4-day workweek popular for doctors’ flexible scheduling

When it comes to flexible scheduling, young physicians and many medical practices appear to agree on at least one thing: Both find advantages to the four-day workweek.

Squeezing full-time work hours into four rather than five days is the most important flexible scheduling possibility when residents and fellows consider practice opportunities, according to a survey released Aug. 17 by Cejka Search, a physician placement firm based in St. Louis.

Researchers surveyed 750 residents and fellows in a wide array of specialties. Half of respondents said the four-day workweek was important or very important, but only 41.9% said the same about job-sharing. Of those surveyed, 37.9% said part time with more than 50% of full-time hours was important or very important, while 29.3% said the same about part time with fewer than 50% of full-time hours.

Previous Cejka research also found that a significant percentage of practices offer four-day workweeks. Cejkareleased a survey March 12 of 80 members of the American Medical Group Assn., which represents larger group practices. The survey found that 75% of practices offered a four-day schedule.

“The four-day week gives physicians the best of both worlds — a little bit of flexibility but still with maximum compensation,” said Lori Schutte, president of Cejka Search. “And anything that gives physicians more flexibility gives a practice an edge when recruiting.”

For physicians, the four-day workweek is a way to have more days off without having to take the pay cut that most likely would come from working part time. Four-day workweeks tend to be easier to set up than job-sharing arrangements, which require willing counterparts. With the same number of hours being covered, it’s possible that a practice would not need to hire additional physicians to cover the workweek.

Physician recruiters advise those looking for four-day workweeks to be upfront about the desire for this schedule, and suggest how it might be structured. Because physicians working four-day weeks are still considered full time, the call schedule would be the same as for those in the office for five days. In addition, physicians need to define the four-day workweek. Some positions are advertised this way but translate to four days of clinical work with one day for administrative tasks.

Good for recruitment

For health care institutions, which often recruit employed and independent physicians, the four-day workweek is a way to compete for physicians, particularly in rural areas that can be a hard sell to many doctors. Only 6.9% of those in the most recent Cejka survey considered a rural community to be a first choice, and 31.9% wouldn’t consider this kind of setting at all. A total of 52.1% put down metropolitan areas as their first choice, and 43.6% wanted to be in the suburbs.

But 46.7% of those surveyed would consider a community that is not their preferred location in exchange for a more flexible work schedule.

“We have found that being flexible regarding work hours allows us to be successful in a very competitive recruiting environment,” said Tammy Jamison, director of physician and executive recruiting with Lehigh Valley Health Network in Allentown, Pa., and past president of the National Assn. of Physician Recruiters. “And it can keep some of your physicians working longer.”

Jamison recruits physicians to be employed by her system as well as those who will work independently in the community. Some practices are in rural settings.

The four-day workweek is possible in urban and suburban areas but is viewed as less of a recruiting tool. It is viewed as most feasible for employed physicians covering shifts within a large health system, such as hospitalists or emergency physicians. Small independent practices may find the four-day workweek a challenge but doable, experts said.

“This does call for some creative practice leaders who understand that this is a new environment that we are in,” Jamison said. “But we have been able to set this up at some of the independent practices in the area.”

Recruiters say the four-day workweek has become more common over the past two to three years in part because offering money is not necessarily the deciding factor in attracting physicians. “Practices are moving from the compensation conversation and moving toward talking about quality of life, which can be much more attractive at the end of the day,” said Jason Bishop, director of physician recruitment for the upper Midwest with Merritt Hawkins & Associates, a search firm based in Irving, Texas.

Practices also are finding other benefits to the four-day workweek. Health system reform and the trend toward accountable care organizations and patient-centered medical homes have increased the need for physicians to be available in the evenings and weekends. This means it may make sense for a health system to have physicians who care for patients outside of usual business hours.

“It actually helps us, because it allows us to have more people to work these extended hours,” said Anton Decker, MD, chief medical officer with Banner Medical Group, an 800-physician organization that provides care to patients within the Phoenix-based, multistate Banner Health system. “And doctors want a sense of control. Flexibility gives it to them, and they will work a lot harder and be more committed.”