Creative Scheduling
Whether it’s to pursue an avocation
or to spend more time with family, physicians are finding ways
to better balance their profession with their lives.
A year ago, Dr. Stacy Childs was burnt out
on medicine. A sought-after urologist with a thriving practice
in Cheyenne, Wyoming, Childs had been routinely seeing 40 to 50
patients a day since 1995, when he set up the practice with two
partners. But after being diagnosed with prostate cancer in
2000, he decided to scale back his workload. He wasn’t
sure how to make the change, but he began contemplating
downshifting his career to make time for other pursuits.
One of those pursuits was skiing.
Childs and his family had always enjoyed the sport and had
spent time in skiing hotspot Steamboat Springs, Colorado. So
when a urology colleague invited Childs and his wife, Diana, to
visit them in March 2004, he eagerly accepted.
It was during that trip that Dr.
Rick Brothers proposed that Childs join Urology Clinic, PC,
Brothers’ growing practice in Steamboat Springs. Six
years earlier, Brothers had sold his own practice in Laramie,
Wyoming, and moved to Steamboat Springs to slow down, starting
a new practice there. But in those six years, the workload in
Colorado had again risen to the point where he wanted to scale
back his hours. If Childs joined him, they could share the
workload and both enjoy plenty of time to ski and relax,
something Childs hadn’t done much of. The timing of the
proposal couldn’t have been better.
On returning to Cheyenne, Childs
gave his partners 60 days notice and began packing for a move
to Colorado. Although the workload was considerably less than
he had in Wyoming, when a third urologist approached the duo in
2005 about joining the practice, they happily agreed. “We
decided to run a busy two-man practice as a slower three-man
practice,” Childs says.
The three doctors now work rotating
two-week shifts and then take a week off. They each schedule
their surgeries during the first of their two-week shift, so
they’ll be available in case a problem arises during the
second week, and use their second week to see patients in the
office and set up surgeries for two weeks hence. So each week,
two doctors are working and one is off. The office also closes
at noon on Fridays.
Despite splitting the workload three
ways rather than two, the practice has grown so quickly that
Childs expects each partner will soon earn as much as he did
before adding the third partner. More importantly, he says,
“I’m having a blast.” He now has time to take
long bike rides, swim—which he never had time to do
before—and is looking forward to becoming a champion ski
racer within a couple of years. Now, “ski racing is my
job and urology is my hobby.”
Of course, with the cut in hours
came a drop in income. Childs estimates his income fell about
30 percent the first year, but is now approximately 20 percent
less than when he was in Cheyenne. “Now there are three
of us in a two-person practice,” he says, adding,
“In 2006, I have 18 weeks of vacation, compared to 6
weeks in Cheyenne.”
Many physicians would likely love to
be able to make such a claim. Recalibrating the amount of time
spent at work and home, or on personal interests, is on the
minds of many today.
Workplace flexibility is key
Since 9/11, the priorities of many
Americans have shifted. For some, the importance of work has
declined relative to the importance of family, friends, and
other activities. A 50/50 split between time spent at work and
time spent at home, once considered a balance, has become
outdated. Cali Williams Yost, the author of Work+Life:
Finding the Fit that’s Right for You (Berkley
Publishing Group, 2004), argues that for doctors, a 50/50 split
isn’t realistic. In fact, the percentage of time spent at
work has climbed, in some cases dramatically, while time spent
outside work has shrunk.
According to the American Medical
Association’s Physician Socioeconomic Statistics book,
the number of hours physicians spend on patient-care activities
has risen in the last 10 years. Some have risen only slightly,
as in family practice, which rose from an average of 49.7
hours/week in 1991 to 50.7 hours in 2001, and some more
significantly, as in surgery, which increased from 49.6 to 58.2
hours. At the same time, reports the Department of Labor, the
number of employees in all fields who work a flexible schedule
has dropped, from 29 million in 2001 to 27 million in 2004.
Yet even as work responsibilities
increase—or perhaps because they are
increasing—physicians today want flexibility to decide
for themselves when and where they will work.
Research conducted as part of
“When Work Works,” a project funded in part by the
Alfred P. Sloan Foundation, bears that out. The study finds
that 43 percent of employees who don’t currently work any
regularly scheduled hours at home would like to be able to.
More than 50 percent of older workers (defined as older than
58) would also like to reduce their hours to part-time, but
still remain employed, while 24 percent of women and 13 percent
of men currently employed full-time would like to go part-time.
And new parents who want to spend more time with their babies
are increasingly opting out of the workforce altogether for
longer periods of time.
Yost says, “There is no one
standard flexible work arrangement that works in all cases.
Most successful arrangements are a blend of adjusting time
spent on the job and/or location where the job is done, a blend
that works in the context of an employee’s particular
job.”
Fortunately, in many cases, creating
a more flexible work schedule does not automatically require
workers to quit their job or move to another state, though
those are certainly options to consider. For physicians
interested in staying where they are, but working a schedule
that better fits their personal needs and responsibilities,
there are several steps to help define and negotiate a more
creative schedule.
Decide what you really want
“Ninety percent of people
don’t have a work-life vision,” says Yost. That is,
a picture of what the perfect schedule would look like. In a
perfect world, ask yourself how much of your life do you want
to spend at the office, at home, and doing other things, like
traveling or volunteering.
To start, Yost advises asking
yourself how you want work to fit into your life. What is your
vision? For some doctors, that might mean a three-day work
week. For others, that might be no weekend call. If you want to
make changes to your current schedule and work obligations,
start by examining what your work life is like and how you want
it to be different.
“Most physicians put their
head down and plow ahead” and don’t think about
what they like or don’t like, says Patricia Raymond, MD,
of Chesapeake, Virginia. And for 10 years, that’s exactly
what she did as a partner in an internal medicine practice,
working 80 hours a week, on average, arriving home around 7 or
8 pm each night.
During those years, however, she
found she really enjoyed the opportunity to do public
speaking—even pharmaceutical presentations—where
she could apply her college theatre training. By 2001, the
speaking opportunities were coming up more frequently, and even
more so after she gave the keynote address at the Society for
Gastrointestinal Nurses and Associates conference. She found
she loved speaking so much that she began accepting weekend
speaking engagements on top of her 80-hour work week. Raymond
would fly out to her destination Friday evening after work,
present on Saturday, and then fly back home to Virginia on
Sunday morning.
After about a year of moonlighting
as a public speaker, Raymond spoke to her partners about going
part-time so she could invest more time in her second career.
However, as a partner, she explains, everyone was paid the
same, not based on performance, and her then five partners
couldn’t see how they would equitably pay her. They
eventually agreed to a part-time schedule whereby she worked
about 50 percent of her normal schedule for 30 percent of her
pay. “I ended up working too hard,” she says, and
in early 2003, she walked away from the group. That was also
the year she started work on books, including Don’t
Jettison Medicine: Resuscitate Your Passion for the
Career You Loved (Carthage Publications, 2003).
For nearly a year she worked two
days a week as a fill-in doctor in another practice, until she
opened her own practice in April 2004. Raymond now has the
schedule she dreamed of—a balance of her thriving medical
and media careers. She works Monday through Wednesday at the
practice and takes Thursday off. On Friday she hosts a regional
National Public Radio call-in show about health,
“Housecalls,” and then takes a flight to her
weekend speaking destination, returning on Sunday. She is also
developing several medical-related products, which she markets
at her Web site: www.rxforsanity.com.
“Being able to do all the
other things that are in my heart, it’s incredibly
exciting,” she says. And she counsels other physicians
that “if there are other things you want to do, you
don’t have to give up medicine altogether. It’s
possible to find time for other aspects of your life that are
important to you,” Raymond says.
Raymond’s ability to make
pivotal career and financial decisions was aided along the way
by her work with a financial adviser, who helped her determine
her financial needs and goals. That information helped her
weigh her many options along the way, keeping in mind her
available financial resources.
