Between 2001 and 2021, average weekly working hours per physician declined by 7.6%, from 52.5 weekly hours in 2001 to 48.6 weekly hours in 2021.
While this average is still more than the traditional full-time 40-hour workweek, it is a marked decline. And the trend toward lower average hours is likely to continue as the physician population is aging, and doctors have begun leaving the workforce earlier than in the past.
Older doctors may begin to reduce their hours or work only part-time as they ease out of the workforce, while some younger workers may opt out of full-time jobs in favor of a better work-life balance.
While there are many reasons for it, somewhere between 26.9% and 70.9% of physicians say they would be willing to go part-time, depending upon a host of factors. Those who do need to understand the rules and requirements for part-time malpractice coverage, the types of coverage available in different situations, and the risks and benefits of buying coverage as a part-time worker.
Part-time medical malpractice coverage is liability insurance available to physicians and other medical professionals who work a reduced schedule. This is typically defined as less than 20 hours per week, although definitions can vary by policy and provider.
Part-time policies should provide the same level of liability protection as full-time coverage, though coverage needs can vary based on specialty and duties. Providers should not expect reduced coverage limits. However, premium costs will be reduced because fewer working hours typically mean there is less time for medical errors to occur.
Doctors in certain high-risk areas may be excluded from part-time malpractice coverage. Full-time premiums may still apply where procedures carry elevated risk, especially in fields such as obstetrics or surgery. Providers may also be expected to demonstrate that their working hours are limited when purchasing a part-time policy.
Both part-time and full-time providers face similar risks, as a lawsuit for malpractice could result in an equally large payout regardless of whether the claim is filed against a doctor who sees one patient or a doctor who sees 20 patients.
The major difference, of course, is that, all else being equal, malpractice coverage helps protect physicians from claims alleging patient harm even when they work fewer hours. Nonetheless, the doctor who is seeing fewer patients has a reduced chance of being sued simply because:
Because of the reduced risk associated with practicing part-time, medical malpractice insurance costs tend to be lower for part-time versus full-time providers.
The specifics of how much premiums are reduced can vary based on hours worked, specialty, and the provider’s profession. However, a part-time provider could often save as much as 35% to 65% on malpractice coverage.
Of course, providers must ensure they meet the insurer's definition of part-time, are accurate in reporting hours, and confirm they are fully covered for all services performed as part of their medical practice, not just direct medical care.
This means carefully reviewing policy exclusions, reading policy terms carefully, and often tracking hours rigorously.
Most malpractice providers define “part-time” as working fewer than 20 hours per week, though eligibility rules can vary based on the carrier and plan structure.
While some carriers offer a single reduced-rate plan for anyone working under that 20-hour threshold, others taper premiums down as hours decline, providing greater discounts as the number of hours worked falls. For example, with a tapered or tiered plan, a malpractice insurance provider might offer:
Individual providers establish their own guidelines for potential savings, so it’s important to compare coverage options when looking for part-time malpractice insurance, and a broker can help compare options and save money when discounts and underwriting rules differ.
Because hours worked heavily impact whether you qualify for part-time status, as well as the level of premium discounts available, it is important to understand what counts as an hour worked. All professional hours count, whether they involve direct medical care or broader medical practice responsibilities.
In general, insurance carriers include all professional hours spent on clinical and administrative duties. This can include time spent on:
If you exceed a policy’s weekly hour limit, the carrier can deny or void coverage for a specific incident.
Hours spent on continuing medical education and general business operations such as marketing the practice usually do not count in the hours worked, but providers should review policy terms when in doubt about whether a duty counts.
For those who both teach and practice, clinical teaching hours count as working hours, while didactic teaching such as lecturing and grading often do not.
Insurers also take steps to verify that a provider is working part-time, because eligibility is subject to the policy’s underwriting rules. Some of these steps include:
If you deliberately fail to accurately report your hours, this could be considered a form of insurance fraud.
Your insurer could void, cancel, or rescind your policy, leaving you personally responsible for legal costs, defense costs, and damages awarded in any medical malpractice claims.
Finding coverage in the future could also be a challenge, and a medical board investigation could be triggered. So accuracy in tracking hours is critical when purchasing malpractice insurance for part-time physicians, including for hospital credentialing and similar reviews.
In some cases, medical malpractice insurance providers limit the availability of part-time coverage for providers in high-risk fields.
For example, some of the most-sued medical specialties with a high rate of claims or with an above-average rate of nuclear verdicts include:
Providers who work in these or other high-risk or surgical fields will need to determine if they are eligible for part-time premium reductions or must pay full-time premium rates. Because these specialties often carry greater exposure, it is key to work with a broker and agency capable of focusing on high-risk placements, so you can compare rates by carrier, helping save money. This is especially true for surgeons and other specialists, whose coverage eligibility may differ.
Part-time medical malpractice insurance is required in a wide variety of different situations, each of which presents its own unique challenges and coverage issues.
Here are some common examples of situations when a provider may require part-time coverage.
Providers who are just beginning to build a practice may not have enough patient volume to work full-time, and lower early-stage volume may also reduce income, making full-time medical malpractice insurance premiums harder to afford even though coverage is still needed to protect a growing practice from early claims. This could affect:
In these situations, providers face several challenges regarding malpractice insurance coverage.
First, low patient volume does not necessarily translate to low risk, particularly when a provider is inexperienced.
Second, a provider’s practice may experience periods of rapid growth, or patient volume may fluctuate substantially from one month to the next as the practice grows and the provider builds a stable base of patients.
Coverage must evolve as the practice changes, and providers must ensure they update their coverage as patient volume or services offered grow.
Some providers choose to work part-time for personal, family, or health reasons. This can include providers who:
Fluctuating hours over time can also make it difficult for providers in these circumstances to ensure they have the required coverage for all services they perform.
Further, those who take extended leave and don’t practice at all for a period of time also must be aware of the risks of canceling and restarting coverage. Depending on whether they have a claims-made or occurrence policy, they could be left with coverage gaps if they don’t put the proper tail coverage in place. If a provider fully stops practicing because of retirement, disability, or a similar event, they may need tail coverage.
Academic physicians often spend part of their time in clinical work and part of their time teaching residents and fellows. Depending on hours spent on clinical work and the type of teaching they do, they may not require full-time malpractice insurance coverage.
However, teaching physicians can face liability exposure beyond their own work as a result of supervising residents, reviewing clinical decisions made by trainees, offering clinical instruction, and performing procedures with trainees. And research, including clinical trials, can create additional risk.
While providers may have institutional or university coverage for some or all of their work, those who do any part-time work outside of the university setting or outside of their direct teaching responsibilities must carefully review the scope and limitations of the coverage that’s in place.
Semi-retired providers may limit the hours they work and the number of patients they see as part of a gradual transition out of medicine.
The biggest risk factor they face is that they are approaching the point in their career when future claims could outlive the practice.
Tail or extended reporting coverage often becomes critical when retirement is the triggering event, so providers need to carefully evaluate claims-made versus occurrence policies in the final years of their professional lives and confirm whether an employer or insurer is committed to purchasing tail coverage if applicable.
Locum tenens physicians take temporary work assignments, filling in for other providers. This work is often irregular, although temporary assignments can be part-time or full-time.
Providers who take on locum tenens assignments may not be covered through the facilities they are providing temporary coverage for. And staffing companies that help place locum tenens physicians sometimes, but don’t always, provide coverage.
Securing adequate coverage for all hours worked on temporary assignments is critical, as is making sure that the coverage extends to cover the work you performed in each assignment after you have moved into the next job.
Moonlighting, or working side jobs, is also common, especially among medical residents who may use it to supplement income while still in training, but outside work still needs a separate malpractice review.
These side jobs are often part-time, and primary malpractice coverage through their main employer often excludes outside part-time work.
Those who moonlight should check with their part-time employer to see whether they are covered by that employer’s policy. Residents and physicians who supervise nurse practitioners or physician assistants in side work should also confirm those duties are specifically covered.
They can explore purchasing their own coverage, but will again need to be careful about the number of hours worked, ensuring that their area of specialization is covered, and confirming they will have continued coverage once a part-time position ends.
It’s also important to note that some side jobs may not involve direct patient care but may still create liability risk that requires professional liability insurance in the form of errors & omissions coverage.
This type of coverage is appropriate when you are providing professional advice but not directly practicing medicine on a patient, since errors & omissions insurance covers claims arising from professional advice in those situations. Examples include:
Malpractice insurers may provide E&O coverage separately or as an add-on policy.
Some providers pursue additional education while still working part-time. This can include providers pursuing:
Providers may substantially reduce their hours to allow time for these academic pursuits. Coverage challenges created by this situation include questions regarding whether the provider is doing clinical work as part of their schooling, how hours fluctuate during breaks from school, and whether the provider will step away from practice entirely when their schooling is complete.
Finally, providers sometimes work part-time performing volunteer or community service work, including for charitable organizations, disaster response programs, or community health organizations.
In these situations, providers must confirm whether the organization they are volunteering with provides malpractice coverage that extends to them. The community work they are performing may also fall outside of their ordinary scope of practice, raising coverage challenges.
And international volunteer work creates even more complex issues related to local licensing, insurance territorial limits, claims reporting, and foreign jurisdictions.
Individual professional liability coverage can help protect volunteers when the organization does not provide coverage, but it’s important to disclose the duration, scope, and nature of the work to find the right policy, especially if there is any doubt about licensing or jurisdiction issues and legal review is needed.
Part-time physicians must consider coverage options carefully to address the unique challenges that arise from their work situation. Here are some medical malpractice insurance options that may be available.
Claims-made policies provide coverage only if the physician is insured and the claim is both made and reported during the applicable policy period. Providers could obtain a claims-made policy independently or through an employer, and may be eligible for discounted premiums for part-time coverage depending on hours worked. Claims-made policies often include legal defense as part of the coverage package.
The major risk to a part-time physician with a claims-made policy is a coverage gap when the policy ends. Once a claims-made policy terminates, it will not respond to a claim reported after that date, even if the underlying incident happened while the policy was active. That exposure is triggered by any event that ends the policy: leaving a job, changing carriers, stopping practice, or retiring.
Moving from part-time to full-time hours does not by itself create a gap, because most carriers simply reprice the existing policy rather than requiring a new one. But if the change comes with a new employer or a new carrier, the old policy ends and the reporting gap opens.
Tail coverage is important in these situations to provide continued protection for any claims that arose during the part-time work period and to protect the insured after a job change or other event ends the part-time role.
Occurrence coverage covers events that happen when a physician is practicing, regardless of when the claim is actually made. Tail coverage is not required. However, occurrence coverage tends to have higher premiums than claims-made coverage.
Discounts are available for part-time providers who are eligible for part-time malpractice coverage. However, for providers working a limited number of hours, premium cost may be prohibitive.
Slot coverage is another potential option, which may be available through an employer that staffs a position with multiple part-time physicians.
Instead of insuring each physician individually, slot coverage insures the position itself. The employer buys one full-time-equivalent slot, and any physician working in that slot is covered while they occupy it. Two physicians splitting a single role can share one slot rather than carrying two separate policies.
For the physician, the advantage is that they do not have to purchase or maintain their own coverage, and the employer absorbs the premium. The tradeoff is that the coverage belongs to the employer, not to the physician. When you leave the slot, your protection for the work you performed there depends on the employer's policy type and on whether tail coverage is purchased for you. Confirm in writing who owns the tail obligation before you rely on slot coverage.
Still need to know more? This FAQ section will answer common questions physicians have about part-time medical malpractice insurance coverage.
The cost of part-time medical malpractice insurance varies by specialty, hours worked, provider, and state requirements. Often, providers who work part-time are eligible for substantial discounts compared to standard malpractice insurance premiums, with some insurance carriers offering coverage at 35% to 65% off.
In New York, rates are often 20% to 50% higher than average, and minimum limits are commonly $1 million per occurrence.
Part-time medical malpractice insurance may be available to providers who work less than 20 hours per week. However, eligibility for part-time coverage depends on specialty. Providers in high-risk areas such as obstetrics and various types of surgery may be required to pay full-time premiums due to the elevated risk of malpractice claims in these fields.
Claims-made policies provide coverage if a claim is made during the insurance policy period, as a result of an incident that occurred after a policy retroactive date, if there is one. As a result, part-time doctors may need tail coverage for medical malpractice insurance if they have a claims-made policy and they change providers or switch to an occurrence policy.
Employer-provided malpractice insurance generally does not cover part-time or moonlighting work if that work is outside of the scope of normal business. That limitation can also apply when the work is done through a provider’s own practice. The employer that a provider is moonlighting for may or may not have coverage for part-time workers, so verifying that the appropriate malpractice insurance is in place is essential.
Ultimately, part-time physicians remain vulnerable to malpractice claims, just as full-time providers do. Any doctor who is working part-time must ensure:
There is also significant variation among malpractice insurance companies regarding eligibility for part-time coverage, availability of part-time policies across different specialties, discounts for part-time work, and coverage rules and restrictions. Compare carriers not only on those points, but also on financial stability and available risk management resources.
Indigo’s focus is helping part-time physicians compare policies with the support of a broker or agent so they can find appropriate coverage and potentially save money.
Contact us today to learn more about our coverage.
Image by Gorica Poturak from iStock.
