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During the open microphone session at an Academy Young Ophthalmologist symposium, an ophthalmologist newly in practice, who was also a new father, asked, “How do I manage the tension between the demands of my job and the responsibility I feel to my son?”
I wanted to hug this young person. Finally, the well-known challenge of managing a young career and a young family has become a nongendered issue. In response to this challenge, some young ophthalmologists—both men and women—now ask about the possibility of practicing part time. But while they might wish to decrease work hours to accommodate other priorities, the concept of a part-time ophthalmologist is a flawed one.
There is no such thing as a part-time ophthalmologist.
Let me explain. A surprising number of physicians report working part time. In a compensation survey of nearly 20,000 physicians across 26 specialties, 22% of the women and 10% of the men report that they work fewer than 40 hours per week.1 In ophthalmology, 24% of female and 15% of male ophthalmologists report working fewer than 40 hours each week. This trend might be increasing as dual professional career families become commonplace. Furthermore, we’re told that today’s young physicians tend to protect family and leisure time more than their older peers have and might be bolder about requesting a day off or protecting their weekends.
Yet no survey can capture the commitment that is required to be a physician. An ophthalmologist who chooses to work fewer hours for a period of time is still a completely committed physician. She might shorten her workday or compress the work week into fewer days, but she brings her training, her expertise, her experience, her compassion, and her wisdom to work when seeing patients. The “part-time” physician often maintains a regular call schedule and full malpractice coverage, and he is committed to continuous learning. The “part-time” ophthalmologist learns new techniques, innovates, and attends educational meetings. The “part-time” ophthalmologist is available for patients, emergencies, and advice to other physicians. In other words, the “part-time” ophthalmologist has a 100% commitment to the practice of ophthalmology.
Much has been written about Baby Boomers, for whom work is a moral imperative, and Gen Xers and Millennials, who reportedly want more work-life balance. This is an oversimplification of reality. For example, of the 15% of male ophthalmologists who work part time, I wonder how many are older physicians who immensely enjoy practice but now choose to work fewer hours and enjoy other activities. We value these physicians for their experience and their wisdom, and they ground us in a tradition of providing quality care, teaching colleagues, and continuing to learn. Likewise, we value the young ophthalmologists who might provide superb ophthalmic care and work fewer hours than their older peers did at the same career stage. And we recognize that many physicians who limit work hours early in their career increase their time commitment in later decades.
Traditionally, full-time work has been measured by how many hours a person works in the office. While this may be necessary for determining benefits, hours logged is hardly a meaningful measure of the value of a colleague. There are many metrics for valuating work, including RVUs, productivity, papers written, leadership roles, and teaching responsibilities. In my own practice, I’ve been impressed by the availability of my young colleagues to discuss a patient or provide advice at odd hours. Once, a colleague discussed a complex case with me, and at the end of the phone call I discovered that he was on a ski slope.
Some ophthalmologists who practice part time feel diminished by the choice and don’t like the label. Let’s acknowledge the 100% commitment to patient care and stop counting the hours. An ophthalmologist is “all in,” even if it’s not all the time.
There is no such thing as a part-time ophthalmologist.
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1 Grisham S. Medscape physician compensation report 2017. April 5, 2017. www.medscape.com. Accessed Nov. 16, 2017.