Edward I. Bluth, MD

While the concept seems simple, developing an equitable consensus-based part-time employment policy for a group is complex. In a recent 

 on part-time radiologists, it was mentioned that in 2013 the ACR Commission on Human Resources attempted to provide guidance for radiologists based on different scenarios, depending on lengths of service in a group, reasons for change of status request, as well as issues of general fairness.

The Commission wondered if a group of radiologists might willingly treat their colleagues differently depending on how long they had worked with the group. The Commission also wondered if there was a difference in how agreeable a group might be in permitting part-time status to individuals that had compelling reasons for the request, such as being handicapped, wanting to pursue an MBA degree, or taking care of small children or a severely ill parent.

Another scenario the Commission discussed was granting part-time status for a fixed, limited number of years to people who wanted to transition to retirement. However, as previously reported, the members of the Commission were not successful in reaching consensus using the modified Delphi methodology.

The members of the HR Commission again met in Dallas in the summer of 2014 and discussion of the part-time work issue occurred again. During the interval, the Commission was reconstituted. The Commission had members of different ages, levels of training, gender, and years to retirement. Seven of the 14 members were new and some members present during the 2013 meeting were no longer part of the Commission. After considerable discussion and debate, it was still not possible to reach consensus on which criteria to preferentially recommend. The Commission appeared to be split in its recommendations, frequently by the age of those voting, suggesting that this is a complicated generational issue.[[{"type":"media","view_mode":"media_crop","fid":"28334","attributes":{"alt":"part-time radiologist","class":"media-image media-image-right","id":"media_crop_5296303801463","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"2855","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 133px; width: 199px; border-width: 0px; border-style: solid; margin: 1px; float: right;","title":" ","typeof":"foaf:Image"}}]]

During the ensuing discussion, it was pointed out by many members that the good of the patients and the good of the business aspect of the practice needed to take precedence over the needs of an individual in requesting part-time status. It was also pointed out that with the need for subspecialty coverage, coverage 24 hours a day, 7 days a week, and high productivity to maintain incomes, any request for part-time status would need to be subjugated to the needs of the practice. It was also felt that although, theoretically, large groups might have more flexibility in granting part-time status than small groups, that is not necessarily true. For example, the large group might need to cover multiple locations. Also, there are often issues in finding the right grouping of people to work in a given shift, taking into account the diversity of modalities the radiologists can cover, how fast they can work accurately, and the need to accommodate certain other needs. These other needs could include the time spent or practice location requirements of the departmental chairperson, the head of the group, division directors, members of certain committees, and officers in the hospital staff. For teaching hospitals, it could also include the residency director and core faculty.   

The Commission did achieve consensus that if two people were absolutely equal, and only one could be granted part-time status, then the number of years in the group should play a role in deciding who would be allowed to go part-time. However, it was also appreciated that it is rare for two people to be exactly equal. It was also felt that job sharing might be an attractive way to solve some part-time issues, although the issue of fringe benefits would need to be addressed so that the monetary amount of the salary and fringe benefits split between the two job sharing people would not exceed that from one full-time person and thus negatively affect the group. On the other hand, no radiologist wants to be thought of as merely a work unit, a nameless inanimate cog in a production wheel. For maximum morale and productivity, as well as insuring group continuity, groups need to consider carefully all personal requests regarding part-time employment not as single issues or events but as part of a broader policy that affects continued membership in a group as well as retirement.

Since the needs, age mix, and cultures of radiology groups are different, the Commission cannot make, nor is it able to make, any specific consensus recommendation under which circumstances, if any, radiologists should be granted part-time status. Instead, the Commission recommends that each group establish policies in advance regarding these matters, but in such a way as to allow some flexibility, and consider each request for part-time employment carefully in regard to its short and long term consequences for the group, the patients it serves, and its hospital(s). In the long term, failure to develop a well thought-out policy regarding part time employment will lead to inequities with resultant explosive emotional reactions leading to group instability. 

Acknowledgement is hereby given to those who participated in the Dallas discussion in addition to the authors:  Elizabeth Arleo, Michael Donner, Sharon Dutton, Michael Francavilla, Robert Harris, Jay Parikh, Jinha Park, Robert Rapoport, Gordon Sze, Sidney Ulreich, and Hang Truong. 

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Edward I. Bluth, MD

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