[Editor's Note: This is a guest post from Jeff Steiner, DO. Jeff is a practicing pediatric anesthesiologist and also the author of The Physician's Guide to Personal Finance: The review book for the class you never had in medical school, while I'll be reviewing in an upcoming post. He and I have no financial relationship. The usual disclaimers apply to both his book and this post. Neither Jeff, his publisher, nor I are hereby rendering legal, accounting, or financial advice and this post is for educational purposes only.]
Even in the face of national physician shortages, physicians are expecting to work part time in the future. In a nationwide survey of anesthesiology residents, 77% of respondents stated they wanted to work part time at some point in their career. (Women tended to want to start working part time in the beginning of their career and men tended to want to work part time later in their career.) Along with the typical partner track, and non-partner track employment agreements, there are now “mommy tracks” which offer reduced work hours, more consistent work hours/days and are appealing to both the physician (to improve their quality of life) and the physician's group (which helps with variable staffing). There are two types of work modes that physicians who don't work full time fall into- part time work and job sharing.
Part Time Work
Part time work can be described as work that is less than what would be expected of a Full Time Equivalent (FTE). Commonly in academic departments and large physician groups, this position is defined as percent of time a physician works. For a group that has its physicians work Monday through Friday and the part time physician works Monday through Thursday, then the part time physician would be considered a 0.8 FTE.
Typically this is where two physicians share one FTE. One physician may work Monday – Wednesday, and the other might work Thursday – Friday. Instead of the thinking of the physicians as two separate positions of 0.6 FTE and 0.4 FTE respectively, they share the 1 FTE. Functionally, this is the same as having two part timers, however, from a budgetary and management standpoint, they are different. Some groups may not allow part time work because of scheduling. However, some groups may be open to job sharing to cover the workload because of logistics of staffing.
Why engage in Part Time Work or Job Sharing?
The most obvious benefit is time away from work; whether that is time away from the stress of work, better predictability in scheduling, or time to pursue other hobbies and interests. This is usually what most think about with part time work.
If you are looking at retiring just over the horizon, it would also allow you to maintain health insurance, maintain an income until retirement accounts can be accessed penalty free (generally age 59 1/2), and would provide a way to “gracefully” downshift into a different season of your life.
Another benefit, that is counterintuitive, is your reduction in your take home pay would drop you into a lower tax bracket. This may allow you to take advantage of some tax breaks / retirement savings vehicles that are not available to high income earners such as Roth IRAs without having to juggle the back door IRA.
Part Time Work Does not Equal Part Time Pay
In most businesses, the cost to employ you is not only your salary, but your benefits as well. In budgeting for new FTEs, business typically budget 130% of the salary. This is because benefits (health insurance, employer part of income taxes, management of retirement accounts) usually add up to about 30% of the salaried pay. So if you are getting a salary of $150k, your employer will have $195k budgeted for you to account for both your salary and benefits.
For a medical practice, the benefits might also include the additional cost of medical malpractice insurance. Typically, to get a price break on your insurance premium for working part time, you have to work very few days during per month; however, it is worth asking your insurance company to see if you can get a price break. Also, the cost to maintain the business structure of your practice and other personnel (nurses, house keepers, the business manager) has a cost to maintain, even if you are not working there full time.
If you are considering Part Time Work / Job Sharing, there can be some significant hurtles to overcome. One is your group's dynamics. It would not be unreasonable to conclude that your relationship with the group may be changed. Commonly, your partners who are working full time, may either be jealous, or be resentful of your part time work, because you are not “pulling your weight.” (Not withstanding the fact you are getting paid less than they are for the work you do contribute to the group.) It can be human nature for your partners to behave this way if you are one of the first ones to enter Part Time Work.
Also, if you have aspirations of leadership within the group, such as a Director or Managing partner, working part time could derail your plans, because it may be hard to lead when you are a “part timer”.
Sick Leave and Vacation Time
In academics and large group practices where you accumulate sick leave and vacation time, you may be accumulating less time than a full FTE. Typically, if you are a 0.5 FTE, you will accumulate this time at 0.5 of what a FTE would. (For example, if a FTE accumulates 8 hours of sick leave, and 8 hours of vacation every pay period, you would potentially be accumulating only 4 hours of sick leave and 4 hours of vacation per pay period.) While you won't be working as much and your need to take vacation may be reduced, it may limit how often you can take extended vacations.
Call for Weekdays, Weekends and Holidays
Does your group take call, and if so, what percentage of call will you be taking? If your group has not defined the monetary value for call yet, they may need to. This will also need to be factored into your decision to go part time when you are planning your finances.
Disability Insurance Benefits
This is an area you might not have thought about. Check with your disability insurance company to see how they would interpret your part time work / job sharing. If your new work hours are reduced, would they consider your new work hours a new job and you would still receive your full benefit if you were disabled? Or would you only receive a partial benefit because you are not working full time? This might depend on several factors including what your new pay scale will be as a part timer. If you would only receive a partial benefit, would that be enough money to meet your needs if you are disabled? This can be a very tricky question and you should get your answer in writing.
One Last Thing . . .
Before starting part time work or job sharing, work through the above considerations, crunch the numbers, talk with your insurance company and negotiate all the details with your group. As with any contract, get it all in writing. This is particularly important with job sharing so that everyone is on the same page and there is no misunderstanding.
Do you have any experience (personally or within your group) with part time work and/or job sharing? Let's hear your story. Comment below!