Chapel Hill, N.C.-based UNC Health often hires physicians whose former employers were not willing to accommodate a transition to part time.
"I can think of several examples over the last year or two when physicians came into our organization after getting a really rigid 'no' at a challenging time, an emotionally charged time in their life — be it a new child, kids going to school, family illness," Lynne Fiscus, MD, president and CEO of the UNC Physicians Network, which includes more than 300 primary and specialty physicians, told Becker's.
"I think a lot of health systems are still in that mode of 'no …. we need you full time.' We've always looked philosophically at if we can keep that person engaged, we would rather have them as a lower FTE continuing to take care of patients.
Numerous reports point to physicians' desire for increased flexibility in their role. Forty-six percent said more flexible schedules are among the top workplace measures that would help most with burnout, and more than half said they would put pay on the line for better work-life balance, according to Medscape surveys published earlier this year. Such findings indicate health systems that deliver on flexibility demands have a leg up on physician recruitment and retention.
More than 33% of physicians within the UNC Physicians Network are less than a full-time employee, and at Phoenix Children's 800-member medical group, 14% of employed physicians fall somewhere on the part-time scale, leaders told Becker's.
"Historically, if you came in as a 1.0 [FTE] and you wanted to go down to .5, that was like 'oh my gosh, what are we going to do,'" Jared Muenzer, MD, chief physician executive at Phoenix Children's, said. "We've moved away from that. We allow it to happen."
While many leaders may still carry hesitation around having a workforce made up of more clinicians who are not working full-time hours, leaders at the two systems said it is doable with the right planning and can present a strategic advantage by being able to mix and match physicians' preferences to where they're needed within the organization.
At Phoenix Children's, trust and transparency between clinical leaders and staff are critical parts of being able to plan accordingly when physicians may be reducing their hours.
"The challenge lies in predicting and having open, honest, transparent conversations with people to make sure that we know it's coming and working with us to figure that transition out," Dr. Muenzer said.
For example, if there are two physicians who are looking to reduce their hours to .8, the system should start considering whether to post a 1.0 position, "because you're almost at that point where with your growth and a decrease in FTE, we're going to need it, so let's get ahead of it," Dr. Muenzer said.
Having a workforce in which a significant portion of clinicians work part time can be costly, UNC leaders acknowledged. But the cost of losing someone entirely outweighs the costs associated with enabling more flexibility, Dr. Fiscus said.
"When we look at that math side by side, it absolutely makes sense to allow folks to be flexible and figure out how to meet those other clinical needs," she said, adding that it is common for physicians who reduce their hours to eventually inch back up to full time.
Beyond accommodating part-time needs, the two health systems are also giving physicians more flexibility in how their roles are structured. At UNC Health, some primary care physicians who have an interest in weight management or substance use disorder treatment become certified and work a portion of their week doing something different, Dr. Fiscus said.
Between 15% and 20% of visits across Phoenix Children's practices are virtual, which has been another avenue to give physicians more flexibility. Some physicians are able to mix in telehealth visits during busy clinic days, while others prefer to work a half day of telehealth, according to Dr. Muenzer.
Both organizations have also seen a growing number of physicians in the subspecialty space who want to spend time in both the inpatient and outpatient setting, rather than doing one or the other, which has historically been the norm.
"Rather than losing somebody to another organization … allowing them to have the job that they want without a doubt has had a huge impact on recruiting and retaining people," Dr. Muenzer said.