Could spine practices implement 4-day work weeks?


The five-day long work week is common for many professions, but reducing it by a day has become a new idea.

The four-day work week is an idea that some companies and countries have tested. For spine surgeons, the possibility of the schedule hinges on different factors. 

Six spine surgeons told Becker's their opinions on the four-day work week and if it could be possible for their practice.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.

Next week's question: How might "smart" implant technology, such as that used with Zimmer Biomet's PersonaIQ, be applicable in spine surgery?

Please send responses to Carly Behm at by 5 p.m. CDT Wednesday, June 14.

Editor's note: Responses were lightly edited for clarity and length.

Question: Many people are touting the benefits of a four-day work week. What would it take for that to be established in your practice? Is it even feasible?

James Chappuis, MD. Spine Center Atlanta: I think that the four-day work week is a great idea. We had implemented this during COVID-19 and have kept it going since. Employees love it and it helps greatly with retention and new hires. This was implemented seamlessly in our clinics as our surgery center was already working on a four-day work week prior to COVID-19.

Chester Donnally, MD. Texas Spine Consultants (Dallas): No, it's not feasible and just a bad idea for the spine specialization industry. Look, if you want an easy job then go into commercial real estate or private equity, yet four days a week might mean they now work more than they do already. Spine surgeons have a tough job, and we knew that going into it. There is a patient safety factor as well as a work-life balance factor. In terms of our staff, yes that would be a recruitment tool for sure, but running an office just four days a week is not feasible in that it really only allows patients in dire need one to two days a week when their surgeon is in the office to actually evaluate the patient. This could lead to delayed care. It’s just not a good idea for a field so critical, such as spine surgery.

Brian Fiani, DO. Mendelson Kornblum Orthopedic & Spine Specialists (West Bloomfield, Mich.): With quite the opposite opinion, I prefer a six-day work week. I am a strong advocate for offering weekend opportunities for patients to be seen. My practice will be establishing Saturday clinic appointments for those patients that work during the week. I will be the first to offer such in our market geographically, and I think patients are already responding very well to this idea. With people working during the week, it is often incredibly challenging to see a spine specialist during those days, which would require them taking time off of work to do so. Also, an extra day will decrease the wait time for patients to be seen for their appointments instead of waiting several weeks or months for an appointment.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: We currently have a four-day work week going. We have had this for the last two years. Since I run a lean practice, my staff loves their time with family, and is incredibly efficient when they are at work. It allows me time to catch up on administrative things, reports, consulting and so forth and allows me the blessing of taking a long bicycle ride. I realize this is not feasible for everyone, but approaching the half-century mark, I am appreciating a true work-life balance — and that starts from the top.

Richard Kube II, MD. Prairie Spine & Pain Institute  (Peoria, Ill.): Being a solo spine surgeon makes going to four days weekly a harder task. I have been using Fridays to pursue other business interests for several years now, so in a way you could say I'm already doing spine surgery four days weekly. That said, if insurance carriers actually paid their bills and if pointless [utilization review] was removed from my workload, I could easily find another day of productivity with patients or personal time.

Issada Thongtrangan, MD. MicroSpine (Scottsdale, Ariz.): It will be very difficult if you are in private practice and run your practice, as the amount of paperwork, forms, etc., are tremendous while the reimbursement is going down each year. In addition, the amount of denial coverage and service by commercial insurances are getting much worse.

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