Employed Doctors: Love the Paycheck, Hate the Rules

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Love the Paycheck, Hate the Rules?

For doctors, being an employee -- rather than running a private practice -- is becoming more common as healthcare reform marches onward.

Most formerly self-employed physicians appreciate now getting a steady paycheck. But many are less pleased that they've traded away a degree of autonomy and independence, and they feel the switch came at a steep price.

Those are some of the insights from an exclusive Medscape survey report that garnered responses from more than 4600 physicians. Here are some of the major findings from Medscape's 2014 Employed Doctors Report:

1. What doctors relish most about being employed: not having to deal with the business of running an office (58%); not having to deal with insurers and billing (45%); guaranteed income/even cash flow (42%), and a good benefits package (28%).

2. On the flip side, employed doctors complained about the profusion of rules and the lack of input into how they practice. Leading complaints were: limited influence in decision-making (45%); more limited income potential (44%); too many rules in general (34%); less control over work/schedule (32%); and being "bossed around" by management (30%). Less than half (49%) of employed doctors said they are satisfied with their degree of autonomy at work, while 25% say they are unsatisfied.

3. Not every employed doctor chose his/her situation, leading to a degree of simmering resentment. Some became employed when their practice was bought out, but they had no say in the decision.

4. Women doctors are gravitating toward employment. Among employed physicians, 38% are women and 62% are men; among self-employed physicians, 22% are women and 78% are men.

5. Is the grass greener? About 70% of doctors who left employment to become self-employed said they are happier now; 49% of doctors who were formerly self-employed (now employed) said they are happier now. However, 25% of now-employed doctors say the switch made them unhappier, while only 9% of self-employed doctors (formerly employed) say they are unhappier now.

6. How are employed doctors paid? The largest group of physicians earned a straight salary (46%), while about 33% received a base salary and are also paid to hit productivity targets. However, quality and productivity targets are becoming more common.

7. Employed doctors consider patient care to be better in an employed setting. More than half (53%) of employed physicians who were previously self-employed felt that patient care was superior now, although more than a third (37%) felt that it was about the same.

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