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Special Report |
1 From the Department of Diagnostic Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756. From the 1998 RSNA scientific assembly. Received April 10, 2000; revision requested June 1; revision received April 16, 2001; accepted May 22. Supported by a grant from the Alfred P. Sloan Foundation under its program on alternative career paths. Address correspondence to J.D.C. (e-mail: jocelyn.d.chertoff@hitchcock.org).
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ABSTRACT |
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 TOP ABSTRACT INTRODUCTIONMATERIALS AND METHODS RESULTS DISCUSSION REFERENCES |
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MATERIALS AND METHODS: A survey was mailed to 1,500 male and 1,500 female radiologists. Questions assessed part-time work and its effect on professional and family issues. The effects of education, radiology practice characteristics, organizational support, human resource practices, and family responsibilities on career and professional satisfaction were studied.
RESULTS: Ten and a half percent of the radiologists surveyed—7.4% of the men and 30.2% of the women—were working part-time. The part-time radiologists reported earning 56.3% of the income earned by full-time radiologists and working 56.9% of the hours worked by their full-time counterparts, with disproportionately fewer benefits. Part-time private practice radiologists were significantly less likely to be partners. For academic radiologists, having worked part-time at any time was significantly associated with lower academic rank.
CONCLUSION: The motivation for working part-time differed significantly according to gender and age. Benefits were disproportionate, and radiologists who had worked part-time were less likely to be partners or full professors.
Index terms: Economics, medical • Radiology and radiologists, socioeconomic issues • Special Reports
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INTRODUCTION |
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TOPABSTRACTINTRODUCTIONMATERIALS AND METHODS RESULTS DISCUSSION REFERENCES |
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As the numbers of dual-earner households increase, younger physicians, especially women, are choosing part-time work earlier in their careers to balance work and family responsibilities. In the 1990s, managed care led to decreased reimbursements, and this resulted in increased pressure for greater productivity and led to the perception that there was an oversupply of specialists, including radiologists (4). Part-time work was suggested as a partial solution to this perceived oversupply (5).
In contrast, in the current atmosphere, part-time work is perceived as a partial solution to the current unmet demand for radiologists. As a short-term solution action, the group on workforce issues from the Intersociety Summer Conference in 2000 recommended encouraging the American College of Radiology Professional Bureau to add a section on part-time and/or retired radiologists (6). However, radiologists filling this niche do so with some trepidation, fearing a negative effect on their careers (7).
Results of surveys conducted by the American College of Radiology indicate that the number of part-time radiologists increased between 1990 and 1995, increasing from 8% to 10% of posttraining professionally active radiologists (1,3). The percentage of men working part-time increased from 7% to 9%, as compared with an increase of 16%–18% among women (8,9). Results of a 1982 survey also showed that 18% of female radiologists worked part-time, with 14% doing so by choice (10). Studies of part-time work in radiology to date have concentrated on age- and gender-related work patterns (1–3,8–12) and on the perceived equity of benefits (11).
The purpose of this study was to determine the extent of part-time work in radiology and to assess the consequences of working part-time in a national sample of male and female radiologists.
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MATERIALS AND METHODS |
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TOPABSTRACTINTRODUCTIONMATERIALS AND METHODS RESULTS DISCUSSION REFERENCES |
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A stratified random sample of radiologists was drawn from the physician master file of the American Medical Association. To our knowledge, this master file is the most complete source of information on physicians in the United States. It contains basic demographic, educational, and professional data on all physicians practicing in the United States, including those who are and those who are not members of the American Medical Association (13). Because the total number of female radiologists is relatively small, this population was deliberately oversampled to ensure a sufficient number of female physicians for meaningful analyses.
The data were collected in 1997. Questionnaires were mailed to 3,000 radiologists; this group consisted of an equal number of men and women. Three follow-up mailings during 3 months to those who did not initially respond increased the total number of completed surveys to 1,293. Informed consent was obtained after the nature of the project was explained in writing. The institutional review board at Brown University, Providence, RI, approved the project. The final response rate, after the elimination of invalid addresses and deceased individuals, was 45.6% (1,293/2,836). The analyses presented here excluded an additional 17 respondents who indicated that they were no longer practicing radiology in the United States because they had either changed fields or moved out of the country.
On the basis of data from the American Medical Association physician master file (13), which were provided by the American College of Radiology, our data were weighted according to age and gender to reflect the population of posttraining radiologists practicing in the United States, where approximately 14% are women (3). Weighted responses that provide an estimate of what the responses would have been if all radiologists in the United States had been surveyed are presented in Tables 1–10. The weighted results are adjusted for differences in sampling rates and in response rates for specific age and gender groups. For example, we received responses from 175 male radiologists aged 35–44 years. On the basis of physician characteristic data that were available in the American Medical Association master file, there were approximately 5,857 male radiologists aged 35–44 years. Therefore, radiologists in this category were assigned a weight of 5,857 divided by 175, which equals 33.47. Our sample included 541 male and 653 female radiologists. The unweighted sample included 45.3% men and 54.7% women. The weighted sample included 84.9% (n = 19,992) men and 15.1% (n = 3,543) women. Radiologists were excluded from analysis if they were still in training or were not currently practicing radiology.
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Work hours and income.—Respondents were also asked how many hours they worked at their regular job in a typical week and how many weeks they worked per year, excluding vacation time. Instructions indicated that the total number of professional work hours should include those spent in clinical practice, teaching, research, and administration and exclude those spent in continuing medical education and at professional society meetings. Radiologists were asked the total income from their main job before taxes in 1996. They were then asked the amount of additional income they received before taxes in 1996 from grants, serving as a locum tenens, consulting, speaking, and legal or other radiology work. The incomes listed in Table 2 are the sums of these two amounts.
Reasons for choosing radiology.—Respondents were asked to indicate how important the following factors were in their decision to enter radiology: income potential, quality clerkship experience, potential quality of life, potential for defined hours, interest in diagnostics, diversity of practice, prestige and status, potential for part-time work, interest in technology, interest in procedures, strong role model or mentor, and other factors. Each item was rated by using the following five-point scale: not important, somewhat important, moderately important, very important, and essential. The responses were dichotomized into two categories: very important and essential responses and all other responses.
Reasons for choosing current job.—Respondents were asked to indicate how important the following factors were in choosing their current job: defined hours, limited call, income stability, income potential, income tied to own productivity, income not tied to productivity, potential for part-time work, teaching opportunities, research opportunities, benefits (including vacation), paid maternity leave, geographic preference, following spouse, mix of modalities, patient mix, mix of clinical problems, and other. The items were rated by using the following five-point scale: not important, somewhat important, moderately important, very important, and essential. The responses were dichotomized into two categories: very important and essential responses and all other responses.
Part-time work.—On the questionnaire, respondents were asked whether they had ever worked part-time as a radiologist. The respondents were categorized according to whether they were currently working part-time, had previously worked part-time, or had never worked part-time. The part-time radiologists were asked to indicate the duration they worked part-time and the reason from the following choices: personal illness, family illness, child rearing, family problems, transition to retirement, quality of life preference, could not find a full-time job, and other. They were asked whether they received the following benefits: malpractice coverage, health insurance coverage, disability insurance coverage, vacation time, sick leave, academic days, time for educational meetings, and bonuses. For each benefit received, they were asked to compare their coverage with that of the full-time radiologists where they worked by indicating whether their coverage was equal, proportional, or less than proportional to the coverage of their full-time colleagues or that they did not know.
Indicators of professional advancement.—Respondents were asked to report all of the categories that described their current position: academic, private practice salaried, private practice partner, locum tenens, resident, fellow, government employee, retired, and on leave. Academic radiologists were asked for their current rank, the number of years at the current rank, and the number of papers published and presentations given during the past year, during the past 5 years, and during their career as first author and as co-author. Private practice radiologists were asked the typical number of years to full partnership where they worked and the number of years at their present status, and partners were asked the number of years it took them to become full partners.
Statistical and Data Analyses
Analyses were conducted by using two computer software programs (STATA, Stata, College Station, Tex; and SUDAAN, Research Triangle Institute, Research Triangle Park, NC). With this software, it is possible to adjust the standard errors by using the probability design effect implied by the unequal weights. This adjustment yields accurate standard errors and P values.
Mean values or percentages for each of the described variables are presented in Tables 1–10. The presented data indicate whether differences in mean values were statistically significant (P < .01) according to selected characteristics, such as full- versus part-time radiologist. Standard statistical tests of differences in mean values were used: two-tailed t tests for dichotomous variables, such as full- versus part-time employment, and cross tabulations for variables with more than two categories. For variables with more than two categories, significance test results can indicate whether two groups vary in distribution across categories, but these results cannot indicate which categories are significantly different from the others. For the cross tabulations that included an empty cell or a cell with insufficient cases for analysis, the 
2 statistic categories were collapsed, as noted in the Tables.
We begin by presenting the demographic, professional, and employment characteristics of radiologists overall and according to employment status (Table 1). Table 1 contains data on three mutually exclusive categories of radiologists that were compared on the basis of their part-time work history: those who had never worked part-time, those who were currently working part-time, and those who previously worked part-time but currently were not working part-time. For an overview of the relationships between current employment and income, employment and income data categorized according to gender, diagnostic area, and current employment status are presented in Table 2. However, our primary goal was to compare radiologists who had never worked part-time with those who were currently working part-time (Tables 3–5, 7, and 8). The reasons for working part-time among radiologists who were currently working part-time, categorized according to gender, are listed in Table 6.
In our final analyses (Tables 8–10), we examined the career effects of working part-time on academic radiologists and private practice radiologists. Because of the relatively small numbers of cases, for these analyses, it was necessary to compare the radiologists who had worked part-time at some point with those who had never done so. Because patterns of part-time work differ between the genders, we present the results of comparisons between male and female radiologists in cases in which there were sufficient numbers to perform such analysis.
Because of the large number of statistical tests performed, the true significance level was lower than that indicated by a P value of .05. For example, in Table 1, the results of 40 tests of significance are shown. An extremely conservative approach would involve adjustment for the number of tests, which in this case, would mean testing at a P value level of .05/40, or .001. However, this approach is so conservative that it appears to be more misleading than that of reporting the levels as we did, and the data obtained with such an approach would not be comparable to those in the existing literature on radiology employment. Therefore, test results that are significant at the P equal .05 level but not at lower levels are to be viewed with caution and thus are not discussed in this text.
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RESULTS |
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TOPABSTRACTINTRODUCTIONMATERIALS AND METHODS RESULTS DISCUSSION REFERENCES |
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Work Hours and Incomes
The full-time radiologists reported working a mean of 51.7 hours per week and a mean of 43.8 weeks per year (Table 2). The mean number of hours and weeks worked did not differ significantly between the male and female radiologists. The part-time radiologists worked a mean of 32.3 hours per week and a mean of 40.0 weeks per year. The radiologists in our survey reported a variety of part-time work arrangements. Some part-time radiologists worked a similar number of hours as their full-time colleagues and reduced call, some worked a percentage of hours and call, and others worked only 1 or 2 days a week.
Overall, incomes were proportionate to the numbers of hours worked. Part-time radiologists worked a mean of 56.9% (1,291/2,269) of the hours worked by full-time radiologists and earned 56.3% ($148,871/$264,426) of the average full-time salary.
Reasons for Choosing Radiology
We examined the reasons full- and part-time radiologists reported for choosing radiology as a specialty. As shown in Table 3, the top four reasons of the group currently working part-time were the same as those of the group that never worked part-time: interest in diagnostics, potential quality of life, diversity of practice, and potential for defined hours. The group that was currently working part-time was significantly more likely to indicate that the potential for part-time work was very important or essential to their choice than was the never part-time group (P < .001). A significantly higher percentage of radiologists in the never part-time group than in the currently part-time group identified diversity of practice (P < .01), interest in procedures (P < .01), and strong role model or mentor (P < .01) as very important or essential to their decision.
On average, the male and female radiologists differed in several respects with regard to their reasons for choosing radiology (Table 3). However, among those who had never worked part-time, there was only one significant gender-related difference in the reasons for pursing radiology: A higher percentage of women (59.5% [1,098/1,834]) than men (42.9% [6,790/15,814]) indicated that the potential for defined hours was either very important or essential in their decision to pursue radiology (P < .01).
Reasons for Choosing Current Job
As shown in Table 4, a significantly higher percentage of radiologists in the currently working part-time group than in the group who had never worked part-time rated several factors as important or essential in choosing their current job: defined hours, limited call, following spouse, and potential for part-time work (P < .001 for each). Compared with the radiologists who were currently working part-time, the group who had never worked part-time rated mix of modalities (P < .01), income potential (P < .001), and patient mix (P < .01) as very important or essential in their choice more frequently.
Geographic preference was the most frequently reported factor in the job choice for both men and women. Furthermore, similar percentages of men and women chose their current job on the basis of the practice’s clinical aspects—namely, mix of modalities, mix of clinical problems, and patient mix—and economic aspects—namely, benefits, income stability, and income potential. Significantly more women than men cited geographic preference, defined hours, teaching opportunities, following spouse, and paid maternity leave (P < .001 for each reason) as very important or essential. Significantly more women than men also cited potential for part-time work as very important or essential, and, as expected, the importance of this factor in choosing a job was significantly different between the currently working part-time and the never worked part-time groups (P < .001) (Table 4).
Among the radiologists who had never worked part-time, five reasons for choosing their current job differed significantly between the genders, and these reasons were significantly more important to women: defined hours (17.6% [2,724/15,463] of men vs 31.9% [554/1,737] of women; P < .001), limited call (14.4% [2,196/15,291] of men vs 30.2% [521/1,726] of women; P < .001), following spouse (6.9% [1,014/14,622] of men vs 32.1% [551/1,717] of women; P < .001), teaching opportunities (16.8% [2,594/15,448] of men vs 26.1% [459/1,759] of women; P < .01), and paid maternity leave (0.5% [72/14,054] of men vs 9.5% [157/1,658] of women; P < .01).
Part-time Radiologists
There were nearly as many radiologists who had previously worked part-time (2,376/23,535 [10.1%]) as there were radiologists who were currently working part-time (2,480/23,535 [10.5%]). Of the radiologists working part-time, 17.4% (430/2,478) were locum tenentes, as compared with 0.1% (15/20,277) of the full-time radiologists (P < .001).
As shown in Table 5, men were less likely than women to have ever worked part-time (16.7% vs 46.9%; P < .001), and men were less likely to be currently working part-time (7.4% vs 30.2%; P < .001). However, because 84.9% of the radiologists were men, there were more male than female radiologists who were either currently working part-time or had previously worked part-time. Although the male radiologists were, on average, older than their female colleagues, the gender-related difference in age was much larger among the radiologists who were currently working part-time than among all radiologists (15.6 vs 5.6 years). The average age of male radiologists working part-time was 60.7 years, as compared with that of female radiologists working part-time, 45.1 years (P < .001). The average number of years since receiving a medical degree for male radiologists working part-time was 34.4 years, as compared with that for female radiologists working part-time, 18.6 years (P < .001) (Table 5). These data indicate that male and female radiologists who are working part-time are in very different positions in terms of both their careers and families.
Reasons for Choosing Part-time Work
The male and female radiologists differed in their reasons for choosing part-time work. As shown in Table 6, quality of life was cited as a reason by 46.8% of men and 63.4% of women. Among the men currently working part-time, 46.7% cited transition to retirement as a reason, as compared with only 8.1% of the women (P < .001). In contrast, 72.9% of the women currently working part-time cited child rearing as a reason, as compared with 5.0% of the men (P < .001). The same percentage of men and women cited a lack of available full-time work, 9.1%, and there was no significant difference between the percentages of men and women who cited personal illness as a reason for working part-time. Interestingly, no men and only a small percentage of women reported that they worked part-time because of family illness or family problems (P < .01). The gender-related difference in the numbers of radiologists who cited "other reason" as a motivation for working part-time was significant only at the P less than .05 level. The majority of these other reasons were the ability to work as a locum tenens during training, being between full-time jobs, or working part-time to supplement income while building a practice.
Benefits
We asked the part-time radiologists to compare their benefits with those of the full-time radiologists in the same practice. As shown in Table 7, the part-time radiologists reported receiving fewer benefits than did their full-time colleagues. Malpractice insurance was the most frequently provided benefit for part-time radiologists; 82.7% of part-time radiologists received this benefit, and of these, 83.8% had coverage equal or proportional to that of full-time radiologists.
Many part-time radiologists received at least partial coverage for a range of benefits. Overall, 47.1% of part-time radiologists received vacation time; 42.2%, health insurance; 37.7%, time for educational meetings; 36.7%, a bonus; 31.4%, sick leave; and 30.0%, disability insurance. A significantly higher percentage of women working part-time received health insurance (P < .01), vacation time (P < .001), and sick leave (P < .01).
Of academic radiologists working part-time, 50.9% received academic time, with no significant gender-related difference. Of these radiologists, 8.6% received an amount of academic time equal to the amount received by their full-time colleagues, and 58.8% received proportional academic time.
Indicators of Professional Advancement: Academic Radiologists
Among academic radiologists, 11.4% (592/5,194) were working part-time, and of these, 55.9% (331/592) were women. Women accounted for 23.2% (1,207/5,194) of the academic radiologists and were four times as likely as their male colleagues to work part-time (27.4% [331/1,207] vs 6.5% [261/3,987]; P < .001).
Academic rank and the number of published works and presentations were examined as indicators of academic progress. As shown in Table 8, having ever worked part-time was significantly associated with lower academic rank (2 = 14.27; P < .001). Of radiologists who had ever worked part-time, 72.7% were assistant professors compared with 35.5% of those who had never worked part-time. In contrast, 7.9% of radiologists who had ever worked part-time, as compared with 30.3% of those who had never worked part-time, were full professors.
Published material is a very important factor in academic promotions. For academic radiologists, currently working part-time was associated with fewer first-authored publications (mean, 1.3 vs 3.2; P < .01) and fewer co-authored publications (mean, 3.3 vs 6.0; P < .01) during the previous 5 years.
As shown in Table 9, there were no significant differences in the number of works published or first-authored presentations given during a career, based on part-time work history, among the early-career radiologists—that is, those aged 35–44 years. However, among the mid-career radiologists—that is, those aged 45–54 years—having ever worked part-time was associated with fewer papers and presentations. The average number of first-authored papers for the mid-career radiologists who had ever worked part-time was 4.0, as compared with 19.2 for those who had never worked part-time (P < .01). The differences in the number of co-authored papers and first-authored presentations were not significant at the P less than .01 level.
Indicators of Professional Advancement: Private Practice Radiologists
Of the radiologists in private practice, 10.6% (1,961/18,461) were working part-time, and of these, 33.7% (661/1,961) were women. Women accounted for 12.7% (2,344/18,461) of private practice radiologists and were 3.5 times as likely as their male colleagues to work part-time (28.2% [661/2,344] vs 8.1% [1,300/16,117]; P < .001). Partnership status was examined as an indicator of professional progress in private practice. Among those currently working part-time, 16.7% of the women and 21.7% of the men were partners in a private practice, as compared with 43.3% of the women and 68.0% of the men who had never worked part-time (P < .001) (Table 1). As shown in Table 10, among all radiologists aged 35 years and older, those who had ever worked part-time were significantly less likely to have partnership status. The differences were significant at three career stages: early, or aged 35–44 years (77.8% for never part-time vs 49.2% for ever part-time; P < .001); middle, or aged 45–54 years (83.6% for never part-time vs 58.5% for ever part-time; P < .01); and late, or aged 55 years and older (88.2% for never part-time vs 39.1% for ever part-time; P < .001).
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DISCUSSION |
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TOPABSTRACTINTRODUCTIONMATERIALS AND METHODS RESULTS DISCUSSION REFERENCES |
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Self-reported data are frequently considered to be a limitation in study design; however, self reports of preference data are accurate but necessarily subjective. The answers to questions regarding prior choices, such as the reported reasons for choosing radiology, are subjective, retrospective, and subject to subsequent experiences and understanding.
Although part-time radiologists knew whether they received a particular benefit, their information regarding how their benefits compared with those of other radiologists in their practice may have been subjective or incomplete, although they were specifically asked to indicate if they did not know. Because the range of benefits may differ greatly between practices and part-time radiologists are not evenly distributed across practices, this portion of the analysis depended on comparisons within practices rather than on a global comparison between part- and full-time benefits.
Willingness to complete the survey may have indicated a bias toward research on the topics addressed in the survey. This is a hazard of any survey. However, in our study, the rates of part-time work overall were similar to those gleaned from the 1995 Manpower survey (10.5% vs 10.0%); these findings indicate that there was no substantial response bias in favor of part-time radiologists (3). We observed a larger percentage of female radiologists currently working part-time (30.2% vs 18.0%) but no difference for men (7.4% vs 9.0%) (9). Although this finding may reflect a higher rate of response to our survey from female part-time radiologists, it could also be a more accurate measure of female radiologists’ work arrangements that resulted from the oversample of women. The rates of response to our survey did not differ greatly between the genders; thus, this finding may reflect an increase in part-time work rather than a response bias.
Part-time Work and Its Consequences
Men and women are pursuing part-time work for different reasons and consequently at different points in their careers. To the extent that there are negative career consequences of part-time work, it is expected to have a greater effect on those who pursue such alternative work arrangements earlier in their careers. This hypothesis is supported by our study data.
The work hours results of our study were similar to those in previous studies. In both the 1990 and the 1995 American College of Radiology Manpower surveys, full-time radiologists reported working a mean of 50 hours per week (2,3), with no gender-related difference in work hours (3,12). The number of hours worked by self-described part-time radiologists increased from a mean of 30 hours and 4.1 days per week in the 1990 survey (2) to a mean of 36 hours in the 1995 survey (3), the results of which indicated that women were more likely than men to work part-time. The slightly longer hours for full-time in our study may reflect the increased pressure for greater productivity with the rise of managed care. Increasing work hours can help compensate for the declining payments for radiological services, but it may be an added pressure that leads to part-time work for those radiologists for whom longer hours are particularly undesirable.
On average, compensation for part-time radiologists was equitable, on the basis of the reported number of hours they worked relative to the number of hours full-time radiologists worked. This finding indicates that practices are making efforts to maintain equity in compensation. Interestingly, we found that men earned slightly more, whereas women received more benefits. This gender-related difference may reflect differences in negotiation and/or needs based on differences in the ages and circumstances of male and female radiologists working part-time. For example, radiologists approaching retirement are less likely to seek disability insurance as a part of their compensation package.
The relationship between benefits and work arrangements is highly complex. A detailed analysis of the relationship between benefits and work was beyond the scope of the data we collected. However, a more extensive analysis of the distribution of benefits to full- and part-time radiologists would be valuable to individual radiologists and practices in negotiating standard and alternative work arrangements.
Our study results indicate a loss of benefits associated with part-time work. To our knowledge, few data on the compensation and benefits received by part-time radiologists were previously available. In a study by Reuter and colleagues (11), 60% of part-time radiologists reported that their salaries were proportional to those of full-time radiologists; 70%, that their malpractice coverage was the same as that of full-time radiologists; 79%, that their vacation time was equal or proportional to that of full-time radiologists; and 56%, that they received no academic days. The Reuter et al study was a pilot study, limited due to the small number of responses and to possible selection bias based on sampling: The survey was distributed in the American Association for Women Radiologists bulletin. We observed a lower rate of benefits to part-time radiologists, with the exception of academic days. In our study, half of the part-time academic radiologists received academic days. Clearly, benefits is an area in which the individual must carefully assess his or her specific needs and preferences. However, in an academic practice, academic time is critical to a successful career.
In 1989, Hillman et al (14) investigated the relationship between amount of time available to conduct research and research productivity among academic radiologists. In their study, radiologists for whom time was set aside for research were the authors of 30% more publications, as compared with radiologists for whom research time was not set aside. In our study, part-time academic radiologists reported receiving substantially less academic time than did their full-time colleagues. Academic radiologists who had ever worked part-time had fewer first- authored papers published than did those who had always worked full-time. This difference was significant for the cohort of radiologists aged 45–54 years: This group generally includes established physicians from whom marked academic progress is expected. Comparisons of co-authored papers and first-authored presentations revealed that the radiologists who had ever worked part-time were not compensating by allocating their time to the production of more co-authored papers and first-authored presentations than their full-time peers.
In academic practices, advancement is usually tied to research productivity and published works (15,16). The results of a recent study by Vydareny et al (17) indicated that in academic radiology, the rate of publication was the most important factor in determining the rate of promotion. In our study, we found that overall, having ever worked part-time was significantly associated with lower academic rank. This could indicate a choice on the part of radiologists to trade part-time work for advancement or perhaps their decision to delay advancement. However, the productivity and advancement of radiologists who have ever worked part-time generally lagged behind those of full-time radiologists. Either more detailed work histories or longitudinal data are necessary to determine whether the delays in promotion are proportional to the reduced work hours.
These results suggest that for part-time academic radiologists to advance professionally, institutions must demonstrate a commitment to faculty development that goes beyond the traditional factors for promotion. This commitment might include a redefined promotion time line, focused mentoring aimed specifically at academic productivity, or at least providing part-time radiologists with a level of support that is proportional to that offered to their full-time colleagues. Without this support, the decreased productivity and lack of advancement of part-time radiologists are likely to persist and to create a cumulative disadvantage that will remain throughout their careers. One might also question whether a proportional amount of time for continuing medical education, while reasonable, can fulfill the needs of individuals who are already less exposed to ongoing educational initiatives within their departments.
On a similar issue, are negative career consequences inevitable when radiologists seeking part-time work are forced to give up a partnership or partnership-track position, as indicated by our study data? As we have previously reported (7), although some radiologists are forced to either leave the partnership track or give up a partnership to work part-time, others are able to remain on the partnership track or keep their partnership positions by negotiating for a percentage partnership. Thus, it appears that when practices are willing to work to maintain equity between full- and part-time radiologists, successful work arrangements can be made for those seeking an alternative career path that involves a period of part-time work.
Changes in the demographics of workplaces, the most striking of which is the increasing number of dual-earner families, require changes in workplace practices that accommodate the needs of working people and thus integrate work, family, and community. Characterizing these needs as women’s issues may limit attempts to address them appropriately or creatively and may disregard the needs of male radiologists in dual-career families. Our study results demonstrate that although women are more likely to work part-time than men, men constitute the majority of part-time radiologists. In describing a new model for understanding the modern workplace, Barnett (18) discusses the need to go beyond the current policies created to address this demographic shift, such as flexible time and parental leave, many of which are not used owing to fear of being marginalized, to adopt a different approach that is aimed at integrating rather than separating work-life issues. Barnett describes new policies such as "alternative career paths and revised criteria for promotion" and proposes that "reduced-hours career options along with clear criteria for performance review and promotion," coupled with an emphasis on how work is accomplished, would benefit both the workplace and the people in it (18).
Part-time work can provide advantages to the individual, the practice, and the profession; however, it is important to understand the unintended consequences of part-time work to assess its value. We contend that structuring part-time work opportunities that facilitate rather than prevent subsequent career advancement would mitigate some of the negative consequences of part-time work. This is a critical issue to address, because early and mid-career part-time work has become an increasingly common alternative to the traditional career path. Additional research in this area is needed to characterize the structuring of current part-time work arrangements and to optimize successful work arrangements. We are currently conducting research to examine the organizational practices that support successful alternative work arrangements and thus identify the critical factors for radiologists and the field of radiology.
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REFERENCES |
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