.6% of a possible 80 hours based upon a biweekly pay period which I am quite sure it varies between employers.

Anecdotally I know physicians who work part-time who work a full 5 day work week but do not take any call and others who take call but only work 18 weeks a year. Therefore any interpretation of the data would be useless.

However, it does seem that there may be a subset of clinicians who work greater than 40 hours a week as part-time. How is this possible? Looking at the table above again ~30 of physicians in this one study still work full-time hours even though they classify themselves as part-time. Therefore it would seem that if they worked originally 100 hours a week and then went down to 50 then the work decreased by 50%.

A third of part-time physicians may work more than 40 hours a week!

Does the U.S. government have any data on physician work hours?

The short answer is no. The usjobs.gov lists each physician position at Full time working from 8 am to 4:30 pm with variation in tours of duty if necessary. When I searched for part-time Jobs most of the listing had a work schedule defined as “20 hours” per week.

Since I could not find too much information I will look into this subject in a future blog post after I complete some more independent research. I welcome any resource to help solve this riddle.

What does Part-time physician work look like?

The most traditional definition of part-time work involves working less than 40 hours per week. This as I have pointed out before can vary widely. Generally speaking each day represent 20% of the workweek. If you work 3 days a week you will be at 60% and so forth. Likewise, if you consider an 8 hour day 100% then a 6 hour day will be 75%. Since physicians do not work 8 hour days using this calculation can be very challenging.

For productivity, RVU based, a physician working part-time limiting the number of procedures will decrease the time spent working in a somewhat linear fashion.

Weekly versus Daily strategy:

A weekly strategy would involve working full-time hours during the week but then working fewer weeks.

The advantages of this strategy:

  • Easy to calculate
  • Less impact on certain staffing models like ER, Radiology, and Anesthesia
  • When you are off you leave your work at work
  • Having entire weeks off at a time will allow for developing a life outside of medicine
  • Easier to take extended travel plans

The disadvantages:

  • Doesn’t solve the daily overload problem especially longer work weeks
  • Unavailable to you patients or rely on others to take care of your interventions
  • Doesn’t give more time to personal daily tasks like spending more time with kids, family or other daily activities
  • Can sometimes feel like full-time if too many weeks go by without a break

Daily Advantages:

  • Get out early every day to take care of personal or family necessities like appointments, kids after school activities, etc.
  • Less work on a daily basis generally leads to more job satisfaction statistically.
  • Less chance of feeling overwhelmed by the end of the week.
  • Your patients will have access to you when they need you.
  • You will be there every day to keep up relationships at work.
  • You could work like Dentists or Optomitirsts and have Monday or Fridays off.

Daily disadvantages:

  • Taking call can be very challenging to administer
  • Your peers may grow to resent you
  • This strategy is very difficult if you are a proceduralist depending on the specialty
  • If you depend on ER or FP consults for referrals, your business may dry up.

What are the ideal specialties for going part-time?

This is a trick question. I personally believe any specialty could transition into a part-time work but it will require a strategy, creative problem solving, great personal resolve and a very very strong will to succeed.

Some specialties lend themselves to easily transition to part-time work but I have met part-time physician in nearly every single specialty.

Google search indexes all the jobs from major recruiting companies and are listed and searchable based upon location, specialty, and full-time/part-time status. Looking only at part-time jobs showed the incredible diversity of specialties and companies seeking out these type of physicians. The more specific job boards like gaswork.com did not come up in this search.

Are Part-time physicians happier than full-time?

It seems to be true based upon hours worked. Physicians have been working fewer hours both in primary and non-primary care. This reduction and desire to further reduce work hours is directly correlated with physician work satisfaction. There seems to be a move to reduce these hours by reducing administrative work more than clinical work. This seems to be confirmed by evidence than the greatest dissatisfier among physicians continues to be electronic medical records.

I transitioned to part-time medicine last year as an Anesthesiologist and I can say with certainty, It was the best move I ever made.

Conclusions:

  • Many physicians practice part-time medicine.
  • Men and women practice part-time work equally.
  • The average physician works greater than 54 hours a week.
  • Part-time work, therefore, is defined as anything less than 40 hours a week.
  • Primary Care and Non-primary care work similar hours.
  • Part-time work leads to greater career satisfaction.
  • Any physician could practice part-time based upon specialty.

References:

  1. Trends in United States Physician Work hours. Andrea S. Christopher MD The American Journal of Medicine. Vol 1267, 7, pp 674-680
  2. Medscape Physician Compensation Report 2018
  3. The Physician’s Foundation 2018 Survey of America’s Physicians
  4. The Balance Career. What is the Average Hours per week in the US?
  5. The U.S. Bureau of Labor Statistics
  6. Pacific Companies. How many hours do physicians work per week?
  7. Google Job Search
  8. Annual Work Hours Across Physician Specialties. J. Paul Leigh, Ph.D. Archives in Internal Medicine, 2011 Vol 171(13) pp 1211-1213.
  9. Variation in Part-Time work among Pediatric Subspecialties. Gary L Freed MD The Journal of Pediatrics. Vol 195 pp 263-268

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