Introduction

The American Academy of Pediatrics (AAP) Division of Workforce and Medical Education Policy is spearheading the Physician Reentry into the Workforce Project. This Reentry Project is a collaborative effort that aims to address the wide range of issues related to physician reentry through a number of venues including the development of these Issue Briefs.

A recent survey on physician reentry into the workforce identified that flexibility of practice influences the decision of physicians to leave or to reenter the workforce. The Reentry Project surveyed members of the American Medical Association’s (AMA) Women Physicians Congress regarding their perspectives on the issue of flexibility and reentry into clinical practice. Respondents were asked to think of employers, medical schools and State/Specialty Societies when answering the following questions:

What Incentives Should Be Offered, by the Groups Below, to Physicians Who Cannot Work Full-time to Encourage Them to Stay in Practice?

Among the Responses/Perspectives Shared:

Employers:

  • Provide fair pay for hours worked along with fair allocation of shifts that respect the employee’s preferences (e.g. day v. night v. weekend v holidays)
  • Provide on-site childcare, especially for sick children
  • Offer shared positions and part-time work
  • Offer flexibility in terms of not having to pay full overhead when working part-time
  • Develop solid leave policies that are more flexible than those usually offered to non-MD staff
  • Provide affordable malpractice insurance options Offer job sharing assistance Offer flexible benefits for those working flexible hours
  • Provide concierge type services Provide part-time liability premiums
  • Offer family friendly meeting times
  • Provide maternity and paternity leave

Medical Schools:

  • Provide outreach and presentations on career counseling and mentoring for physicians interested in part- time positions that focuses on how to best manage part-time work and benefits that should be sought in a part-time contract
  • Support longer times to complete medical school
  • Provide information on shared positions and part-time opportunities
  • Support shared residencies
  • Provide solid family leave policies Provide time off-the-clock for faculty working toward tenure
  • Provide clinical training and educational opportunities for physicians attempting to reenter clinical practice
  • Support electronic testing from home
  • Provide alternatives in tenure and other promotional tracks
  • Schedule meetings at family friendly times

State/Specialty Societies:

  • Provide outreach and presentations on career counseling and mentoring for part-time physicians including how to best manage part-time work and what benefits should be sought in a part-time contract
  • Offer CME to keep physicians up-to-date with clinical issues
  • Offer reduced membership fees and a special section devoted to this group of practitioners
  • Provide potential model contracts and practice arrangements
  • Develop content and testing modalities for reentry screening
  • Provide educational Resources, training program referrals, and a database to identify potential partners for job sharing
  • Advocate for more affordable malpractice options and affordable reentry training programs
  • Advocate on behalf of part-time physicians (part-time liability reduction, adequate leave polices, childcare at meetings)
  • Provide malpractice coverage at a pro-rated cost
  • Offer conference calls and Skype calls for meetings

What Resources Could Be Provided, by the Groups Below, to Reentering Physicians to Help Them Get Up to Speed After an Extended Period of Clinical Inactivity ?

Among the Answers/Perspectives Shared:

Employers:

  • Provide opportunities to ease into more complex cases when returning to clinical practice
  • Provide opportunities for shadowing a mentor in group practice
  • Encourage discussion of cases to ensure the physician is comfortable with clinical decision-making
  • Offer internships and/or supervision by practicing medical doctors
  • Provide mentoring opportunities
  • Support proctoring (this can be difficult given credentialing rules)
  • Provide CME offerings specifically designed to help with reentry (latest medications, changes in standards of care etc.)
  • Willingness to employ reentering physicians
  • Provide mandated feedback on performance
  • Offer paid job shadowing and precepting
  • Offer part-time arrangements
  • Provide on-site child are with extended hours (weekends, evenings, early mornings)
  • Offer concierge services
  • Support sabbaticals and flexible schedules

Medical Schools:

  • Provide counseling to help ensure fair contracting
  • Provide online discussion opportunities with mentors about clinical issues
  • Offer refresher courses (reentry certification courses)
  • Offer assessment and clinical reentry programs
  • Offer mini-residencies
  • Offer discussions on what to do if you take a leave of absence and how to prepare for it
  • Provide retraining options
  • Offer testing to place in higher level on restart
  • Provide on-site childcare
  • Provide mentoring opportunities

State/Specialty Societies:

  • Provide counseling to help ensure fair contracting
  • Provide online discussions with mentors about clinical issues
  • Offer CME opportunities
  • Provide a list of medical schools that offer mini-residencies
  • Provide review and assessment courses in specialty areas
  • Provide information on reentry opportunities
  • Offer easier ways to get recertified
  • Offer recertification centers that are closer to home
  • Provide credit for time already in the specialty
  • Serve as a clearinghouse for available reentry programs and license requirements

Comment

This survey was sent to the AMA Women Physicians Congress members for whom e-mail addresses were available. This survey was fielded in July 2009. The Introduction to the questionnaire asked respondents to comment even if they were not, a reentry physician or were not planning to become a reentry physician. Despite a low response rate, it is evident that the responses received are creative, well-intended, sometimes though-provoking, and in all instances, useful. The Physician Reentry into the Workforce Project will be considering the information gleaned from this survey as we move into the next phase of the Reentry Project, our Maintenance of Practice ™ initiative. The plan is to develop Resources to help physicians who plan to leave the workforce, but intend to reenter in the future, hence the use of the term: Maintenance of Practice.™ The Physician Reentry into the Workforce Project is grateful to those AMA Women Physician Congress members who took the time to share their ideas and perspectives. We also thank the AMA Women Physician Congress Governing Council for allowing us to field this survey.

Resources

The Web site at www.aap.org/reentry provides additional information on the Physician Reentry into the Workforce Project. The Web site also contains practical Resources for both physicians seeking to reenter the workforce and others interested in the issue, including employers, educators, regulatory groups, and medical and specialty societies.

Fair Use Policy: Individuals or organizations interested in distributing this Issue Brief or using its content should acknowledge the authorship of the Physician Reentry into the Workforce Project in an appropriate citation.

Suggested Citation: Physician Reentry into the Workforce Project. Issue Brief: Perspectives on Flexibility and Reentry into Clinical Practice from the AMA Women Physician Congress.Elk Grove Village, Ill. American Academy of Pediatrics; 2009.