When a doctor wants to work part-time (MEDICAL ECONOMICS SPECIAL SECTION)

May 1, 2007

Here's how to keep things humming when a colleague steps off the partnership track to smell the roses.

Will your practice be ready when a doctor wants to cut back his hours?

The younger owners saw things differently, however. While wanting to reward the senior partner for his loyalty and hard work building the practice, they weren't willing to ransom the group to ease him out. With the help of Max Reiboldt, CEO of the health-care consulting firm, The Coker Group in Alpharetta, Ga., the urologists worked out a compromise that also became their semiretirement policy. In exchange for giving up call, the senior doctor agreed to relinquish his share of ancillary revenue and his voting rights. "We also tweaked the compensation formula so that income was more closely tied to individual productivity instead of a nearly equal division of profits," says Reiboldt.

The challenges of meeting such work schedules are not inconsiderable, however. Doctors working half-time struggle to generate enough revenue to offset their portion of the group's fixed overhead expenses. And prorating call based on the number of hours a part-timer works usually leaves the rest of the doctors grumbling about taking more than their fair share.

Yet part-timers can also be a valuable asset to a group. In one six-physician neurology practice, the doctor moving into semiretirement happily took all the patients requiring high management, spending over an hour with each one. "This doctor was beloved by the group, patients felt well taken care of, and he allowed the younger doctors to be much more productive and see a greater number of patients," says Jayne Oliva, principal of The Croes-Oliva Group in Burlington, Mass. "The other physicians had no trouble sharing some of their revenue with him-he was paid quite nicely-and they wanted the arrangement to last as long as possible."

Part-time doctors can also help groups increase their capacity and extend their office hours. And they might be the perfect answer for groups that don't have the patient volume to support a full-time physician, such as the dermatologists who gratefully recruited a part-time Mohs surgeon.