More doctors work part time, flexible schedules

Wilfred Watkins, MD, and Jennifer Shu, MD, are at very different points in their careers, but they share the same desire, as do many of their peers -- they don't wish to work full time.

Dr. Watkins, 77, has chosen to work part time rather than retire. Dr. Shu, who is in her early 40s, doesn't want a full-time position so she can have the freedom to spend more time with her two young children and write books.

"I worked part time long before children. For me it was quality of life," said Dr. Shu, who works three-quarters time with a 14-physician pediatrics practice in Atlanta. "There are things I want to do outside of medicine."

A survey released March 12 by Cejka Search, a physician search firm based in St. Louis, and the American Medical Group Assn. found that Dr. Watkins and Dr. Shu have plenty of company. In 2011, 22% of male physicians and 44% of female physicians worked less than full time, up from 7% of men and 29% of women from Cejka's 2005 survey. The 2011 survey covered 14,366 physicians in 80 practices, which had from three to more than 500 doctors each.

Two of the fastest-growing physician demographics -- men near the end of their careers, like Dr. Watkins, and women at the beginning or middle, like Dr. Shu -- are the most likely to demand part-time or flexible work schedules, according to experts in physician recruitment.

The physician population rose 60%, from 615,421 to 985,375, between 1990 and 2010, according to the American Medical Association, with the male population getting older and the female population getting younger. During that period, the number of male physicians older than 65 grew 109%, from 87,941 to 184,064. Meanwhile, the number of male physicians younger than 44 declined, down 44,000 to 201,507 in 2010.

The number of female physicians younger than 44 grew by 109%, from 75,214 to 157,588. The fastest-growing physician demographic also is the smallest in number -- women older than 45.

Dr. Watkins, a urologist in Nampa, Idaho, had planned to transition his solo practice to a younger partner and then retire. But even though Dr. Watkins recruited a partner, he realized he wanted to scale back rather than step down. So his private practice is open one half-day per week for long-time patients, and he works a day or two a week at a local Dept. of Veterans Affairs facility.

"It's the best thing I didn't retire," he said. "I would have gone crazy."

Where to find part-time work

So where are all these part-time physicians finding work? "If physicians look, they will find something," Dr. Watkins said.

From the Cejka/AMGA survey, it appears that the first place to look is large, physician-owned practices. Twenty percent of male and 23% of female physicians in practices of 500 or more doctors worked part time. Meanwhile, only 6% of male and 4% of female physicians in practices of three to 50 physicians worked part time. In hospital-based practices, the total working part time was 5% of male and 7% of female physicians.

Physician search firms said the increasing demand for part-time work -- and large practices' positive reaction to physicians' part-time requests -- is pressuring smaller groups to offer similar options. According to the survey, 75% of groups in 2011 offered a four-day workweek, and 30% allowed job-sharing.

"Practices need to keep an open mind if they have a good candidate interested," said Steve Marsh, managing partner of The Medicus Firm, a physician search firm with offices in Dallas and Atlanta. "Try to find a way to make it work."

For example, search firms said a practice with a physician considering retirement might be able to carve out part-time work to keep him or her caring for patients. A small practice also might consider offering part-time work when it needs to expand but isn't in the position to offer full-time work and the promise of a practice share. With the Cejka/AMGA survey showing few physicians working part time at hospitals, small practices might be able to compete with them for doctors by offering the possibility of a more flexible schedule.

"It's good for practices to say, 'How can I make this work?' rather than, 'This cannot work because I have to do it this way,' " Marsh said.

Honesty in job searching

Experts advise that physicians looking for less than full-time work be up-front with potential employers about what they want and why they want it. Because of the ongoing work force shortage, flexibility is possible.

When Dr. Watkins was considering his options, the Army and Navy veteran approached the VA to find out what its needs were and how he could help. Dr. Shu has worked part time at smaller practices by stating her availability and negotiating a schedule that works for all concerned. And she did so at practices that had a history of hiring physicians for part-time work.

"For me, it wasn't hard, and I had that as a priority," said Dr. Shu, an at-large member of the Governing Council of the AMA's Women Physicians Congress.

Some specialties, however, may find it more difficult than others to set up a part-time or flexible arrangement, physician recruitment experts and consultants said. Part-time practice is not uncommon in pediatrics and other nonsurgical specialties but can be harder to set up for surgeons. Specialties that are more shift-oriented, such as hospitalists, and urgent care and emergency department physicians, may find part time easier to arrange.

Physicians also need to think about what kind of hours they want, consultants said. For example, offering to work less-popular time slots or hours with high patient demand may be more appealing to a practice.

"There's usually a reason that somebody wants to work part time," said Lori Schutte, Cejka's president. "If you do not offer that option, they will find someone who will. But there are ways to do it. Sometimes a small group can be more flexible or more creative."