Part-time practice joins the mainstream

Young and old physicians of both sexes embrace the idea that working less is more

By Steven Brown

When doctors talk about part-time practices, the discussion soon comes round to female physicians. While it's true that women are more likely to attempt to balance family and practice life by reducing their work weeks, it's wrong to single them out. The truth is that women are leading the retreat from 60-hour weeks but are being closely followed by their male colleagues � especially newly graduated physicians and those over age 55.

A recently licensed Montreal radiologist, Michel D, in his late 30s, for example, isn't as atypical as tradition might suggest. He and his wife, Therese, a psychiatrist a few years older than he is, have a six-year-old daughter and are expecting a second child in November. "I'm in a group where I work a 40-hour week," he chuckles. "Some people might call that a full time job but it's part-time for most doctors. I work evenings and split shifts and am able to pick our daughter up from school every day. It works well for both of us."

At the opposite end of the spectrum is a 57-year-old GP who, seven years ago, moved from Hamilton, Ontario to join a group in Victoria, BC. "I came in as a part-time physician right from the get go. I had an angioplasty at 49 � my father and grandfather on his side both had serious heart problems � and I decided to make some changes." Initially he put in a 35-hour week, which has a way of creeping up over 40 hours. "That worked for five years but I found I didn't have as much time to call my own as I wanted." Two years ago, with the blessings of the group, one of the other physicians went from full time to half time. The two now work one week on and one week off, alternate weeks and it's worked well for everyone.

Part of the reason the part-timers have been able to swing it, is that the group has taken a flexible approach to the two thorniest challenges of part-time practice: call time and overhead. As far as call time goes, there is no compromise, group physicians share equally whether full or part-time. Says the former Ontario GP, "I wasn't crazy about the idea at first. I really wasn't being fully compensated for it but I understood the rationale. I'm perfectly happy with it now with the week on, week-off formula." The new arrangement has also simplified the overhead question. Previously he had shared equally in fixed expenses � rent, telephone, utilities. Staff salaries, supplies and other variables are apportioned according to the percentage of revenue brought in by each group member. Under the new arrangement he and his part-time colleague simply share expenses as though they were a single group member.

Not all groups are as generous. Many require that all doctors share equally in overhead expenses. The reasoning here is that the group is required to give round the clock coverage and there should be some continuity of care. Practice nurses are assigned to individual physicians and help bridge the gap when the part timers are away from the office. The part-timers are, in effect, covered even when they're not there.

WORK LESS, EARN LESS
The other side of working less, especially in your prime earning years, is that you have less income. The Quebec couple each has a car, a necessity. They own a four-year-old Chevy Cavalier and a 1996 Honda Civic respectively. With the new baby they plan to trade one in for a second hand mini van.

When they were first married the couple purchased a heavily mortgaged triplex in Outremont, an upscale section of Montreal. They live on the top floor and rented the lower two. The rent just about covers the mortgage payments. They've been able to contribute substantially to RRSPs. They took out an RESP for the six-year-old and plan to start one for the new addition. One item they haven't cut back on is one restaurant meal a week. Says Therese, " One night a week, usually Thursday, we splurge. Babysitter, candle light, a nice wine, the whole thing. We work hard and we deserve it, don't you agree?" she adds with a wink.

As a couple who together still put in 100+ hours a week, who would disagree?