One of the greatest challenges that many physicians confront is balancing the demands of a career and family/personal life. Pediatricians can lead the way on this important issue because your expertise focuses on healthy child development. As a result, you greatly value the time that parents spend with their families. Part-time or reduced-hours positions are one way that many pediatricians have integrated their own careers and family/personal life. That's why there are higher rates of part-time work within pediatrics in contrast to other specialties. What do we know about pediatricians working part-time?
According to the AAP Periodic Surveys 2018-2019, one in four pediatricians works part-time. The report further indicates that women pediatricians in their 40s (40%) are more likely than other women (33%) to be working part-time.
Another 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 ambulatory 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 identify as men except in older age groups
- Are less likely to work in a hospital setting or in academic medicine
It has also been shown 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. You need to set realistic goals and communicate upfront with your colleagues, patients, and employer.
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 work life balance issues or burnout.
Identify what you need out of this arrangement and what the practice needs. Aim for meeting those needs. 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 the practice. It has to work for everybody.
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 10 hours making calls, charting, and handling other administrative tasks outside of the office - perhaps at home. Take those additional tasks and time 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.
Part-time physicians' pay is frequently tied to productivity, working during high-volume times makes sense from an income perspective. Many part-time pediatricians choose to work an afternoon shift to so you can accommodate patients who call in the morning and need to be seen that day. This often 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 clinic. For instance, will other pediatricians be expected to fill in when you go from 42 office hours to 25 office hours or will the practice hire non-physician clinicians or other part-time pediatricians?
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. These situations are difficult to find and require a lot of commitment on all sides to make them work.
It's riskier to go part-time as a solo practitioner from a financial perspective 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 locum tenes physician to cover night or weekend shifts, which boosts revenue without increasing many overhead costs. In a larger group, the employer bears the burden of fixed costs, but you may have to make some concessions. You may 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. Negotiating a fair pay rate for your part-time position can be challenging. Hospitals and practices usually use three models when formulating part-time physician pay: percentage of full-time physician's salary based on hours worked, percentage of fees collected for patient services, per diem or revenue-based rate (minus overhead expenses). Per AAP research, starting salaries for part-time positions were about 30% less than the starting salaries for full-time positions In today's tight employment market, employers may be willing to offer full-time benefits to part-time physicians, sometimes including malpractice insurance.If malpractice insurance provided is not an occurrence policy make sure it includes tail insurance for claims brought after the policy is terminated. 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 and economies of scale for overhead expenses.
No matter how loyal your patients may be, 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. As a result you may have to rebuild your patient-base when you come back to full time. You may 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 given the high priority that younger physicians place on work-life balance.
American Academy of Pediatrics