Reflections of a Part-Time Physician

It is all going to be wrong if a third of the openings in medical school have been awarded to part-time professionals or misplaced housewives. One hopes that the new woman physician learns quickly the value of her considerable profession and its consequent considerable income, and frees herself of many things that can be done well by others.1 —E. Grey Dimond Lacking any knowledge or self-awareness vis-à-vis parenthood, I did not consider, during school or residency, that I would ever work less than full-time. Even during pregnancy, I did not reflect on part-time possibilities. I had my first child when I was a fellow; the terminology itself suggests some gender-bending gestational experiment. Yet in some ways, I was a fellow—prior to motherhood. By a year after my son's birth, as I worked full-time, I became unhappy with my work-to-home time ratio. Even though my husband was similarly enthralled with our child's every expression and mere presence, he felt no need to spend more time with our son. My spouse and I had been medical students together, then residents, then fellows, but by the time we began our academic careers, I had changed. I initially cut back to 80% time, then, finding no improvement, to 50%. In academic anesthesiology, this means I work approximately 35–40 hours per week. Reduced-hours work has been reported to be as high as 60 hours per week.2 The fact that working part-time in medicine is considered unusual, and that such part-time work might be almost full-time in another profession, is telling. Years ago, I was asked to participate in a panel on “alternative lifestyles” at a conference on women in medicine. Reflecting on my extremely “square” existence—a job in academia; a suburban Leave-It-to-Beaver house with patch of grass and sizable mortgage; a supportive husband; a healthy child and a dog (a Labrador, no less), I could not fathom why anyone would categorize my lifestyle as alternative. When I asked the conference organizer, she readily replied, “That's easy. You're alternative because you work part-time.” I have only two children and the youngest is now 12 years old, yet I'm still a part-timer. I am fortunate to have the luxury of such choices, and I don't pretend to advocate part-time for everyone. Perhaps I'm stuck in the rut of the trail I helped blaze, but in fact, I frequently feel pressure to rejoin the full-timers on the main road. This pressure may be due to my chosen specialty, but it may also be an internalization of the general medical work ethic. Though studies demonstrate that part-time work is not associated with decrements in patient satisfaction nor care,3 the unstated premise for such studies is that the culture of medicine equates dedication with long hours. It is true that someone else could listen to my children and sort out their various daily triumphs and agonies. But if it is not their mum, then I have missed an irretrievable, substantial part of their lives. Rather, I believe that as a part-time physician, I not only have a considerable profession, but one whose rewards include flexibility, dedication, and joy. Audrey Shafer, MD

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