Question on changing to 0.8FTE

[HikingDO]

I have a question for anyone who works less than full time. I work for a large group in the Phoenix area as a family physician, and I'm interested in decreasing to 0.8FTE. Currently, 1.0FTE involves 36 hours of patient contact. However, lowering to 0.8 will only decrease my patient contact hours to 32 hours. This means I'll be receiving 80% of full time pay for working 88% of full time hours.
This hardly seems fair, as I feel 80% of full time pay should equal 80% of full time hours hours (29 patient contact hours). Does anyone else have experience with this? Is this typical?

[GasFIRE]

I used to be in a large practice where I was 0.7 FTE, but that was the gross revenue. After subtracting fixed costs like malpractice (no discount) and office expenses (shared equally by all physicians), my net take home was less than 0.7 of FT.  Since you're in a large group, it sounds like someone has already created a scale for the group of time vs money.  I would ask whoever is in charge for the reasoning behind this. You may or may not agree, but at least you'll know the ground rules.

[wideopenspaces]

That sounds messed up to me. 1.0 FTE for me is 28 hours of patient contact,/ week. I have worked 0.75, 0.5, 0.33 and 0.25 FTE in the past 18 months and it's always been the equivalent fraction of patient hours and pay. However I only get retirement contributions and health insurance once I'm at 0.5 FTE and only get vacation and sick time once I'm at 0.75 FTE so there is a differential there. But at 0.25 FTE I booked 7 hours of appointments each week and made 25 percent of the pay that you make at 1.0 FTE.

Our office manager used to make us book 10 percent over our contracted amount of patient care hours to make up for no shows but this applied to everyone, no matter the FTE. However, I recently convinced her to stop making me do that so now if I ever go back to 0.75 FTE I will get the same pay but only have to schedule 21 hours of appointments instead of 23 hours/ week. So you could ask what the rationale is and try to negotiate from there.
Good luck!

[FIREshrink]

Benefits are the difference as both wideopenspaces and GasFIRE have indicated. Someone has to pay to keep the lights on and if everyone went 0.8 everyone’s share of the overhead would not decrease, and your take home pay per RVU generated would decrease.

[VagabondMD]

Agree with the above.

I recently went to 0.6, and my compensation of 0.6 is based on adding all costs attributable to a full partner (including malpractice insurance, employment tax, health insurance, salary  etc) and taking 60% of that number. From that starting point, calculating salary and other benefits. You will find that due to the fix costs, my salary will be lower than 60% of full time salary if I maximize all other benefits, Malpractice insurance and heath insurance, as examples, are still 100% despite that you are only working 80%.

Expenses attributable to your share of office expenses may or may not decline with you dropping to 80%. If you have an assistant assigned to only you, for example, that person might not be expected to drop to 80% just because you do.

There is nothing wrong with asking for an explanation and to see the numbers that back this up.

[HikingDO]

Thanks for your help everyone, that makes sense. I'll ask for a breakdown of the numbers just to see what their reasoning is.

[q-school]

Generally the organization I work for discourages part time so it wouldn’t be proportional reduction. Primary care physicians have charting time built into their schedule already. We have significant access challenges, and many of the primary care physicians are part time already so this has been reviewed a number of times. I do believe a lot of primary docs are spending the resultant personal time inboxing.

We do have job share which is truly 50/50.

Obviously different workplaces will handle things differently.

[hightower]

As a hospitalist, if you go to 0.8 or 0.7 FTE they reduce your pay by the same amount and the number of shifts required per year by the same amount.  Benefits such as health insurance and 401k match all stay the same.  The productivity bonuses, quality bonuses and CME reimbursement are reduced proportionally based on your FTE.  I think it's a better deal to work part time and pick up extra admitting shifts which pay on a fee for service basis because those shifts pay more than if you work them under contract.  Plus, you get the added benefit of being paid for them in full each paycheck without having to wait for the quarterly reconciliation checks.

As an office based doc, you could reduce your contract to 0.8 or less and then pick up extra work with a hospitalist group on your days off.  You'd probably end up making more money that way and would have fewer required hours in the office if that's something you're wanting to get away from.

[FIREshrink]

Now for the real question, will you be getting a lot more hiking done when you go to 0.8?

[GXA]

At our shop we would prorate pay directly proportional for FTE status.  CME and malpractice expense would prorate lower offsetting the higher group expense for license/DEA/boards.

[HikingDO]

Haha! Actually yes FIREshrink, that's the plan. Less time in the clinic = more time on the trails!