“Burnout” has been a buzzword circulating in the medical community quite a bit lately. The World Health Organization has just recognized the term as an official medical diagnosis as part of ICD-11. One moment you’re graduating medical school, full of hope and excitement for residency. The next moment, you’re overly stressed and working insane hours every week. Honestly, it isn’t a huge surprise that nearly half of all physicians experience burnout. People have suggested all sorts of solutions to this problem. I’ve proposed that creating financial freedom through passive income can help tremendously. A commonly mentioned solution involves simply working fewer hours. While it might have been something frowned upon years ago, it’s becoming more of the norm today. According to a 2011 retention survey conducted by Cejka Search/American Medical Group Management, 21% of working physicians were working part-time. That is an 18% increase from 2005. I’m sure it’s even greater now. Even more recently, a U.K. survey reported that 42% of female physicians and 7% of male physicians were working part-time just ten years after graduation! According to a recent Physicians Practice Poll, 63.53% of physicians say they would be willing to go part-time, and 57.09% say they wish they worked fewer hours. If so many others are doing it, could this be something that a good number of physicians should consider? Is it even practical? Everyone has their hurdles to get over in the process, but it isn’t as unrealistic as you might think. What is part-time for a physician? Before we dig in deeper, I think it’s important to try to figure out what going part-time as a physician really means. Work part-time means working less than full-time. Well then, what is full-time for a typical physician? I’m sure it varies according to specialty and the type of practice you’re in, but it seems across many surveys, the average amount of time working is between 50-60 hours a week. This includes patient care as well as the ever-increasing time for paperwork. If a typical physician were to cut down 25% of their working time to .75 FTE, that would still put them around 40 hours, which is full-time for most other people. Imagine cutting 25% of your clinical time right now, it would seem drastic and life-altering. Yet, you’d still be working what’s normal to the general population. So in discussing part-time in this post, I refer to anything less than the expected full-time commitment of your position. Perhaps it’s a schedule without some weekend call or fewer nights. Perhaps it’s one day less clinical time. Either way, it’s taking what you do and cutting out a piece of it to devote to something else. Now let’s get to some of the pros and the cons of working part-time as a doctor. The pros Spend more time with loved ones Surely, it’s no surprise that doctors lead busy lives. Trying to balance the significant time commitment of our careers with a good family life is a huge challenge. How many of us have heard stories of successful physicians who sacrificed their family lives to get where they are? My father was a physician; a surgeon in fact and I do remember him being quite busy even as a child (although I think he did a pretty tremendous job of trying to be home for dinner and taking us on family vacations). Unfortunately for some, like my father, they just don’t have much flexibility in their schedules at their current positions. They end up working late on a daily basis and seeing their family for very small moments of time in any given week. They are the brand, and if they don’t see patients, no one else can step in and do it for them. But more and more, I see physicians come to the realization that their job is ultimately not their entire lives and look for a change. This is evident in the type of jobs that many of the residents I work with seem to be looking for. They want the lifestyle jobs with some flexibility. Sure, being a physician is a big part of your life, but perhaps there are more important priorities. No one on their deathbed says, “I wish I had worked more.” When we all reach that point, we’ll look back on our lives and only wish for more time with our families and friends. It’s difficult to imagine letting go of working full-time, but when it comes down to it, do you have enough time in your current schedule to allow for enough time with your loved ones? I didn’t, and that only came with working part-time. Have time to pursue other ventures Maybe you are lucky enough to have time for both your family and work. But do you have enough time to pursue those other ventures you have always dreamed about? Perhaps you always wanted to open a business or invest your time in a nonprofit. Just because you’re a doctor, does that mean that you should have to give up all of your other dreams or interests? Again, your job is not your entire life. However, I often hear other physicians talk about a side hustle they’d love to try — if only they had the time. Going part-time might just give you enough time to explore those other interests. I know that’s the way it’s worked for me. As I’ve given up more and more clinical time, it definitely hasn’t freed up time for me to just sit on the couch. In some ways, I hustle more, but it’s for things that I’m also passionate about. Since I enjoy it, it doesn’t feel like another job. It’s actually fun. Avoid burnout, gain career longevity Working too many hours with large loads of stress is a recipe for disaster. However, that’s the situation most physicians find themselves in. If one of your friends or even patients asked you for recommendations to combat symptoms of burnout and/or depression, what would you tell them? Would you ask them to continue at the same pace? Most likely not. Focusing on personal health is just as important for physicians as it is for everyone else. We’re often so good at taking care of others and giving wise advice, but unfortunately, we’re terrible at following it ourselves. For me, sustainability is the key. I worked hard and committed a lot of time, energy, and money to pursue a career as a physician. I also enjoy it quite a bit, so I’d love to do it until I can’t do it effectively anymore. I don’t want to quit anytime soon. So working part-time can help for career longevity. Even better: if you’re financially independent, medicine could be a hobby for you. The more balance you have in your lifestyle, the happier and more content you could be in every aspect of your life. To take it further, if you’re happier at work, there’s no doubt it will bleed into your care as a physician. It allows for more empathy and more compassion. It’s hard to take care of others when you’re hurting inside. More favorable tax bracket It’s quite possible that if you work part-time, you might drop tax brackets. As a result, your effective tax rate might end up being lower. The hours that you drop from working full-time are most likely the hours that get taxed the most heavily. Therefore, the economic impact of working part-time might not be as significant as you think. For example, if you’re a California native and you’re a high-earning physician, the income that you’re dropping might be the income that’s taxed at 50% (federal + CA taxes). After a certain income, your time working is actually valued less and less. If you’re able to then take the newly found free time to create income from sources that are more tax-efficient, like businesses or from investing in real estate, then it’s a double bonus. Not only are you making more money, but you’re making more tax-efficient income and therefore taking home more at the end of the day. Cons So far working part-time sounds pretty great, right? However, there are some downsides to consider. Pay cut and drop in benefits Okay, this one is pretty obvious. If you work less, you’ll likely make less. I remember when I first started cutting shifts, and I saw the resulting paycheck. It was initially hard to swallow — especially when I was used to seeing a certain consistent number hit my bank account. It’s also possible as a part-time physician that you may not qualify for benefits such as healthcare and retirement benefits. So are you prepared to handle this drop in income and benefits? If you have multiple sources of income then this might not impact you as much. Only you know whether you can handle the financial consequences of working less in medicine. Decreased experience and proficiency Experience definitely plays a role in your proficiency as a physician. Sure, you spent hours and hours in training, but some things can only be learned when you’re out there working as an attending. If you’re working part-time, especially as a young physician, it’ll take you a longer time to gain significant experience in your field. The more you are exposed to, the better physician you’ll likely be. Seeing as new medical advances and diseases are being discovered all of the time, it is always important to be as up-to-date as possible for our patients. If your field is very technical, you definitely perform a procedure a certain amount of times to gain and maintain proficiency. You might’ve heard it said that it takes practicing something 10,000 times to really become an expert at it. Well, if you’re working part-time it just might take you a lot longer to get those repetitions in. Then maintaining those skills is a whole other matter. It’s possible if you don’t work enough or do the procedures enough, you might not be as competent as if you were performing it on a daily basis. Give up academic aspirations and career standing Some of you reading this are extremely motivated to be the best in your field. You have aspirations to make a name for yourself, perhaps become chairman, or become extremely well-known in your field. It’s hard to do so while working part-time. It usually takes another level of commitment to reach that high level, and working part-time might show a lower level of commitment to that goal. The chances of you climbing the ranks are severely minimized when you make it clear you have other, more important priorities. Takes longer to financial independence It takes time to build up your investments and passive income sources. One of the fastest ways to achieve financial freedom is to take the capital that you make as a physician and create passive income sources. For example, perhaps you’re committed to reaching financial freedom through rental properties. It can take a certain amount of capital to purchase a multifamily property. Making less can possibly take longer to reach that stage, possibly pushing your timeline back. I like to say that you should create little money printing machines with the money you make as a physician. In order to make that happen, you need that initial capital. It will likely take you longer to build that up if you’re working part-time. But again, if you have other sources to make up for the income loss, then this point may not be the case. Being seen as weak Part of the stress of being a physician can also come from your coworker’s impressions of your part-time work. There is a stigma in the medical field that you could be considered ‘weak’ for going part-time. I obviously don’t agree but it’s still a part of our culture, although this is changing as well. Your mental wellbeing is just as important as your physical wellbeing. If you are feeling burned out, you should immediately take steps to improve your quality of life, whether that being going part-time or another form of release. At the end of the day, you know what’s best for you and should feel empowered to take steps necessary to improve your situation. Is it worth it? So, considering the pros and the cons of going part-time as a doctor, is it worth it? That’s a question that only you can answer, but it’s definitely one that I think everyone should at least consider. This is true especially with the number of physicians hitting a wall these days. Could some of us avoid burnout? Could some of us ultimately end up being better physicians by working part-time? For us physicians, working part-time is simply the same as others’ full-time hours. I believe we should consider the strength of working part-time and see that it might be a way to save our careers and do better for others at the same time. Source
