1 in 4 Physicians Employed by Large Groups Are Part-Time

March 21, 2012

March 21, 2012 — The nation's largest medical groups increasingly rely on part-timers, and a higher percentage of them are men.

In 2011, part-time physicians represented 25% of the workforce in large groups, up from 13% in 2005, according to the latest physician retention survey conducted by the American Medical Group Association (AMGA) and Cejka Search, a healthcare recruitment firm.

To calculate part-time employment in 2011, the AMGA and Cejka Search excluded 1 outlier group in which 90% of the physicians are part-time.

Part-time employment also is becoming more of a career track for male physicians, who account for 62% of physicians in the groups responding to the survey. The percentage of male physicians who are part-time more than tripled from 2005 to 2011, increasing from 7% to 22%. The part-time rate for women physicians increased at a slower clip, from 29% to 44%.

In addition to accommodating physicians who want fewer hours, large groups are attempting to make the practice of medicine more flexible for full-timers. The survey shows that 3 in 4 groups offer a 4-day full-time work week.

All this physician-friendliness is designed to attract practitioners, and then retain them. Large groups have succeeded in keeping their turnover rates at least steady. In 2011, the turnover rate was 6%, which was slightly down from 6.4% in 2005. It had dipped to 5.9% in 2009, reflecting the downturn in the economy and housing prices, according to the AMGA and Cejka. During rough financial times, physicians tend to delay retirement and relocation, which are key drivers of turnover, the groups state. Their report cautions that as the economy continues to recover, physician turnover could continue to rebound.

Group practices ought to watch physician turnover rates like a hawk, as a lot of money is at stake, said Lori Schutte, the president of Cejka Search in St. Louis, Missouri. When a physician jumps ship, there is not only the cost of recruiting a replacement but also the matter of lost revenue as a new physician gets up to speed. Hiring a locum tenens before a permanent replacement comes aboard also adds to the total, she said. All in all, turnover can hit a practice for as much as $1 million per physician.

Turnover Rate for NPs, PAs Double That for Physicians

The turnover rate for nurse practitioners (NPs) and physician assistants (PAs) in large groups in 2011 was nearly 13%, or more than double that for physicians. Last year was the first year that the AMGA-Cejka retention survey solicited data on these 2 professional categories.

Schutte gives several reasons why NPs and PAs have a higher turnover rate than physicians: Markedly lower pay is one, and most NPs and PAs are women, and if they are married, they are prone to pick up and move when their husbands are offered an out-of-town job. The men, who still dominate the medical profession, are less likely to pull up roots based on their spouse's employment, Schutte told Medscape Medical News.

Elevated turnover rates for NPs and PAs also reflect high demand for their services, as healthcare organizations turn to these clinicians to fill in for scarce physicians. In a buyer's market, NPs and PAs "will transfer for more money," said Schutte.

The 2011 AMGA-Cejka retention survey was given to some 2800 medical organizations. It was the first year that non-AMGA as well as AMGA groups were asked to complete it. Eighty groups submitted responses, with 37 belonging to the AMGA. These 37 groups employed 81% of the physicians covered in the survey.

More than 125,000 physicians work in AMGA member organizations such as the Mayo Clinic, Permanente Medical Group, and Intermountain Medical Group. The average AMGA group has 300 physicians.

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