The Part Time Question: Making it Work for Smaller Practice Physicians

Across all medical specialties, locales, ages and pay grades, there's one thing that a majority of physicians agree on when assessing the most important aspects of practicing: flexible scheduling. According to a recent survey by Cejka Search, a physician placement firm in St. Louis Missouri, roughly half of all respondents (from a variety of specialties) indicated that a flexible working environment, specifically a four day work week, was an "important" or "very important" factor in their own job, in choosing a practice to work with and whether or not to stay with one.

But why four days instead of five?  Logically, cutting a day should have a significant impact on productivity, and if excising a day means chopping up lost hours and redistributing them among the remaining five, doesn't that only add to an overbearing workload? The reality is that many physicians are faced with the challenges of raising children and tending to a family, and find their priorities and work-life balance unevenly tempered when working full time, or at a five day work week. However, the phenomenon isn't exclusive to young adults as veteran physicians desiring to scale back their hours and involvement, but not leave altogether, still want to practice medicine. It shouldn't come as any surprise that, according to the same Cejka survey, the two fastest growing physician demographics are male doctors in the twilight of their career, and female doctors in the dawn, so the four day work week is becoming more and more prevalent. 

"Four day work weeks have become more common in the past two years because offering money isn't the deciding factor in attracting physicians," says Jason Bishop, director of physician recruitment for Merrit-Hawkins and Associates. "Moving away from 'compensation conversion' and towards 'quality of life' is much more attractive at the end of the day" (Making Part Time Work). In fact, a hefty 46.7% of the survey respondents claim they'd relocate to a "less preferred" practicing area (a rural one) if they were guaranteed the flexible scheduling perks like a four day work week.

For Physicians

In the eyes of a practical physician, the four day work week offers a hearty dollop of both occupational worlds. On one hand, they get flexible working hours and a chance to keep their personal life in check, and on the other they're still getting healthy compensation for their services. Furthermore, the four day work week is a strategic way for them to plan more days off without accepting the pay-cut that'd result from actually working part time hours.

If the four day work week is still too much, part time hours can be attractive to aging physicians on the precipice of retirement. Simply put, it can keep them from going stir-crazy. They still maintain regular contact with a beloved profession and practice, they're not phased out cold turkey and they're still free to pursue other necessities and interests.

For Practices

The four day work week also lends its benefits to a practice. "Anything that gives physicians more flexibility, gives a practice an edge when recruiting," says Lori Schutte, President of Cejka Research. As it stands, about 75% of larger group practices offer their physicians a four day work week, to stay competitive in the job and recruitment market.

Additionally, as healthcare reform and ACA statutes are changing the dynamic of physician-patient interactions to something more "patient centered," a healthcare system has an increased need for physicians to work outside of the normal business hours. re-packaging five shorter work days into four longer ones can have physicians caring for patients into nights and weekends, and freely accommodates the changing healthcare landscape.

Ultimately, the four day work week endows physicians with a sense of control, good for fostering loyalty. It also allows for slightly longer work days and extended hours. When they know their personal life is in order they tend to work harder and with more commitment, which is passed on to the practice in quality work.

Practices must also acknowledge a physician shortage which is only going to increase in the coming years.  Accommodating requests for four day flexibility and even part time hours can be to their advantage.

How It's Been

Traditionally, the four day work week has been best applied to large practices and hospitals in a well-established healthcare system. They're generally focused in larger metropolitan areas with a  larger patient base and access to resources, but these trends shouldn't be the undisputed norms. Take, for example, Jennifer Shu, MD. Cited in Victoria Stagg Elliot's More Doctors Work Part Time, Flexible Schedules,  She works in a small pediatrics practice (14 physician) on a four day schedule, and finds that her decision to work fewer hours in exchange for her own work-life balance, don't hinder her in-clinic productivity in the least.

Looking critically, the four day work week may be a challenge for small or independent practices, but experts say it's more than "doable" (Stagg, Four Day Work week Popular for Doctors' Flexible
Scheduling). "It calls for more creative practice leaders who understand that this is a new environment we're in," says Tammy Jamison, Director of Physician and Executive Recruiting with Lehigh Valley Health Network in Allentown, Pa. "It can keep some physicians working longer." Business savvy and an attention to overlaps, heavy patient workflow times and shift details can have small practices offering the same flexibility that a large-scale practice can.

Into Action

If it turns out the four day work week is a viable or attractive option physicians, some of the most important elements of setting it up involve the establishment of clear and specific goals regarding their choice. While it's not cryptic science to figure out if it's right for them, a clear acknowledged understanding of one's personal goals outside of medicine help to make an informed decision inside of it.

Additionally, it's important for physicians to adopt an "up front" mentality with their superiors about these intentions, especially when applying for positions. Some listings will clearly outline positions with a four day work week option, but it's not always the rule. When a physician is forthright in the initial stages, they'll get much farther with superiors than if they try and spring it on their colleagues later in the game.  Most practices find it in their best interests to adopt a 'how can we make this work?' business plan, rather than a 'we've always done it this way,' one. In many cases, this can be the most important factor that makes a small practice viably competitive with a larger one, and a more attractive place for physicians to work. Aspiring physicians should also ensure that when they're vying for a four day work week, that they're actually profiling what this entails. Some practice offer four days of clinician work, and then set aside one day for performing administrative tasks.

Prevent Resentment

While personal and logical, the decision to take a four day work week, if done without care, may leave other colleagues feeling resentful or snubbed by feelings of "lack of commitment. Physicians scaling back their in-office time or redistributing their availability can take measures to prevent this from happening by showing their commitment and work ethic. This might mean taking a proactive approach to working unpopular shifts (like Friday and Saturday evenings) or performing less popular tasks more regularly. It's a compromise that can carry plenty of weight.

In other instances, contributing a special skill to a practice demonstrates a physician's value to the practice, that they're stretching above and beyond the standards of normal physician duties, and that they're an asset. As an example, a physician who speaks another language, (spanish for example) will be an appreciated addition to a practice in an area with a high hispanic population.

Conclusion

An honest look at one's goals, capabilities and aptitudes can reveal much, and a move to the four day work week can often bestow physicians with the flexibility and efficiency that they need to maximize the quality of their in and out-of-office work. As long as mindfulness permeates their in office work, sensitivity to a practice dynamic guides their actions and a proactive outlook accompanies all their in-office work, physicians in practices of all sizes and flavors, can attain the flexibility they need.

 


 

References

Elliot, Victoria S. "4-day Workweek Popular for Doctor's Flexible Scheduling." Amednews.com. American Medical Association, 17 Sept. 2012. Web. 13 Nov. 2012. http://www.ama-assn.org/amednews/2012/09/17/bisa0917.htm

Elliot,Victoria S. "More Doctors Work Part Time, Flexible Schedules." Amednews.com. American Medical Association, 26 Mar. 2012. Web. 13 Nov. 2012. http://www.ama-assn.org/amednews/2012/03/26/bil10326.htm

Elliot,Victoria S. "Making Part Time Work." Amednews.com. American Medical Association, 26 Sept. 2012. Web. 13 Nov. 2012. http://www.ama-assn.org/amednews/2011/09/26/bisa0926.htm

Fried,Jason. "Be More Productive. Take Time Off." NYTimes.com. The New York Times, 18 Aug. 2012. Web. 13 Nov. 2012. http://www.nytimes.com/2012/08/19/opinion/sunday/be-more-productive-shorten-the-workweek.html

Hering,Beth Braccio. "The Case for the 4-day Workweek." CNN. Cable News Network, 5 Sept. 2011. Web. 13 Nov. 2012. http://www.cnn.com/2011/09/05/living/four-day-workweek-cb/index.html

Dylan J. Chadwick

 

Dylan Chadwick is a graduate of Brigham Young University where he earned a Bachelor of arts in English and a minor in Spanish. Though spending his formative years in Cardiff Wales, he came to adolescence in Elizabethtown Kentucky, and considers it his home. He received the Eagle Scout Award, served a voluntary humanitarian mission to inner-city Los Angeles from 2007 to 2009, and once met Alan Alda on a golf course. He's an avid writer who cut his teeth contributing to student papers and continues writing for various print magazines, blogs and web resources. A ravenous fan of baseball, rock music and Dan Aykroyd-era Saturday Night Live, he plans on one day utilizing these interests in a Masters degree in American Studies and Literature. He also maintains a freelance illustration company on the side.