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Forward slash docs outside the box . All right , sarah Ledbetter , you are the physician recruitment manager at Provider Solutions and Development . What's good how you doing ?
Great , how about yourself ?
I'm doing excellent . It is July when we are recording this .
Obviously , this is a very interesting time for folks who are coming into residency , as well as those third years , maybe even chief residents who are beginning their foray into their chief year of residency , but also , at the same time , this is the perfect time for them to start looking for what they're going to be doing afterwards .
Also , we got some doctors who have just finished residency , just finished fellowship , and maybe they are trying to figure out what to do next with their life , with their career
¶ Understanding Full-Time Equivalents
. So we got you on here to talk about choosing the right type of full-time employment , and what I mean by that is are you going to be a full-time doc ? Are you going to be a part-time doc ? Will you do locums ?
And I think that when it comes down to looking for a position , I think most people who are looking for a position always have in mind that that job , that hospital , that clinic , that private practice is always looking for someone to be completely , fully employed . You're here to debunk that theory .
So , before we jump into that , why don't you just introduce yourself and then we'll go right into it ?
Yes , thank you so much . My name is Sarah Ledbetter . I'm a recruitment manager for Provider Solutions and Development and we provide recruitment services to dozens of healthcare organizations across the country and we recruit for hundreds of job opportunities across most specialties .
Even trauma surgery .
At some point I'm sure we have , if not right now .
Because a brother may need a job yo . So I was going to make sure I could at least get a job with you guys .
Well , I've been a physician and provider recruiter for nearly 10 years , primarily in Washington state , and I'm really excited to be joining you here today to talk about some of the trends we're seeing .
Okay . So listen , you wrote a journal article talking about what people need to know about becoming a part-time physician . If you go to this article , guys , there's even like there's two gentlemen there . They're chilling , they're having a hot chai tea or whatever .
They're having something , they're getting together and having a good time , and I think that a lot of people nowadays are more concerned about not just being an excellent provider , an excellent physician , but also , at the same time , they want to have a dope life , they want to have a great lifestyle . Let's talk about this 1.0 FTE , full-time equivalent .
Talk to us about what that means , and then the different types of employment type models .
Yeah , I think that's a great place to start , because we'll be using that phrase , fte , a lot . Fte stands for full-time equivalent and I think the easiest way to think about it is that it's basically a percentage of time that an employee works . So let's say you have a 40-hour work week , which is very common for companies across the U .
If a physician's working 40 hours in a 40-hour work week , then your FTE is going to be a 1.0 .
You lying , hold on . So just so we clear , like really .
Like 40 hours . 40 hours according to companies , yes , what ?
Because I know , and I'm not even making light , like I know , like on average , like we are putting in at least 60 hours , 50 to 60 hours , and it's like wait , can I get 1.5 FTE ?
Right , I know . No , I completely understand the discrepancy , um , but yeah , I seriously didn't know that .
I did not know it was based off of 40 hour work week for doctors . I thought it was based off of residency or something or something like that .
Yeah , yeah , yes , so a 40-hour work week is fairly standard . You might see some variation here and there , but I would say most organizations will have a 40-hour work week as a standard .
Is there a difference between sorry to cut you off again , no , that's okay , you just threw me for a loop there . I literally thought you were going to say 60 hours . But like , is it the same for clinic versus like someone who's hospital-based , like a hospitalist versus you know , I don't know a private , uh , a dermatologist who has a a clinic ?
yes , it would be 40 . It would be based on a 40-hour work week . Whether or not people are actually working that amount is a different story .
Okay .
Yes , so that's what an FTE is . If you're working 20 hours out of that 40-hour work week , you would be at a 0.5 FTE , which is basically 50% , and then 30 hours would be a 0.75 FTE .
Okay , so those options do exist . I know that I've heard a lot about FTE really in the academic world , mainly because you know there's so many attendings or so many people when they graduate , they go and work in an academic institution , whatever name it may be , if it's Ivy League or whatever academic institution it may be .
There's always like additional things that you may be doing , right , whether you're going to be a program director for something or you're going to be a part of some organization or some committee or something .
And I always hear like , well , I'm not going to be like 1.0 FTE , I may be like 0.8 FTE and then the rest , the other 20% , would be based off of me writing grants or me being a part of this organization or me starting a podcast or whatever it may be that negotiation that occurs with a hospital .
So for me , it's something that I normally heard or hear about within the academic realm . Does this exist , like in community based situations ?
Absolutely yes . It would probably be easiest to describe it as an HR type of term , so that there's standardization for employment across the organization .
Got you Okay . So I found this really interesting because I think that , as residents , when we graduate , the number one thing that we're thinking about is look , we want to get a job , we're going to work , but I think , more and more , this generation I'm talking about Gen Zs talking about Gen .
Yers , you know they're more interested in having that balance , which I think we all need to be concerned about . So I've seen a lot more doctors start to ask hey , is this position amenable to less than 1.0 ? Which in my generation I'm not used to asking .
My wife asked that when she came out of residency , when we were looking at a job I worked at this one job for locums and then we say you know what ? We want to work here full time . I wanted to work there full time . And then my wife was like , well , actually I want to work part time . And I was like well , why are you going to ask them that ?
They're going to say no , obviously they're going to say no , right . And she's like well , you don't understand . Like my part-time or , excuse me , my full-time or no . No , the way how she described it is is my part-time work is equivalent to your full-time work as a trauma surgeon .
And I didn't understand it until later on down the line that , wow , like she's just as busy as I am on a part-time basis as I am on a full-time basis . So talk to us about that , because I didn't think this existed at all .
Yes , I think you'll see part of what you were talking about earlier about . You know , I was thinking it was a 60-hour work week . If you think about it that way , where if full-time for most people within your specialty or your role is 60 hours , to be able to work part-time means
¶ Navigating Part-Time Opportunities
that you would have a more balanced life , an opportunity for more balance in your life so you might decrease that 60 hours down to 40 hours by taking a part-time opportunity .
So when companies submit an application with you guys or I don't know application , but when they say , hey look , we want you to help us find physicians to fill this job , this specialty and so forth , I'm assuming the majority of them , all of them , are like we expect this to be like a full-time equivalent , like 1.0 , full-time equivalent , 100% right .
So if a job is posted and says this is a full-time position , then oftentimes it is . There's opportunity for full-time , but you might have the opportunity to ask , like your wife did , could this be a part-time position ? And it's up to the organization , it's up to the hiring team to be able to determine what the possibilities are there .
Here's a tip when looking for your next job , understand your strengths and weaknesses . For example , if you've been practicing for a while and you know you have a problem with closing charts , then it's important that you find a place that's going to help . You have administrative help Right . So there are plenty of options when it comes to your career in medicine .
But , just like every patient is different , every physician has their own personal definition of success , and that's where our sponsor steps in Provider Solutions and Development doesn't bring just one answer for all . They are recruitment experts focusing on who you are before helping you find what you're meant to be .
So , whatever you're ready for next , they'll help you find it with no quotas , no commissions to get in the way . So even if you're looking for a more collegial feel at work or just heck a more healthier work-life balance , they can help find the right fit for you . So reach out today at infopsdconnectorg . Forward slash docs outside the box .
How often are you seeing that nowadays where , like you know they , you know a job or , excuse me , a clinic or a hospital post , a position , and then say , hey , you know , we're kind of open to you know , taking less than one , you know , taking a part time position in this situation Like how ?
often does that occur ? I think it is happening more and more . I think that a lot of organizations are recognizing that people that especially people who are early on in their careers , um , might , might be seeking a little more , more balance in their life . Um , that it's . There's a need to create flexibility in their schedule , um .
So I do see organizations , uh , starting to put in their advertisements open to part-time , um , or open to open to being at least amenable to conversation more than they might have in the past . So , yes , I'm seeing it more and more .
So I think that oftentimes there's like these huge disasters that occur or something major occurs , that kind of resets everything right . So COVID reset everything right .
So a lot of let's be honest , a lot of doctors are like , well , if they're not in critical care or if they're not in ER , or if they're in a specialty that's deemed as non-essential , I think a lot of them are like this is something that I've never seen before . Right , like , how the hell is my position considered non-essential ?
And I think it's kind of changed the way in which a lot of doctors look at , one , their alliance to a position . Two , making sure that they're as balanced as possible with their finances . And three , thinking about what does full-time employment like , what does long-term employment look like with a company ?
And I think all of those things are changing and it's fluid .
So I bet you , a lot of people now post-COVID or actually I shouldn't say post-COVID , but like you know , we're kind of two years into COVID now are just like well , look , I got to do me at this moment and I got to be very open and honest with what I need and what's going to help me to be , you know , the best , not just the best physician , but the
best person that's out there . So let me ask you a question when should , let's say , you have a resident or you have an attending who's looking to work with you guys ? When should this come up in a conversation that , hey , I'm looking to change positions but , to be honest with you , just between me and you , I just want to be less than 1.0 .
Is that conversation happening like that , on a low low , or they should be very open and honest and tell you straight up .
I think that it's best to be open and honest from the beginning , especially if it's something that you know might be a deal breaker for you . There's no need to waste any of your own time on something that might not be a possibility at all .
So I would be very forthcoming to a recruiter , to a hiring manager , in the early conversations about what it is that you're looking for .
Okay . So let's say you're working with me trauma surgeon , I'm looking for a new position , I'm moving , you know wherever it may be and I say , hey look , let's keep it real . I'm trying to do this podcast and I'm doing other things . So I'm looking for like 0.75 , right .
What happens ?
next .
Yeah , so , as a recruiter , if you're talking to me , I'm going to present your interests to the hiring team and I'll include what your FTE interests are , or what your schedule interests are , and say you know , this has great background , these are his qualifications , this is what he's looking for . Is this something that we can work with ? Did ?
it hang up on you when you say that .
No , Within a few days potentially have a yes or no answer . It might be a yes right away or we'll see what we can do . Let's talk to him and see . While we're trying to figure it out , at least have a conversation .
So that's how I see this playing out , and we're seeing it a lot in different specialties where I haven't historically myself seen it in the past .
Neurologist recently expressed so neurology is becoming more open to that , okay .
Well , I've seen candidates from neurology . I've seen candidates from palliative care , candidates from urology , just across different primary care . It's very common to do part-time and hospital medicine as well , so across different specialties , I'm seeing a lot of interest from candidates . How ?
about surgery . In certain surgical specialties it is , it could be yeah , urology was a recent candidate . We we interviewed okay , so they get back to you . They let you know , hey , yeah , we're interested in this . Let's move forward .
Um , because I I'm glad that you you clarify that , because I do think that talking about deal breakers is very important for someone who's coming to you and looking for a specific type of job , for them to know what's their absolute like . I'm walking away from the table if I cannot get this For me . I always thought about that . This is something .
Once we go through the process of you know interviewing at the place now probably doing interviews on you know virtually , and then when the contract comes , that's when you start talking about all those different things . So you're saying talk about that even before you get the contract .
I think it's ideal to have the conversation early on .
Oh , okay , Okay , All right Now . So you mentioned like the primary care specialties you find that those are to be . Those are the ones that are most amenable to part-time work .
So why don't we , before we get into anything else , why don't you just like define for us what's the difference between part-time work , locums and then a lot of times people get confused between part-time work , per diem and locums , like those three things
¶ Comparing Employment Types
kind of confuse people .
Yeah . So I think with part-time versus full-time , you'll actually find some different definitions depending on the company . So in my organization this is just one example Full-time employee is either a 0.9 FTE or above , and then anything less than that would be considered part-time and then anything less than that would be considered part-time .
I'd say that you'd see some variation in that FTE . Some organizations might consider a 0.75 FTE to be full-time . So it's always good to ask what do you all consider to be full-time versus part-time ? And one thing that I think would be important for everybody to know is that full-time and part-time are guaranteed hours Like you're guaranteed .
The organization is guaranteeing to you like you'll have this set number of hours on a weekly or a bi-weekly basis , whatever the timeframe is . So that's what differentiates full-time and part-time . With per diem , a per diem job is an employed position . You might hear it called PRN . Some people say PRN in exchange for per diem .
It's an employed position , but the hours are not guaranteed . So that's one of the main differentiators there .
It's considered an as-needed basis .
But you're kind of still employed by that hospital . You are still employed , that's correct , and that is something that differentiates per diem with locums . So oftentimes locums providers are not directly employed by an organization and locums work , by nature , is temporary work .
You might be providing coverage for somebody who's on a leave or providing coverage while an organization is recruiting for a full-time employee .
Okay . So , hey guys , so for the people who are listening , my wife currently works at a job per diem , and that's something I never heard before .
So , basically , when she works there just like you said , sarah , like her hours aren't guaranteed , but they ask her like a month in advance , two months in advance , three months in advance , what can you cover , what weekends can you cover ? And then she works that weekend , but she is employed , but she doesn't get any benefits except for like the 401k .
But if she goes above a certain amount of hours , then they kind of consider her to be a part-time employee and she may qualify for like health benefits , like you know , healthcare or what have you .
She hasn't gotten to that level yet , but there's a provision at this specific job that you know , if she provides a certain amount of hours , she gets healthcare , she gets CME , she gets certain other benefits , but it would be at a part-time rate and so forth .
I mean at this point , though , when she finishes , though she gets , you know she's W-2 , like she gets at the end of the year a huge W-2 and you know she's considered an employee , but they can't tell her hey , you know , we have a physician shortage , we need you to work and you're going to work like they can't tell her to do that , whereas with locums ,
you know which we prefer locums is more of a hey , you know , like we want to hire you for your services and you're going to work with us in this type of fashion A lot of times . The hospital doesn't provide medical malpractice , they just pay a rate .
And the hospital doesn't provide medical malpractice , they just pay a rate , and then that rate is what the physician receives and in that rate and that total amount , that's what the physician is supposed to use to pay for their medical malpractice , their 401k , any other benefit that you would think an employed doctor is supposed to use that rate on a per hour
basis is supposed to hopefully cover that . So that's kind of what we do . We do ReneWork , works per diem , I work 100% locums and I think that , depending on where you live , depending on what your specialty is , it kind of depends on what you want . But I think a lot of people don't understand those differences and don't even know that those differences exist .
So question then let's talk about the benefits , though . So between let's talk CME , pay , time off I'm looking at my list other benefits out there , salary . What's the difference ? Part-time , full-time , per diem how does all that stuff work ?
¶ Benefits and Work-Life Balance
Yeah , this is a great point and something that you'll definitely want to clarify with organizations as you are exploring different opportunities . I would say that for anything less than a 1.0 FTE , you're going to want to confirm what the benefits are . Things such as CME and paid time away are going to be prorated , oftentimes based on the FTE that you have .
So if you have a 0.5 FTE that you're working , you might get half of the CME or half of the paid time away that a full-time employee might be earning in their work . So those are a couple of things that are prorated . I would say check on healthcare benefits . What does eligibility look like ?
You might not be eligible if you're below a 0.5 FTE for healthcare benefits . So you want to check to see when can I become eligible for healthcare benefits ? And also , how does the FTE affect the premiums , because you might pay a slightly higher premium for healthcare benefits based on your FTE . Those are definitely some things I check in on .
I've seen that . I've seen people do that where they have to pay higher premiums . But , folks , the reason I'm bringing this up and I should have mentioned this in earlier , that's my bad as a host is there's a Medscape report that came out this year . It's the Medscape Physician Lifestyle and Happiness Report 2022 .
Not all of you guys feel into this , but there's a large portion that do so . 55% of physicians would take a pay cut to have a better work-life balance . I ain't say that . That's what that study says . That report says that . So we got to go with the numbers .
So a lot of people out there , a lot of professionals out there , are interested in learning to kind of maybe pull back and be open and honest about what they really want in terms of their work style if it means cutting , you know , a portion of their salary . So you know , I'm interested .
Have you ever seen any negative effects from any employers finding out that a doctor is looking for part-time work ?
I'd say that the only negative that I can think of are when it's not a possibility . If for some reason operationally they're not able to accommodate a request like that , in that case if it's truly a deal breaker for a candidate to have a part-time position , then that opportunity might not be the right fit .
So that , I would say , is the biggest negative that I could foresee .
Is there lingo that hospitals are using or an employer may be using , so that you know if something is negotiable or not negotiable in the actual job description ? Or is it just the devil's in the details ? You just got to ask .
You just got to ask , I would say , because even a job advertisement , something that's posted online , it may not say explicitly we're open to part-time , but they might actually be open to it . So I would always , always ask . It never hurts .
Now in terms of writing a cover letter because I know you mentioned that it's really nice if a doctor has their CV and possibly a cover letter , but I just want to ask you like is doctors ? Are doctors really still writing cover letters ? I feel like this is like an old relic . Is that still necessary ?
It is not a necessity . Oftentimes we just get CVs through application portals or emailed to us , but I would say a lot . I do see a lot of cover letters and it's always refreshing to see it because I think it's a great way for somebody to explain a little bit about their background and what they're interested in .
I would say , the most commonly what I see is an email introduction , just a you know , attachment of the email . But also , you know , here's a little bit about who I am and why I'm interested in this opportunity that caught my eye .
How long should a cover letter be ? Like two pages , one page ?
Oh no , I don't think it needs to be that long . Even just a few sentences it could suffice . But I think most commonly I would see a paragraph . Yeah , so short and sweet .
Okay , all right , I like it . So . Okay , we were talking about it from the perspective of young doctors , young folks , young nurses , whoever's coming in , everybody who's coming in , they're young . But , like you know , I guess technically I can say it now I'm 10 years deep . I guess I'm officially mid-career .
What about mid-career doctors , mid-career healthcare professionals ? What's the driving force for them seeking less than 1.0 ?
Do you even see that at all ? I do . I think across the board I see it People coming right out of residency , fellowship people , mid-career , but also late career people seeking less than 1.0 .
And I would say for the mid-career folks , what I'm seeing most commonly are balancing home life with work life and oftentimes there are children involved , especially if there are two physician spouses . That happens a lot .
Where actually happened fairly recently with a candidate I was speaking with two of them actually where they said we have kids and there just needs to be a little bit more of a balance . We can't both be working full time . So that is something I see quite often . And also people who want to , people who want to pursue other things outside of clinical work .
They want to be docs outside the box . You can say it , sarah , come on now .
A hundred percent . They might want to have their own podcast . They might want .
You know , there are lots of things .
Some people want to teach , some people want to do administrative work . So just extra time that they can have to pursue other interests of theirs .
Yeah , just as an anecdote . Folks , that's kind of how me and Renee live . We have our kids center at the center of our life and obviously our relationship is at the center of our life also . I didn't realize it initially , but Renee said she wanted to be part-time mainly because we had just recently gotten married .
We had been dating long distance for several years through residency and fellowship , so this is the first time that we were actually getting
¶ Mid-Career and Family Considerations
to really know each other and learn to live with each other . And being in a household where , you know , full-time OB , full-time trauma , we would have been like this right , just kind of like sliding doors past each other high and by , and I don't know if that would have led to like a really strong relationship in the beginning .
So she asked for a part-time gig . They obliged her and then , you know , when it was time to have kids and then take care of kids , you know we made a pact also which is the children will always have a parent with them , no matter what . So the way how it works is when she is working , I don't work .
When I am working , she doesn't work , and it could be a little bit hard to manage .
Sometimes the calendars don't necessarily , you know , correlate , and sometimes there's literally a situation where I'm coming home that same day from a locums that's four hours away and as soon as I get there she's waiting there with the kid and then she runs off to her per diem job or wherever it may be , and then she gets in her car and leaves .
We don't like those , but those are few and far between , but it's a lifestyle that we both appreciate . It's a lifestyle that we feel really comfortable about and just want people to know that there's so many different ways that you can skin a cat .
There's so many different ways that you can live your life , balance your life , balance your career and be happy all at the same time .
Because it's not just me saying this , you can see by this Medscape article , medscape report , that 55% would take a pay cut and that also means , you know , possibly cutting other benefits , you know , in order to have a better work-life balance . So , sarah , this was great . Thank you so much for teaching us about the ability to get less than 1.0 FTE .
If folks want to learn more about you , if they want to contact you so you can help them start this process of maybe leaving one job and going to another job or just looking for a job in general . How do they get in contact with you ?
Oh , my goodness . Well , email works great and we also have a website as well . Would it be OK if I just ramble it all off , or Would ?
it be okay if I just ramble it all off . Yeah , so I'm sure the website will put in the show notes . So should people contact you directly or should they just go straight through the show notes and go through ? Oh , yeah , okay . So , folks , we're going to go ahead , please .
The show notes sound great and my email address is my first name dot . Last name Sarah SARAH dot . Ledter . L-e-d-b-e-t-t-e-r at psdrecruitorg .
Sarah , this was dope . Thank you again for coming on . For those people who are starting their whatever positions , they are in residency or if you're just recently just out , make sure you check out Provider Solutions and Development .
They're going to take you all the way , from step A to step Z , to help you find a job , figure out what your deal breakers are , educate you . They do all of that and that's
¶ Finding Your Balance and Closing
why we team up with them with Docs Outside the Box . We are going to catch you guys on the next one . Y'all Peace , hey guys . Thanks again for listening as well as supporting Docs Outside the Box . Listen , this show is produced by Darko Media Group and the dope audio experience is edited by the one .
The only , christian Parry , also known as your podcast pal , links to him in the show notes . Listen , this is Dr Nii , the Doc Outside the Box . I'll catch you on the next one . Peace .