Hi everyone,
This question was posed to me the other day and I've been thinking about it. I think most of the women on this forum are all for physician careers being more caregiver-friendly (meaning part-time!), but are there some areas of medicine that should only be practiced full-time? I.e. SHOULD all fields of medicine allow for part-time practice as physicians, or is the responsibility so great in some fields (I'm thinking especially acute areas of medicine, like surgery) that people should only enter them unless they intend on working full-time and making it the top priority in their lives?

nb--I know that many fields are not really open to part-time work as doctors--my question is SHOULD they be, from an ethical point of view? Another way of asking it might be, would you be happy for you or your child to be seen in all areas of medicine by a part-time doctor, or are there some areas, perhaps a complicated surgery, where you wouldn't be happy with anyone but a die-hard "I've dedicated my entire life to my job" full-time surgeon?

I'm not sure how I feel about this and would be interested to hear your inputs.

I think that once a skill is mastered, you don't need to practice full-time in order to keep it. So I don't think there are any areas that must be practiced full-time. But I do think that people underestimate the learning curve that occurs after residency, where you are still in the process of mastering certain skills. That will take longer if you are doing it part-time. The same goes for new techniques that come along while you are in practice.

I agree with sahmd. The learning curve when you are actually on your own in practice is steep. I'm glad I worked full time at the beginning. And truthfully, at first it didn't feel too bad b/c my hours were less than residency hours anyway.
I do think though, you need to do a certain number of procedures in a certain time to stay in practice-an example for me are circumcisions. Not like I would forget how to do them, but I am definitely a bit more careful and it takes longer if i haven't done one in awhile. The hard part is quantifying the number needed and the time span. I think people can be dedicated and still work part time. In some ways I would be happier if the physician was balanced in their life and sleeping regularly. I think some fields are exceedingly difficult to do part time. Transplant surgery would be one example. That is really like giving up your life for something....you have to leave to procure organs on a moments notice, etc. Talk about dedication.

i knew an endocrine surgeon in a community hospital affiliated with my med school who worked part time. she was the best thyroid surgeon in the group. it can be done.

I am at least as proficient as my full time colleagues. Probably more so than many. When I took my board recertification exam, I my score was more than one standard deviation over the mean in my specialty. I have no doubt that working half time is NOT a problem in terms of the quality of care I deliver to my patients. NB I have never worked full time since residency.

KPZR-what type of doc are you?

I am a general pediatrician (same as yourself, I think). I do not do circumcisions or many procedures though (in our community, circs are done by the OB's or pediatric surgeons and we really don't do suturing even). So, my procedures are limited (simple I and D's, bladder catheterizations, removing foreign bodies from nostrils and ears is about it). I think the cognitive stuff is easier to maintain than procedure-based work. This is what I prefer anyway. Because of the type of practice I am in, half time work has never been a problem. My colleagues check my labs and documents on my days off (I check theirs on their days off) and urgent issues are handled by the docs in the office. If I am out of the office for more than a day at a time, I do log on to our EHR from home to go through stuff, this is great!

I think the issue here is less proficiency in procedures and more the continuity of care for patients. There are certain fields where cross coverage is fairly straight forward and some where it is more complex.

As a pediatrician, my patients are mostly straightforward. Anyone can really step into my shoes for a day or two a week without a problem. On the other hand, I do have some patients who have my cell number because they are complex and to start explaining their history to another provider for a question would be very difficult.

I could see that in fields like surgery, for example, there would be some fields that should not be part time. A general surgeon doing routine hernias and such could probably be covered by another general surgeon fairly easily. However, if there is only one thyroid surgeon in town, as in the case above, who manages her patients on her off days?

I am late to this thread and am going to comment about the initial post. I am not sure that pediatrics would qualify as a field that should never be part time. With proper documentation, within a group, coverage should be a feasible possibility. Pediatrics is an emotionally taxing job. In my opinion, parents should not have such incredible expectations of their physician that they expect them to be available to them 100% of the time. That's just my opinion.