When Manjusha Gupte, MD, had her second child, she realized that parenting and working full-time as a hospitalist was going to be too much.
“My husband is a hospitalist as well, so since there’s two in the family, we needed to get our time a little better situated with the kids,” she says.
She and another hospitalist, also a mother, approached their program director at Gaston Memorial Hospital, a busy community hospital in Gastonia, N.C., about going part-time.
Since then, the two physicians have shared a full-time job. Dr. Gupte works three or four consecutive shifts a week, two weeks a month. She still sees a full complement of patients—about 20 at a time—and she gets to spend more time with her daughter, 4, and her son, almost 2.
“Most hospitalist programs are scared,” Dr. Gupte says. “They think there won’t be continuity of care for patients, or it’s going to be disruptive to other doctors who are full-time. I have not yet heard of anybody complaining about continuity of care.”
Even though hiring part-timers and job-sharers raises these and other concerns, it’s increasingly important to offer this kind of scheduling flexibility, industry experts say.
“Hospital medicine, more than many other specialty, tends to attract people who care a lot about lifestyle,” says Leslie Flores, MHA, Nelson/Flores Associates. “A practice that isn’t willing to be flexible and consider part-time is sort of shooting itself in the foot.”
Before deciding whether to hire part-time or job-sharing hospitalists, there are many factors to consider, such as how to handle benefits and malpractice insurance and how to make sure a part-timer with a private practice doesn’t draw patients away from the hospital’s crew of referring doctors—intentionally or not.
There are benefits to the hospital: It’s easier to provide vacation and gap coverage, it’s less likely the full-time hospitalists will burn out, and in some cases, a part-time specialist can provide services the hospital didn’t offer.
“We’re real advocates of part-time hospitalists,” Flores says. “I think the benefits really outweigh the risks.”
A part-time hospitalist can be anyone from a physician who cuts back to 75% of her hours so she can spend more time with her kids, to a resident or fellow who signs up for a few shifts a month. A job-sharer splits a full-time job with another physician, sometimes sharing office space and even a malpractice insurance policy.
Part-timers can free full-time hospitalists to participate on committees, conduct research, teach, attend a conference or seminar, take a sabbatical, or simply pursue outside interests, says Kenneth Simone, DO, who founded and served as director for 10 years of a hospitalist program in Maine. He is now president of Hospitalist and Practice Solutions, a consultancy, in Brewer, Maine.