Who stays, who leaves? Transitions from part-time to full-time private-sector employment among physicians in Portugal

BACKGROUND: The transition of physicians from part-time to full-time private sector employment has significant implications for healthcare workforce management, particularly in dual practice settings. Yet, such transitions remain underexplored in the literature. OBJECTIVE: This study examines the physician- and firm-level determinants associated with the transition from part-time to full-time private sector employment using employer-employee linked data from Portugal for the years 2010 to 2019. METHODS: We summarize the share of private-sector contracts that are part-time and use a panel logit model with random effects to analyze the factors associated with physicians' shifts to full-time private sector roles. RESULTS: Transitions were more common among women and younger physicians, and among specialists. At the firm level, above-market wage premium was associated with higher predicted probability of transition in the pooled and specialist models. The evidence on physician entry was positive but more specification-dependent, while lagged exit rates showed less stable associations. Firm size showed a nonlinear association, with the clearest evidence pointing to higher predicted probability in the largest physician firms, particularly among specialists. Among specialists, higher firm-level formal education was positively associated with transitions, whereas greater within-firm dispersion was negatively associated. CONCLUSIONS: The study reveals insights into the dynamics of physician employment, highlighting gender disparities and age-related trends in the transition from part- to full-time private practice. It also demonstrates how institutional characteristics are associated with physicians' career decisions. These patterns can help target retention and recruitment efforts in the public sector and motivate causal evaluations of specific policies.