Cover Story | Flexible Career Schedules: How Do We Work Them In?

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Over the course of a career, everyone – women and men – may need some flexibility within their work schedule for a variety of personal needs, from maternity and paternity leave and being a working parent to other family or personal demands.

Creative solutions are needed to allow for flexible scheduling for cardiovascular professionals, whose number of hours worked per week is among the highest of any medical specialty.

Overall, cardiology ranks 11th of 41 surveyed specialties in terms of annual hours worked.

Furthermore, MedAxiom data show a steady decline from 2012 in the proportion of cardiologists who work part time, reaching just 5.7% of the total workforce in 2018.

Among cardiovascular professionals, MedAxiom data also show that 87% of women and 94% of men work full time and 83% of women and 87% of men are on full call.

At ACC's Cardiovascular Summit, Athena Poppas, MD, FACC, vice president of ACC, Mary Norine Walsh, MD, MACC, past president of ACC, and Suzette Jaskie, MBA, vice president of the cardiovascular service line at Ascension Wisconsin, discussed strategies for preserving the physician-patient relationship while finding opportunities for cardiovascular professionals to work less than full time.

They noted that the need for a flexible work schedule is not linear or permanent and can vary by age and gender.

Notably, the capacity to accommodate flexible work schedules, when needed, can help with workforce recruitment and retention.

However, overhead costs remain a concern, as they don't appear to vary with the FTE adjustment.

Several potential models that differ from the traditional full-time employee (FTE) model with full call schedule and bonus include:

  • 0.8 FTE with full call and bonus.
  • 0.6 FTE for three years before retirement with no call or bonus and, ideally, job sharing.
  • Per diem where recently retired master clinicians help educate fellows and are a bridge for new employees.

While there are barriers to flexible scheduling, including existing policies that don't provide adequate guidance; differences between slow-down (retirement) and part-time schedules; physician contract alignment; internal disagreement about policy application; operational costs; and impact on recruiting, the speakers stressed solutions.

These potential solutions include internal agreements around flexible work schedules; policies that address specialist issues; carefully thinking through the tough issues like compensation, call, and the duration of the part-time position; and designing scenarios that are win-win for everyone.

Flexibility in work schedules for cardiovascular professionals is a priority for ACC and a workforce health policy statement is being developed.

In September 2019, the ACC released a companion policy document on Cardiologist Compensation and Opportunity Equity, that elucidates a set of principles for the development of compensation plans that advance equity in both compensation and access to opportunity.

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Keywords: ACC Publications, Cardiology Magazine, Health Policy, Personnel Staffing and Scheduling, Parental Leave, Physician-Patient Relations, Retirement, Pregnancy

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