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Switching to Part-time from Full-time

 
​​​​One of the greatest challenges that many physicians confront is balancing the demands of a career and family/personal life, and it has been suggested that pediatricians can lead the way on this important issue. 

Pediatrics is in a unique position, because it has one of the highest proportions of women physicians among all specialties and because pediatricians, whose expertise focuses on healthy child development, greatly value the time that parents spend with their families. Part-time or reduced-hours positions have become one way that many pediatricians have tried to integrate their own careers and family/personal life, which has resulted in higher rates of part-time work within pediatrics in contrast to other specialties.​ What do we know about pediatricians working part-time?

An AAP survey of nearly 9,000 pediatricians describing themselves as working part-time (less than 26 hours per week in any number of professional duties) found that part-time pediatricians:

  • are most likely to be providing primary care services at an a​mbulatory setting in an urban community
  • spend a significantly greater portion of their time providing direct patient care than full-time pediatricians, and a smaller portion of their time on health care administration and research
  • are less likely to be men except in older age groups
  • are less likely to work in a hospital setting or in academic medicine

It is expected that many younger pediatricians are planning to continue to work part-time for much of their medical career, and that among older pediatricians, part-time practice may be a transitional phase prior to retirement.​

Making the Transition to Part-Time

Going part-time may require some financial sacrifices or scheduling concessions, but, faced with today's workforce shortage, many employers are receptive to considering alternative work arrangements. The key to making it work is setting realistic goals and communicating upfront with your colleagues, patients, and employer.​

Identify what you need out of this and what the practice needs out of this. Aim for meeting those needs.​

Put those pieces together and work out an arrangement that works for everyone. It has to work for everybody — otherwise it works for nobody.​

For many pediatricians, part-time medical practice has more to do with flexibility than reduced hours. You might cut your weekly clinical hours from 40 to 20, for example, but put in another 20 hours making calls, charting, and handling other administrative tasks outside of the office - perhaps at home. Those additional tasks must be taken into account to determine your true workload. For some, the ability to stay independent and maintain control over your group's style of practice more than makes up for the extra hours worked from home. However, other pediatricians may choose to simply spend fewer hours with patients to lessen their overall workload.​

Consider the needs of the practice when working out a part-time schedule. For example, seeing patients from 10 am to 2 pm might be ideal for your family life, but is not very convenient for patients or helpful for your productivity.​

Since most part-time physicians' pay is partially tied to productivity, working during high-volume times makes sense from an income perspective. If given a choice, working an afternoon shift so you can accommodate patients who call in the morning and need to be seen that day typically meets important practice needs and patient preferences. Plus, it helps your productivity and salary.​

Have conversations upfront with your employer and colleagues about how your schedule changes will impact the office. For instance, will other pediatricians be expected to fill in when you go from 40 office hours to 20 office hours or will the practice hire non-physician clinicians or other part-time physicians?​

Job sharing, where two or more physicians share one full-time position, is another scheduling option that often meets the needs of both employer and employee.​

From a financial perspective, it's riskier to go part-time as a solo practitioner than as an employee due to fixed overhead costs, but there are ways to make it work. The most economical strategy is to hire one or more non-physician providers to help with routine appointments. Another option is to hire an additional part-time physician to cover night or weekend shifts, which boosts revenue without increasing overhead costs. In a larger group, the employer bears the burden of fixed costs but you may have to make some concessions. You may switch to a part-time nurse or share a nurse with another physician in order to compensate for your reduced productivity.​

Typically, part-timers are paid a base salary or hourly rate plus a productivity bonus tied to relative value unit reimbursement. In today's tight employment market, employers may be willing to offer full-time benefits to part-time physicians, sometimes including malpractice insurance. Larger groups and hospital employers often have the flexibility to offer higher salaries to part-timers than smaller practices due to their negotiating power with insurance plans.​

Career Impact

No matter how loyal your patients, going part-time is likely to have a long-term impact on your patient-base. Depending on how long you go part-time, some patients will leave and when you come back to full-time you may have to rebuild your patient-base. You’ll likely lose referrals once referring physicians learn of your part-time schedule. However, those potential drawbacks are unlikely to slow the trend toward more part-time pediatricians, considering the increasing number of women going into pediatrics and the high priority that younger physicians place on work-life balance. 

Part-time options have many benefits for pediatricians at various stages of their careers. In addition, part-time schedules can retain those pediatricians who would otherwise choose to leave clinical medicine due to burnout.​​

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