Doctors find more opportunities for part-time work

By Mary Jo Feldstein
http://www.stltoday.com

When Dr. Jane DeFalco finished her residency in the 1980s, few physicians worked part time.

DeFalco, a pediatrician, knew she wanted a lighter schedule while raising her children. But she figured part-time work would be scarce, forcing her to give up the freedom and earning potential of owning a private practice for a career of hourly wages.

In recent years, however, medicine has become more accepting of doctors with lives outside of the exam room. This trend has given physicians the ability to nurture families or explore personal interests without committing professional suicide.

Nearly 20 percent of physicians are working part time versus about 13 percent just two years ago, according to a recent survey of nearly 14,000 doctors by Cejka Search, a physician recruiting firm based in Clayton.

It was the second consecutive year that the figure hovered around 20 percent. Carol Westfall, president of Cejka Search, said the question is whether it will rise even higher.

“I’m over the surprise, because I’ve worked in this industry with physicians for over 20 years now and we can see the changes in the work force,” said Westfall. “For these physicians, having a balanced family life and time for themselves is equally as important as the prestige that might be involved in having a full-time, highly career-driven job.”

Seven years ago DeFalco started her own practice, Chesterfield Pediatrics, with three other physicians. She works the same number of days but only 40 hours a week, about half as many hours as her partners. She planned to return to work full time when her kids entered high school, but found she preferred attending their sporting events. DeFalco also took time out last summer for a medical mission to help children in Kosovo.

“I think the kids have really appreciated the fact that I’ve worked part time, and I have some very good partners right now who are very flexible,” DeFalco said. “In general, I think I’ve led a very blessed life.”

Experts say the change in attitude has been driven more by necessity than social awareness.

As the need for doctors grows, particularly in certain geographic areas and specialties, hospitals and physician practices are becoming more flexible.

“Physicians are in the driver’s seat in the sense that they can set the rules about how they are willing to work,” Westfall said. “The industry is having to adapt a bit.”

Despite the growing acceptance, drawbacks still exist. Many part-time physicians are paid relative to the number of hours they work or patients they see. Depending on the arrangement, they can have the same responsibilities for off-duty call and visiting hospitalized patients as colleagues in full-time practice. And some practices refuse to offer partnerships to doctors working part time.

“People felt very strongly about that one way or another,” Westfall said.

DeFalco spends as much time on call and making hospital rounds as her partners. She also must pay the same for malpractice insurance as a full-time physician. And, though she’s not always there, she has to contribute to the office’s costs for secretarial staff, billing and other overhead.

“It can be difficult to cover your expenses,” DeFalco said.

There’s also the relatively frequent, unexpected emergencies, said Tim Elliot, an attorney for the Lowenbaum Partnership in Clayton.

“It’s not like physicians punch a clock,” said Elliot, who negotiates health care employment agreements.

Though the majority of physicians seeking part-time employment are women beginning their careers and men nearing retirement, this is changing as well. Westfall has encountered married physician couples who both want to work part time immediately after finishing their residency.

There are more part-time-friendly positions for these physicians to enter. There’s an increasing number of radiology clinics, urgent care centers and a new breed of medical staff called hospitalists who treat admitted patients. These opportunities give many physicians the chance to work a desired shift rather than have an ongoing responsibility for patients.

PracticeMatch Inc., another local physician recruiting firm, has assembled a pool of physicians paid by the day or week for hospitals or doctors’ offices facing a short-term need.

There’s an unintended consequence, however, to easing the physician shortage with more part-time physicians: The fewer hours each doctor works, the greater the need for more doctors.

mjfeldstein@post-dispatch.com | 314-340-8209

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