Allowing part-time surgeons may help address workforce shortage

More part-time employment for surgeons, particularly retiring older male or young female surgeons taking time off for their families, may considerably reduce the surgeon shortage in the United States by 2030, according to a study published in the September issue of the Journal of the American College of Surgeons.

Opting to work part-time is gaining popularity among Generation X (currently ages 30 through early 40s) and Millennial physicians (currently mid to late 20s) who want to achieve a better work-life balance by working fewer hours than their predecessors. The study authors found that having the option of a part-time schedule could encourage them to practice more years rather than outright retiring, a situation that would help address the looming shortages in several key surgical specialties.

"Health care workforce paradigms are changing rapidly," said Bhagwan Satiani, MD, MBA, FACS, vascular surgeon and professor of clinical surgery at The Ohio State University Medical Center, and the lead author of the study. "The trifecta of surgeons working fewer hours, sub-specializing even more, and retiring earlier, will make it difficult to address the shortages we currently face. This study demonstrates that efficient part-time employment models can begin reducing shortages almost immediately."

Interestingly, recent physician polls validate these current trends across the spectrum of providers and specialties as well. In an unrelated survey of almost 12,000 physicians, only 51 percent said they would maintain their current work schedules. Eleven percent stated they planned to retire, and 30 percent planned to cut back or work part-time.ⁱ Recent assessments by the Association of American Medical Colleges also found that among physicians over the age of 50 (one-third of physicians), 42.6 percent stated they would remain active past retirement if part-time work were available.ⁱⁱ According to the survey, part-time male physicians over 50 worked an average of 16.6 hours per week, and part-time female physicians worked an average of 21.3 hours per week.

The authors of this study used a 2005 workforce baseline of 99,000 surgeons in general surgery and the sub-specialties of obstetrics and gynecology, thoracic surgery, otolaryngology, orthopaedic surgery, urology, and neurosurgery. Study authors assumed 3,635 Board Certificates are earned per year and that the average surgeon will practice for 30 years, with 3,300 retiring each year. Assuming variables are unchanged, researchers calculated that if one-quarter (scenario one), one-half (scenario two), or three-quarters (scenario three) of potential retirees worked half-time for an additional 10 years, the United States would have 4,125 (four percent increase), 8,250 (eight percent increase) or 12,375 (16 percent increase) additional part-time surgeons, respectively, thereby alleviating the predicted surgeon shortage by 14.2 percent, 28.3 percent, or 42.5 percent, respectively.

The study authors also concluded that employment models should address flexible work schedules, malpractice premium adjustments, academic promotion, certification and licensure maintenance, and employment benefits. All the evidence indicates that part-time surgeons perform just as well as full-time surgeons do. In order to succeed, health care systems must change their view of part-time surgeons, and proportional reduction of liability premiums must be addressed.