How do you handle your medical practice staff’s paid time off and leave?

Having a generous paid time off/leave policy for staff is a great recruitment and retention tool, but it also can lead to headaches if key team members’ time away isn’t properly managed to avoid disruptions. 

But as only 29% of medical groups report rising turnover in 2025, there may not be a clear impetus for expanding PTO for staff: A May 20, 2025, MGMA Stat poll found that only 21% of medical groups expanded PTO or leave benefits in the past year, while 77% did not and another 2% were unsure. The poll had 403 applicable responses. 

The chances of any employer suddenly changing PTO or leave policies in any given year are relatively low. Many human resources professionals tend to prefer consistency in how PTO is accrued or allocated.  

This preference for stability was reflected in this week’s poll. Among practice leaders who responded “no” to changing PTO policies, roughly half noted that expanding PTO was not practical due to the organization’s performance, while the other half felt they had already improved their policies and remain competitive with other employers in their market. 

Additionally, as more practices transition to hospital or system ownership, decisions about employee benefits are increasingly made by the centralized HR teams of the parent organization, leaving practice managers with limited influence over those policies. 

PTO 

In many medical practices, staff receive between 10 and 20 days per year, with accrual often increasing with tenure. This typically includes a combined PTO bank covering vacation, sick leave, and personal days, though some practices continue to offer separate sick leave. Most practices also observe six to 10 paid holidays annually, including the major federal holidays such as New Year's Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day. 

Disability 

Some medical groups offer short-term disability (STD) coverage as part of their benefits packages, typically providing 60% to 70% income replacement for medical leave lasting from 90 to 180 days. Long-term disability (LTD) is less common, particularly in smaller practices, though an increasing number of practice leaders are viewing LTD as beneficial for retention and recruitment. 

Family leave 

Under the Family and Medical Leave Act (FMLA), organizations with 50 or more employees must provide up to 12 weeks of unpaid leave for eligible employees. In smaller practices not covered by FMLA, leave policies are often informal or discretionary. Paid family leave remains rare but is gaining traction in non-mandated states as a valuable tool for attracting and retaining talent. 

Emerging trends for better recruitment and retention 

To improve recruitment and retention amid staffing shortages and increased competition, many ambulatory medical practices are evolving their PTO and leave policies: 

• Enhanced PTO, faster accrual: Accelerated PTO accrual, especially in the first year, is becoming more common to attract new hires, and practices increasingly allow rollover or cash-out options for unused PTO days. 
• Mental health and wellness days: Dedicated mental health or wellness days separate from general PTO. 
• Parental and family-friendly benefits: Paid parental leave, particularly maternity leave (four to 12 weeks), is on the rise, and some practices also offer family caregiving leave (paid or unpaid). 
• Rewards for tenure: Additional PTO days awarded at milestone anniversaries (e.g., after five, 10, 15 years of service). 

Flexible scheduling as a PTO alternative 

Rather than simply increasing PTO allotments, many practices are enhancing employee satisfaction through schedule flexibility: 

• Compressed workweeks: Offering four-day workweeks (e.g., four 10-hour days or four 9-hour days plus a half-day) is becoming more popular for attracting younger employees who prioritize work-life balance. 
• Flexible shifts: Providing options for earlier or later shifts — such as 7 a.m. to 3 p.m. versus 9 a.m. to 5 p.m. — or rotating weekend schedules allows employees more control over their time. Some practices even offer occasional remote work for administrative tasks. 
• Hybrid and remote work options: For administrative roles (e.g., billers, coders, schedulers), remote or hybrid options remain highly attractive, particularly competitive labor markets, as they reduce commute time and allow for more home-life flexibility. 
• Job-sharing and part-time roles: Some practices are introducing job-sharing arrangements, allowing two employees to split the responsibilities of one full-time position. This offers greater flexibility for those seeking part-time schedules or reduced hours. 

However, it’s important that many prospective employees are not looking for flexibility; with increased consumer costs, many workers would much rather opt for a slightly higher hourly wage than flexible scheduling. Understanding what a staff member values most will help you design the best compensation and benefits package. 

As the healthcare labor market remains competitive, even modest shifts in PTO offerings or increased openness to flexible scheduling can give practice leaders a strategic edge in attracting and retaining high-quality staff. 

 Share your story

Is your organization seeing success in staff recruitment and retention with strategies not mentioned in this article? Let us know at connection@mgma.com.

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