Can EM docs work part time?

[mdbold]

I was thinking, since EM is such a draining field - would it be strange to see a doc work EM part time, and, say, GP part time?

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[docB]

Working part time in EM is very common. Coupling it with primary care is not very common and is fraught with problems as mentioned on other threads. I know many EPs who work part time to stay home with kids, are semi-retired or have other activities like administration, weight loss clinics and so on.

 

[Birdstrike]

I agree, yes, in theory. It works best in a very large group. However, in some (not all) locations it's frowned upon. Why? The explanation is a fairly long economic one, however, someone who works part time costs the other partners money if you want to be paid the same hourly rate as everyone else. An ER doctor is essentially a "business" in and of himself. You generate "overhead expenses" before you generate a penny for your group (and yourself), for example, malpractice insurance, benefits, billing costs, professional fees, credentialing, cost of flying you down to interview, possibly a signing bonus, etc. That money has to come from somewhere. Does it come from a magical pot of money that has no owner? No. Its a business expense (it comes out of your partners paycheck, or your hospital administrators paycheck). Also, if I'm interviewing 10 doctors and my goal is to hire 1 doctor, what would I rather do: hire one doctor, or spend twice the recruiting expense and twice the time hiring two "half doctors". That being said, are there ER doctors that work part time? Yes. Is it frowned upon in some groups, particularly smaller groups? Yes. As an administrator or ED director you may only have to work as few as a couple shifts per month, but you're working full time the rest of the month as an administrator. Usually, this is someone who's been around a while and "paid his dues" so to speak, or just doesn't want to or can't work the shift work any more. If you've been at a place for years and want to semi-retire that may be a benefit offered, but it does cost the group (unless you accept being paid less overall AND less per hour). Again, this is usually someone who's paid more than his fair share of "dues", not a new hire fresh out of residency. An ER group is a business like any other business. It sucks, but its true. That being said, is it possible? Yes. Does it happen as much as it should? Not in my experience.

 

[NERDY]

Working part time in EM is very common. Coupling it with primary care is not very common and is fraught with problems as mentioned on other threads. I know many EPs who work part time to stay home with kids, are semi-retired or have other activities like administration, weight loss clinics and so on.

Weight loss clinics? What does that have to do with EM?

 

[docB]

I agree, yes, in theory. It works best in a very large group. However, in some (not all) locations it's frowned upon. Why? The explanation is a fairly long economic one, however, someone who works part time costs the other partners money if you want to be paid the same hourly rate as everyone else. An ER doctor is essentially a "business" in and of himself. You generate "overhead expenses" before you generate a penny for your group (and yourself), for example, malpractice insurance, benefits, billing costs, professional fees, credentialing, cost of flying you down to interview, possibly a signing bonus, etc. That money has to come from somewhere. Does it come from a magical pot of money that has no owner? No. Its a business expense (it comes out of your partners paycheck, or your hospital administrators paycheck). Also, if I'm interviewing 10 doctors and my goal is to hire 1 doctor, what would I rather do: hire one doctor, or spend twice the recruiting expense and twice the time hiring two "half doctors". That being said, are there ER doctors that work part time? Yes. Is it frowned upon in some groups, particularly smaller groups? Yes. As an administrator or ED director you may only have to work as few as a couple shifts per month, but you're working full time the rest of the month as an administrator. Usually, this is someone who's been around a while and "paid his dues" so to speak, or just doesn't want to or can't work the shift work any more. If you've been at a place for years and want to semi-retire that may be a benefit offered, but it does cost the group (unless you accept being paid less overall AND less per hour). Again, this is usually someone who's paid more than his fair share of "dues", not a new hire fresh out of residency. An ER group is a business like any other business. It sucks, but its true. That being said, is it possible? Yes. Does it happen as much as it should? Not in my experience.

Birdstrike makes a good point. Just like everything else in EM it depends on your group. My group is very willing to let people work part time but that's because we are fee for service and we don't pay much overhead. For example we don't pay anyone's licensing costs. We do pay for credentialing but that's less than licenses.

I guess what I'm saying is that Birdstrike is correct. We use part times because we don't pay a lot of the fixed costs that other groups do. The benefit we get from them is that they can fill holes in the schedule that can often be a real problem.

Weight loss clinics? What does that have to do with EM?

Nothing. But it's cash pay so it can be really lucrative. Lots of EPs and other types of docs are going into that, vein care, medical aesthetics, erectile dysfunction, etc.

 

[Arcan57]

It may be more of a factor for someone who's working part time at several hospitals, but administration tends to not like part-timers either. The more you work in 1 system, the more efficient you get. Knowing the personalities in the ED and on the other end of the phone line improves efficiency independently of medical knowledge or overall "speed". Also, it becomes difficult to effectively do quality improvement initiatives because they are not working often enough to make meaningful changes to their practice style. That being said, there are tons of docs that work for more than 1 hospital or even more than 1 hospital system.

 

[EctopicFetus]

If you want to work part time I imagine an EmCare, TeamHealth type deal might be best. To docB's point, I know EM docs who do much of those things including botox etc to get some extra easy money. I think it depends on how much you like your job. My current group is happy and stable and we dont have anyone who does that.

When I moonlit bunches of them were involved in other things as mentioned above and also included doing SWAT, jail medicine etc.