It is the state of physical, emotional, or mental exhaustion combined with doubts about the competence and value of their work that can cause burnout among healthcare professionals. To prevent themselves from reaching this stage, some doctors may choose to stop working full-time, and opt for a part-time or flexible schedule.
In Singapore, full-time doctors are required to work at least 40 hours per week, as stated by the Singapore Medical Council, while part-time doctors should work at least 20 hours per week. However, the reality is that because of the combination of direct patient care and additional responsibilities, most full-time doctors work approximately 80 hours a week instead.
The rise of part-time doctorsTherefore, working part-time would be more appealing to doctors as it allows them to have a work-life balance, and an adequate time to pursue other interests. A 2011 Physician Retention Survey—which included 14,366 doctors in 80 practices— found that the number of male doctors working as part-time physicians tripled from 7% in 2005 to 22% in 2011, while the number of female doctors doubled from 29% in 2005 to 44% in 2011.
Upon analysing the demographics, experts in recruiting doctors concluded that those who opt for part-time or flexible schedules tend to be men nearing retirement, while for women it is in the beginning or the middle of their careers. Flexibility was found as a key factor for retaining doctors, including allowing males doctors to go part-time which made them delay their retirement.
Many healthcare workers wish to be seen as part of a caring workforce, while being able to balance their highly demanding workload with their personal lives. Contrary to the common belief of being the cause of the workforce crisis, the ability to have a flexible schedule could be the solution to attract more people in pursuing a healthcare career.
Furthermore, some doctors strongly feel that they should set a good example for their patients as healthy individuals. Instead of sacrificing themselves for the benefit of others, it is important to find the right work-life balance, allowing for a better mental capability to empathize with patients and their families.
Expectations on going flexible
Additionally, doctors extend their passion for medicine by choosing to allocate time for other interests such as giving lectures to medical students, or speaking for pharmaceutical companies, or even taking on the role of a medical expert witness. This way, the doctors are able to retain enthusiasm in their specialty, whereas overworked individuals tend to leave due to burnout, being exhausted and feeling unexcited about their job.
Studies comparing part-time and full-time doctors show that there is equal patient satisfaction and trust, and less burnout has been associated with part-time doctoring. However, some who chose the part-time route voiced out that they have yet to achieve a balance in life.
Reality sets in, and without proper planning, some part-time doctors find themselves putting in additional time at home on extra afterhours responsibilities like paperwork. It is therefore important to be very careful about the maximum hours (official or unofficial) worked per week. Furthermore, those who chose to work part-time in primary care also tend to get lower salaries and may take a longer time to pay off their loans.
Controversy regarding part-time doctoringKaren Sibert, an anesthesiologist and mother of four, brought up the issue of doctors - mostly females - choosing to go part-time.
“Medicine should not be a part-time interest to be set aside if it becomes inconvenient, it deserves to be a life’s work… Medical education is a privilege, not an entitlement, and it confers a real moral obligation to serve,” said Dr Silbert.
Such a viewpoint is still controversial, and her views led to debates on the idea that doctors should be allowed to pursue any other interests apart from medicine. Some even compared the role of a doctor to other important professions, justifying that it is not the only profession that should be given the greatest priority.
Others claimed that Dr Sibert’s view could be slightly biased, as anesthesiologists tend to have a less demanding work schedule compared to other specialties. Additionally, there is a concern about disruption of continuity in patient care from part-time doctors. Some argue that in their specialty, once the part-time doctor goes home, his patients are either discharged or under the care of an inpatient team.
Part-time doctoring could be plausible for some specialtiesAccording to doctor recruitment experts and consultants, unlike pediatrics or other non-surgical specialties, certain healthcare specialists may face difficulty in allowing doctors to go part-time or opt for flexible schedules. Specialties like neurosurgery would be unlikely to work well with part-timers as surgical skills are gained with experience. Therefore, shift-based specialties such as urgent care and emergency departments, and hospitalists might be more suitable for part-time options.
Ultimately, whether a doctor performs better as a part-timer or a full-timer depends on the individual’s ability in coping with long working hours and continuous high stress level. A career in medicine has always been regarded as a prestigious job, but the number of work hours clocked in might not always be representative of his passion for medicine. MIMS
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