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Join emergency physician Maureen Gibbons as they explore the concept of rethinking shift work in health care. They discuss how distributing shifts among multiple physicians can reduce burnout, enhance job satisfaction, and improve patient outcomes. Learn how aligning schedules with natural energy patterns and prioritizing seamless handoffs can create a healthier, more effective workplace for providers and patients alike.
Maureen Gibbons has transitioned from a fulfilling career in emergency medicine to one where her skills, training, and passion for teaching yield unparalleled returns—physically, emotionally, and financially.
She discusses the KevinMD article, “Rethinking shift work: Why ‘job sharing’ is the key to happier, healthier doctors.”
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome Maureen Gibbons. She’s an emergency medicine physician and physician coach. Today’s KevinMD article is “Rethinking Shift Work: Why Job Sharing Is the Key to Happier, Healthier Doctors.” Maureen, welcome to the show.
Maureen Gibbons: Thank you. Thank you so much for having me. I can’t tell you how much I appreciate your time.
Kevin Pho: All right, well, thank you for writing and for coming on. Let’s start by briefly sharing your story.
Maureen Gibbons: So I’m classically trained in emergency medicine. I have a lifelong passion for wellness, physician wellness, nutrition, fitness—kind of all that on the back end. But I absolutely love and did love emergency medicine. I was full time on the ground, a nocturnist for almost 15 years at a level two trauma center that is very close to my heart still.
I realized that—well, a couple of years ago, I started venturing into different things. I started helping people through their own journeys on the side, and they started to ask me, “Can you be my doctor?” And I said, “I don’t know—maybe,” for the first time. Because, you know, when you’re in the ER, people ask you quite often, “Hey, do you have an office outside of here?” and I was always like, “Nope, they barely let me outside of here to run codes.” So when people started asking, “Can you be my doctor?” I started saying, “I don’t know—maybe.” That was the birth of—I have a remote lifestyle medicine practice now that was completely organic from people asking me to help them, which was pretty neat.
Kevin Pho: All right. So tell me about some of the things that you do or see as part of your lifestyle medicine practice.
Maureen Gibbons: We do quite a bit of weight management—long-term weight management. I really hesitate to call it weight loss because we take a lot of those people who do not meet FDA guidelines for approved medications. Lots of people with different reasons for needing medications, whether it is the new GLP-1s or something else. We do a lot of coaching, a ton of community, weekly meetings, community education, and support for people who want to make their lives better from a wellness standpoint instead of attacking it 20 years down the road from an illness standpoint.
Kevin Pho: All right. Your KevinMD article talks about shift work, why job sharing is the key to happier, healthier doctors. For those who didn’t read your article, tell us what it’s about.
Maureen Gibbons: This article about shift work is kind of born of my own journey because I wanted to decompress. I have a son who’s now 11, and as he grew older, I thought I needed more time at home. I wanted more time at home. I only—I know it’s only 12 shifts, but when you’re working nights, that’s split. You’ve got flip days, you’ve got a lot of recovery. I was very good at maintaining a sleep schedule and exercise regimen. I had finally gotten my health on what I thought was a good track, though I found out a little bit later that it wasn’t quite as good as I thought.
So I was trying to reduce my stress level while decompressing, and I had talked to my boss about, you know, “Hey, as soon as I can find a way to decompress the financial constraints, I was going to drop a couple of shifts.” That didn’t go over very well. And from my own standpoint, for the longest time, I really wanted one job. I wanted that feeling of security of having a full-time job. It was still a 1099 contractor. There were no benefits really, except for the feeling within the group, which was very important to me.
Once I did have this second thing that was really feeding my soul—I was working with patients on the ground but just differently, working on their wellness instead of in crisis mode—we were all in crisis mode, and it just felt different. It was not well received, which was OK. You know, in retrospect, it was one of the best things that could happen. I realized that when I thought back to the doctors I really respected in the beginning of my emergency medicine career, it was the ones who knew they were the commodity, who could run their lives the way they saw fit. Not that this is right for everybody, but I remember one of the docs who comes to mind. He would always work in three different places. He would tell them, “This is when I can work,” because that fit into his life. That wasn’t me for a very long time.
Kevin Pho: So when you talk about these doctors who, quote unquote, see themselves as a commodity, tell me the type of mindset that takes, because of course, not all physicians, like you said, think that way. They think medicine is a passion, a calling, so that’s kind of the furthest thing from thinking of doctors as a commodity. Tell me more about that mindset.
Maureen Gibbons: Yeah, and I don’t think it’s mutually exclusive, and this is really what kind of came—he always said it that way, but I think of it a bit differently. It’s realizing our value, that we worked so hard, we got called to medicine, we worked so hard, we have very high levels of education. Going forward, I could see that yes, we need to realize our value, and in emergency medicine especially, for that one patient, they don’t know how many shifts you work. They only know that they’re talking to you, and you can still build that interaction. I have the blessing and the curse of being able to form relationships very quickly with patients. Even in the ER, that was hard for me—good, very good, but also very hard. Realizing that, for that one patient on the ground, they don’t know that you work three shifts or 12. They only care if you’re a good doctor. So you can actually reconcile that passion, that calling, with the value of your education.
Kevin Pho: So you requested fewer shifts for months. You said that didn’t go over well. Talk about what happened next. Is that the time you opened your virtual lifestyle practice, or what happened next?
Maureen Gibbons: Yeah, so I’d actually opened the virtual practice six to eight months before I requested to go down in shifts, because I had decompressed the finances and started to support my family that way. I was told that it was easier if I worked full time. I thought, “Easier for who?” because my husband actually mentioned—he’s also an emergency physician—he said, “We actually sort of have a two-and-a-half-physician household at this point.” I’m like, “I’m struggling just a little bit. This is tough.” And I absolutely loved my group, but I also admit, in retrospect, I wasn’t the best fit for that because they wanted a person to take those 10 shifts still going forward, and I could not fulfill that role.
Kevin Pho: What happened next? What did you do next?
Maureen Gibbons: I went out to the freestanding in our system. I did work there nearly full time for a bit longer, not of my own choosing—which was OK. Like I said, in retrospect, it was what needed to happen, especially for my own health and sanity. When I went out there, it was a lot easier to decrease shifts in a freestanding work environment. I know not all states have them. Here in Texas, we do. In a freestanding work environment, it’s a bit more flexible. The flexibility isn’t frowned upon there the way it was in the main.
Kevin Pho: In your article, you talk more about job sharing. Tell us more about that concept.
Maureen Gibbons: I would love to see in the future—and I of course have specific people in my mind who I know want to decompress their clinical workloads—if they could even do half the amount of work in the main by supplementing with some sort of external endeavor. What I do, from the coaching standpoint, is dig in and see, “What do people want to do? What are they called to do that might not necessarily be medicine?” Sometimes it is, sometimes it isn’t. But this isn’t a “Hey, invest in real estate, passive income” scenario. It’s something that still feeds your soul, that nurtures that love of medicine.
If you could have two physicians who come to work energized, filling that same full-time role, the patients benefit, the organization benefits, the health of the group improves. I just think it’s a different way of looking at things instead of saying, “No, it’s easier if you work full time.” Maybe not. Maybe it might be easier, because it is easier—until it’s not.
Kevin Pho: So you’re talking about two physicians who each take a half-time role, and when combined they comprise, in the eyes of the administration, a full-time FTE?
Maureen Gibbons: Correct.
Kevin Pho: Is that common? Does that ever happen in the emergency department setting?
Maureen Gibbons: It absolutely happens. It absolutely happens. There are quite a few, especially now—if you are an emergency physician, you know how many texts you get on your phone a day of, “Hey, we’re looking for locums people. We can’t fill. We’ve got a five-shift minimum. We’re just grasping at straws because we need to fill the room.” Imagine if we actually nurtured that sort of thing so we wouldn’t have to go outside, beg for locums. You could have a group of 15–20 physicians that fill the roles, that still have an emotional investment in the group, but they just don’t work 12 shifts or 10 shifts or whatever the minimum requirement is to be full time.
Kevin Pho: What are some of the obstacles that prevent more emergency departments from adopting a model like that? For instance, in the story you told, what prevented that particular group from a job sharing arrangement?
Maureen Gibbons: I don’t know of anything other than tradition. It’s hard to move in medicine. We’re moving pretty quickly, and medicine education and some back-end financial processes are having a tough time keeping up with technology and that movement. One of the things is I really think it’s just tradition. It’s thinking, “No, you need to be married to your job.”
Kevin Pho: You mentioned that in your particular role, you were a 1099 contractor. Would benefits in a W-2 situation, for instance, make it harder to have a job sharing arrangement?
Maureen Gibbons: I think so, because they would have to provide those benefit packages to more people. If it was insurance, for example, they’d have to pay for two rather than one. I also know a lot of my physician colleagues would prefer to be a 1099 for the benefits that we get from that. Again, it’s a personal situation. Everything is a personal situation.
I would just love for administration to look at it from a standpoint of, “How do we create the best group to try to keep as many people in medicine as we can, even if they’re not here full time?” Because full time, we get crispy—we get burned out. One of my higher-level bosses once told me, “The only way for any longevity in emergency medicine is to go part time clinically.”
Kevin Pho: You could say that with any field of medicine as well. I’m a primary care physician, and I work half time, and the other half time I do podcasting, talking to guests like yourself. Obviously your world is emergency medicine, but are you familiar with job sharing arrangements in other specialties, just from hearing your colleagues?
Maureen Gibbons: I finally am seeing it, like you said, in primary care. You said you work half time. How does that work with you, with your patient load? Do you work a certain number of days, so that just cuts your days?
Kevin Pho: Half time would be 16 patient contact hours per week.
Maureen Gibbons: And that’s obviously doable, because you have a fantastic, thriving second career. We’re not calling it a side hustle. It’s not a side gig; this is a second career. You have a two-career life, and that’s fulfilling, and I find that amazing.
Kevin Pho: Now, for those new physicians who are looking for their first job, for instance, and are hearing you on this podcast and read your article on KevinMD, perhaps interested in a job sharing arrangement, what’s the best way they can ask about that and inquire whether that’s even a possibility?
Maureen Gibbons: I think the best thing going in is—sometimes, for example, I was offered a very lucrative bonus to come in full time. I did that for two years and then stayed full time for 13 more, just because it was easier than not. It’s easier to just slide back in and do what we know, do what we were trained to do. I think going in, explore options. Say, “How do you think in the future this would go if I wanted to drop to half time or if I decided to have a family?” I know it’s usually taboo in interviews, but I do think it’s reality, and I think it’s something we should address as humans.
Kevin Pho: Tell us a story of a successful job sharing arrangement that either you have personally seen or heard about from your colleagues. What exactly would that look like in an ideal situation?
Maureen Gibbons: So, in an ideal situation, even in my current contract, I am PRN. That means they don’t guarantee me shifts, but if I tell them I want to work two shifts a month, they’re more than happy to accommodate that, which I find just incredibly refreshing. I have a very, very close colleague—actually a couple of them—and each works half time, six shifts. It’s not even considered necessarily job sharing. They just made an agreement that they are part time/PRN. There’s really no difference except that they don’t guarantee the shifts. If you’re full time, they guarantee the shifts.
But if we go part time, it’s at the freestandings, which is the difference. Not a lot of new—well, that’s an educational thing. New docs coming out need to be on the floor in the main, understanding what emergency medicine really is, because sometimes being at the freestandings can get a little hairy. Both of these docs work six shifts a month, and they both cover nights, ironically, so between the two of them, they cover 12 nights a month in a rather busy freestanding. It’s actually a gift to the practice. They each work six, they get what they need financially, and they still have plenty of time at home to pursue other interests.
Kevin Pho: We’re talking to Maureen Gibbons. She’s an emergency physician and physician coach. Today’s KevinMD article is “Rethinking Shift Work: Why Job Sharing Is the Key to Happier, Healthier Doctors.” Maureen, let’s end with some take-home messages that you want to share with the KevinMD audience.
Maureen Gibbons: I think the most important thing that I didn’t understand in the beginning is that tailoring your medical career to your own financial, educational, professional, and family goals—just because it’s yours doesn’t mean it’s wrong. We don’t all have to follow the same path.
Kevin Pho: Maureen, thank you so much for sharing your story, time, and perspective, and thanks again for coming on the show.
Maureen Gibbons: Thank you.
