Is part-time work the solution to physicians leaving the profession? Or is an increasing desire among physicians to work part time an indication of how overwhelming a high-stakes career in medicine may sometimes feel for those who are trying to balance vital but competing interests?
Research recently published in JAMA Network Open may shed further light on the discussion.
The study, “Factors in Considering and Adopting Part-Time Work Schedules Among Early-Career Physicians,” showed that women physicians, physicians in nonsurgical specialties and those with increasing time out of residency or fellowship training are more likely to consider working part time. Being a parent, a woman or being further out of training also was associated with working part time, the research shows, though there was a significant gap between physicians considering going part time and those who actually did so.
“This gap suggests that barriers may prevent physicians from realizing their desire to work part-time, including physician shortages, high levels of debt from medical training, or cultural stigma attached to reduced work effort,” wrote the authors of the study, for which Tasha M. Hughes, MD, MPH, was the senior author.
Understanding the reasons behind the divergence between expressed wishes and actualization presents an opportunity to explore how best to preserve physician well-being and reduce attrition, said Tiffani Bell Washington, MD, MPH, MBA, chair of the AMA Women Physicians Section Governing Council, commenting on the study.
“Sometimes we talk about part-time work as though someone is backing away from their career. I don't necessarily see it that way,” she said. “For some physicians, reducing clinical hours may be exactly what allows them to stay engaged in medicine rather than burning out and eventually leaving altogether.”
Dr. Bell Washington is a quadruple board-certified physician specializing in adult psychiatry, child and adolescent psychiatry, obesity medicine and lifestyle medicine. A wife and proud mother of six, she has spent much of her career balancing family responsibilities with demanding professional schedules, often working the equivalent of one and a half full-time positions. Her career most recently included clinical work at Massachusetts General Hospital, a faculty appointment at Harvard Medical School, full-time medical leadership responsibilities and medical entrepreneurship.
“I have thought a lot about what I want the next phase of my career to look like, and one of my goals is to have a smaller number of clinical hours each week while continuing to do other work that I find meaningful,” she said. “For me, that doesn't mean I want to work less because I care less about medicine. If anything, I think I am trying to figure out how to continue doing the work I love for a very long time.”
Wants change for work schedules
The JAMA Network Open study reports the results of surveys of 710 physicians following completion of residency training between 2015 and 2024. The median follow-up time was slightly more than eight years.
When the study began, 52.1% of the respondents were women, 38% were in a surgical specialty and 50.1% were parents. Over the study period, the percentages of physicians considering part-time work increased among all groups.
Women physicians were much more likely to say that they were considering working part-time or working part-time. Surgeons were less likely than physicians in nonsurgical specialties to say that they were considering part-time work or working part-time.
At the 10-year follow-up, the following percentages of physicians considered part-time work:
- 70.9%—Female nonsurgeons.
- 60.3%—Female surgeons.
- 37.1%—Male nonsurgeons.
- 26.9%—Male surgeons.
The number of study participants reporting they were considering part-time work increased with increasing years out of training among all groups of physicians.
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Can part-time work help all physicians?
Though the study shows a clear correlation between being a woman physician and wanting to work part-time, Dr. Bell Washington cautioned that the conclusions likely have much more to do with well-being than they do with gender or even parenthood.
“We have to be careful about turning part-time work into a ‘women’s issue,’” she said. “The fact that women and parents may be more likely to consider it is important, and we should absolutely understand why. But flexibility should be normal in medicine, not something reserved for mothers who are trying to figure out how to make everything fit. Fathers should be able to want more time with their children. Physicians should be able to care for aging parents. Someone may want time to teach, write, do research, build something, protect their health or pursue another interest.”
There are seasons to life, she noted, and someone will be shortchanged if physicians are forced to choose between medicine and a well-rounded life outside of a clinical career.
“There is an important difference between a physician choosing part-time work because it fits the life they want and a physician feeling forced to reduce their hours because full-time medicine has become unsustainable,” Dr. Bell Washington said. “We shouldn't confuse the two.”
A way out of the doctor shortage crisis?
If the U.S. is to contend with a worsening physician shortage, medicine must become a lifelong career that doesn’t take more than it gives, Dr. Bell Washington said. Part-time work is not a panacea that will solve all the challenges, though.
“Not everyone wants to work part time, and I don't think part-time work is automatically better than full-time work. But physicians should have more options for creating careers that are sustainable for them,” she said. “I’ve worked full-time throughout my career, sometimes combining full-time and part-time positions while raising six children and pursuing my MPH and MBA. Hard work and complicated schedules aren't foreign to me, and I don't necessarily view them as undesirable. But I believe physicians should have the option to adjust their schedules as their circumstances evolve. Health systems risk losing experienced and talented physicians when they cannot offer that flexibility.”
The study’s authors wrote that the option of part-time work should be one option on a menu of ameliorations for issues like physician turnover, overwork and burnout.
“Creating pathways to part-time work, in addition to improving working conditions to support a more diverse workforce with increasing demands outside of work, may serve as a complementary strategy to curb workforce attrition and lost productivity,” the study says.
The goal is more flexibility, and a deeper appreciation of the fact that physicians have values both inside and outside of their professions that impact how many hours they spend in clinic every day.
“Ultimately, I would love to see us expand what a successful physician career can look like,” Dr. Bell Washington said. “It doesn't have to be a straight line, and it doesn't have to look the same at 35, 45 and 55. You can be deeply committed to medicine and deeply committed to having a life outside of medicine. Those things should not be mutually exclusive.”
