Category Archives: Health Care Policy

Sick of the part-time debate yet?

There’s been a lot of fallout over this weekend’s New York Times Op-Ed piece about doctors, particularly female doctors, working part time. I enjoyed reading the multiple reactions and reader comments and have been thinking about it quite a bit over the past few days. On my recent half day off I joined one of my partners at a conference reviewing Rheumatology board questions with the residents. Afterwards, since I was close to the office, I stopped by to sign some papers, review labs and make a few follow up calls.

Walking in, my partner says, “Hey, what are you doing here? Isn’t this your day off?”

Me: “Yeah, well, haven’t you heard? I’m ruining medicine with this part time nonsense!”

What exactly is part-time? In this world of “widget” medicine where we’re only paid for patients seen face-to-face in the office, we need to assign a value to the hours of uncompensated time outside normal office hours. Indeed, my “time off” is often spent attending meetings, participating in teaching sessions, reviewing research projects, filling out patient forms, catching up on labs, phone calls and emails and coordinating care for patients with difficult or complex cases. Things I maybe didn’t have a chance to do or couldn’t do before the office opens at 8am or after the doors close for the day. Fortunately or unfortunately, the fact that I can access my EMR from my laptop means I’m (and probably a lot of other “part-timers” are) never really away from work.

Is it easier to work a full-time schedule in more of a shift-based specialty like anesthesia, hospital medicine or EM where there seem to be less demands outside of one’s actual on-site work? I certainly don’t want to speak for my colleagues in primary care, as I know my office paperwork burden is a fraction of theirs. However, until there is less bureaucracy in medicine, compensation for time spent in non-contact care coordination and, yes, malpractice reform, physicians (male and female) will continue to seek part-time work or explore other practice environments. I applaud those who have made this lifestyle choice, whether to spend more time with kids, write a book (or blog) or pursue other interests related or not related to medicine. Thanks to those who have echoed Dr. Centor’s assertion that he would rather see a committed part-time doc than a full-time doc who is burned out.

Here are some links to related articles:

Dr. Centor – medrants.com

Dr.Jen

WSJ Blog

KevinMD

Dr. Au’s response

NYT parenting blog

Health Care Hemorrhoids

The main problem in healthcare is the total lack of value.  We pay a lot for care and don’t get a lot in return.  Costs are going up but we are not seeing an increase in quality along with those rising costs.  Why is this happening?  $100 dollar hemorrhoids show us what’s going on.

Thanks, Dr. Rob. Couldn’t have said it any better. Read the whole post here.