A new policy at UC San Diego Health is getting pushback for its requirement that contracted psychiatrists spend at least 60% of their total work hours seeing university patients.
It is a move that one psychiatrist said this week disproportionately affects mothers who must work part-time due to family commitments, though the university strongly disagrees with this perspective.
UCSD Health notified its 144 psychiatrists in late April that, as of July 1, they would need to commit “60% total minimum effort,” with new hires required to reach or exceed a threshold of 80%. Minimum effort refers to the minimum percentage of a 40-hour work week that must be spent seeing UCSD Health patients. The move restricts the amount of time that university-employed psychiatrists can spend in private practice or other work activities.
The reason for this new policy, according to the notice, is “to limit any risk from inappropriate self-referrals,” and prioritization of the psychiatry department’s “clinical service lines” and “institutional integrity.”
While the university said in an email Wednesday that the rule will affect only three new hires, there is some dispute over how many current psychiatrists working part time will have to increase the number of hours they allocate to UCSD Health.
Dr. Simi Brar, a psychiatrist in the Women’s Reproductive Mental Health Care program at UC San Diego Health, said she and her colleague, Dr. Alison Reminick, have identified about a dozen psychiatrists who do not meet the new 60% threshold and could be affected.
For her part, Brar said she is only able to give about 40% of her time to her practice at UCSD, with an additional 10%, four or five hours per week, allocated to work with pediatric patients at Rady Children’s Hospital.
A busy family life, she said, makes increasing her hours at UCSD unworkable.
“As a mother of three children, and (caring for) four aging grandparents, it would do harm to me personally and professionally,” Brar said. “I don’t think ethically and morally it would be a good idea right now in my life to go up to 60%.”
She said that absent a change in the new policy, she will end her practice at UCSD and has already started notifying her patients that they will need to find new counselors by Aug 14. It is difficult, she said, to deliver the news to those currently in treatment for debilitating conditions such as postpartum depression.
“How do I explain this to them?” Brar said. “If we leave, and I’m forced out, communities suffer, families suffer. UCSD is one of the few sites that we have in terms of access to maternal mental health.”
UCSD takes exception to any notion that services would be reduced or that anyone is being forced to leave.
And, UCSD Health spokesperson Jacqueline Carr said in an email that the number of employees affected is small.
“There are only 2 clinicians in the department who will fall below the 60% threshold for next year,” Carr said. “All other providers are either fully clinical or funded variably by research or affiliated program efforts with the (Veterans Administration) or contracted community partners.
“All of the part-time staff doctors were given opportunities to increase hours to care for their patients. Going from .4 to .6 effort is a three-hour differential (per week).”
Brar said that she stands by the estimate that about a dozen UCD psychiatrists, at least nine of them mothers, will be affected, including a few who had planned to reduce their hours below 60% to meet family obligations.
And, she added, she believes that the 80% time commitment required for new hires will make it more difficult for women to find work-life balance in the future.
This issue has not remained confined to this relatively small group of health care professionals.
Even though it does not represent UCSD psychiatrists, University Professional & Technical Employees, a labor union that represents 10 different classifications of mental health workers in the university health system, has gotten directly involved.
UPTE recently posted a letter on its website calling for UCSD Health to rescind the policy and stating that it “will directly harm patients, disrupt continuity of care, and undermine recruitment and retention of highly specialized clinicians.”
UPTE is also supporting a demonstration at UCSD Health on Thursday.
A union spokesperson said this week that UPTE got involved on behalf of the workers it does represent, including behavioral health counselors, clinical social workers and psychologists, who support psychiatrists and would be affected by any reduction in workforce.
But Carr said in an email that the plan is for expansion, not contraction.
“UC San Diego Health is expanding its Women’s Reproductive Mental Health program to increase access to specialized care and meet the growing needs of our patients and families,” Carr said. “This expansion reflects our ongoing commitment to providing timely, evidence-based care for individuals experiencing mental health conditions.”
Hiring, Carr said, has already been underway to increase headcount.
“The first of these providers are expected to begin seeing patients in July 2026, with additional physicians and team members joining throughout the fall,” Carr said.
Brar said that she is aware of the push to hire additional workers, but said she considers them replacements.
“The people that are replacing me, interestingly, are women, and none of them have children,” Brar said.
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