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Why A Marketplace For Hour Exchange In Certain Fields Makes Sense

Post written by

Steven Lee

Founder and Chief Science Officer at Opternative, the first online vision test that delivers a glasses/contacts Rx.


As a young eye doctor, I recall being excited by the prospect of being able to work as many hours as I wanted. Putting in long hours allowed me to make good money in a profession that I loved. Like many of my colleagues, I enjoyed the work and came to enjoy a certain quality of life outside the practice.

But time outside of work was scarce for me and other doctors at my practice. After years on the job, we wanted to be able to enjoy what we had earned and perhaps bring a bit of balance to our lives. That’s where the profession is not so accommodating. Doctors can make plenty of money, but they don’t have time to use it. And what good is that?

I imagine the same conversations play out in all types of business where job requirements require you to fulfill a certain time requirement on a week by week basis, and the ability to take time off may come with a number of limitations. Take, for instance, factory workers who need to maintain certain machine functionality in order to ensure the entire operation is running smoothly. If a few individuals are absent, this can cause a substantial impact on efficiency. Another example is the restaurant business, where the operations of each location require a certain amount of employees dedicated to specific functions to ensure efficiency.

Doctors usually go to scheduling managers and ask if they can get a day or two off for a family event, speaking engagement or whatever else is happening in their life. They are often told that there are too many patients and not enough doctors, and it’s just too complicated to reshuffle schedules on short notice.

And the problem’s only getting worse. America’s population is getting older, meaning more people making appointments with eye doctors. And the profession (medicine at large and eye care in particular) is struggling to keep up.

It seems unlikely that the folks in charge of staffing will become more flexible anytime soon, so it’s going to require an innovative approach -- an alternative to normal time off that does not leave gaping holes in the patient calendar.

One solution that occurs to me is a market for employee hours, and in this specific example, doctor hours. When doctors need a day off, they can pay for it. That money would then go to another doctor who works beyond their normal hours to take the empty shift, meaning the practice comes out on balance.

If the schedule or staffing is tight or the request is coming in late, the cost of a day off could go up, further incentivizing doctors who offer to fill in. In practices with a broad range of experience and seniority, human resources could set a cap so that wealthier doctors do not buy up all the time off.

It would not only give administrators a way to offer some flexibility to individual doctors, it allows for a more responsive approach overall. Physicians who are determined to rack up hours can do that, while those who want to spend more time out of the office (for whatever reason) can be accommodated. And the business doesn’t lose hours or patients.

This approach would help address a much broader issue in the ophthalmology profession and in the medical field across the board. Doctors are burning out.

While a few extra days off won’t resolve the underlying causes -- such as too many bureaucratic tasks or computerization of the practice -- it does make the profession more enjoyable and allows doctors to have a bit of work-life balance when life inevitably comes calling.

And that touches on another priority in America’s medical field: We need to make the profession more attractive. In the coming decade, a quarter of our doctors are expected to retire. At the same time, the number of older Americans is ballooning and the number of applicants to medical schools is falling.

Just 12 years from now, the Association of American Medical Colleges predicts that the country could be short at least 100,000 doctors. We need to do whatever we can to make medicine a less grueling professional, even if its a few days off here and there.

Dr. Carolyn Anderson, an eye surgeon and entrepreneurial author, wrote an article for The Huffington Post about just this. She argued that attracting a wide range of young doctors into the field required a different way of thinking about workload: “Workplace flexibility is the key to decreasing doctor burnout, reducing turnover rates and making medicine an attractive field of study for a diverse group of people.” The same can be said for running a startup or new business where you are trying to attract talent in a highly competitive space. Providing a mechanism for workplace flexibility, while maintaining boundaries of executive expectations is important in the day-to-day operations of thriving companies.

One argument I have heard against the hour exchange is that employees (and in this example, doctors) are not always interchangeable, especially when it comes to patient preferences. What if someone only comes to a practice because they trust a certain doctor, and that doctor takes a day off when they have an appointment?

Sure, there will be some disappointment, but it won’t happen often. And at the end of the day, patients benefit more than anyone from having doctors who are feeling better rested, less stressed and more focused when they are on the clock. This is also the case for employees with similar skill sets who can fill in for one another. Overall, happy employees equate to greater efficiency and productivity.

