Take the time now to ensure your new job—and contract— will add to, not detract from, your quality of life as a physician.

MY FATHER, A RETIRED PHARMACIST who practiced for 50 years, and my father-in-law, a retired cardiologist, both passed away in 2023. Their quality of life mattered to those around them. For physicians in all specialties and career stage, quality of life matters. Before entering an employment agreement, make sure your quality of life is protected.

Schedule

How many hours each week are you committing to work? Many physician employment agreements specify the number of hours each week you’re expected to work. Some employment agreements specify the minimum number of hours you’re supposed to work. Confirm whether that time is for clinical duties, administrative duties or both.

Very few physician employment agreements include a maximum number of hours each week, even for “shift” arrangements common for hospitalists or radiologists, for example. When the end of your shift occurs, you likely can’t just walk out. You need to ensure a smooth hand-off to the next physician. Understanding how much additional time, on average, it takes before you can leave for the day is a critical component to work/life balance.

Location

Knowing where you will work can be equally important as knowing for how long. If your employer only has one location, no further clarification is needed. But what if the employer acquires or merges with another health care system or private practice? Or takes on a new lease to expand its catchment area? Routinely working inmultiple locations may change your commuting patterns and the length of your day.

Similarly, a consistent location or locations creates efficiencies. Being asked to be more nomadic can create inconsistencies and frustrations and negatively impact your quality of life.

You may also be asked to work in different office settings in the same day. Transition time is down time, where you’re not generating any revenue. That’s important to take into consideration.

Staffing

Staffing is a critical issue negatively impacting the health care delivery system. For a physician, the lack of adequate and qualified staffing can have significant consequences on your efficiency and productivity and negatively impact your quality of life.

Will you have a dedicated medical assistant? A very competent medical assistant can help maintain timeliness. Similarly, having a stable cadre of licensed professionals — nurses, physician assistants, surgical professionals — creates consistency that is beneficial for physicians and patients alike.

On-call responsibilities

Call is one of the most overlooked and misunderstood elements of the factors impacting a physician’s quality of life. Being on call can be very hard, and it takes you away from family and friends.

Clearly understand your call frequency and how on-call duties are allocated on weekends and on holidays. Some employers have a seniority system in which the more junior physicians take additional call or get “last pick” in terms of when the physician is scheduled for call.

If yours is a two-physician family with children, the scheduling of on-call responsibilities takes on added importance to ensure there is coverage at home as well.

Last, but certainly not least, know if you’ll be paid “extra” to take call. Some employers build in a certain amount of call as part of the physician’s base compensation; each additional call taken would then be extra compensation. You should know how much you’ll earn for each additional call, whether the call pay amount changes over time, and the frequency with which the additional call compensation will be paid.

It is not uncommon for a physician who reaches a certain level—job title, age or tenure—to elect to take less or no call. Or, you may be able to pay a colleague to take your call. The dynamics of taking less call or paying someone else to take it should be clearly delineated in your employment agreement or the employer’s policies to minimize intra- group tension.

Quality of life is critical

Your employment agreement can help protect you and set fair expectations for both you and your employer. After both my dad and father-in-law passed away, no one remembers or talked about how much they worked. We do remember what events they missed with family and friends while they were working and taking care of others.

Quality of life is critically important to a physician’s success. And you don’t get a second chance for these issues. •