Seven Job-Search Mistakes of New Physicians

Leigh Page

Disclosures

April 07, 2015

In This Article

What Do You Look for, Who Do You Trust?

4. Not Understanding the Pros and Cons of Employment at a Hospital

Many new physicians prefer to work in hospital systems rather than physician-led practices. Merritt Hawkins' 2014 survey of final-year residents found that 36% planned to work in a hospital. Their preference for all kinds of employment with a hospital may be much greater because hospitals also offer many positions within group practices, which are listed as a separate practice location in the survey.

New residents flood into large health systems in many parts of the country. In northern California, for example, Sutter Health and Kaiser Permanente dominate the job market, according to Keith Borglum, a healthcare consultant in Santa Rosa. "Kaiser alone takes a phenomenal percentage of the residents from training programs around here," he says.

Borglum thinks that large organizations can be a better fit for new physicians than for older doctors, many of whom have experience working in smaller, private practices and often can't tolerate the shift. For new physicians, large organizations mirror the large teaching hospitals where they've been training. They're used to working in teams and letting the administration take care of issues like billing. Also, "in my experience, new doctors tend to be less sure of their clinical skills," Borglum says. "They want to work in a group setting with mentors around them."

The pay isn't bad, either. According to the 2014 Medscape compensation survey, hospital-employed physicians made $262,000 on average, somewhat less than in a single-specialty group ($273,000) but more than doctors in a multispecialty group ($260,000), solo practice ($222,000), or academic, research, military, or government organization ($198,000).

However, Borglum and others warn that new physicians need to be cognizant of the drawbacks of employment as well as its advantages. In a separate Medscape survey,[6] employed physicians indicated that they liked not having to run a practice, deal with insurers, or work extra hours, but many of them were concerned about having limited influence in decision-making, less autonomy, and more limited income potential.

For example, income can be connected to meeting productivity goals, which means that these physicians need to be speedy and efficient, like doctors in a private practice. Dale J. Block, MD, a family physician employed by Premier Health, a five-hospital system in southwestern Ohio, says that new physicians who enter employment still need to develop basic business skills. Dr Block, who runs a Premier-owned solo practice, also helps recruit physicians to Premier and lectures residents about the business of medicine.

New physicians gravitate to big systems to find security, but in truth, "there are no secure jobs," Dr Block says. "You're going to have to work hard and prove yourself." At Premier, he says, the newly hired physician starts with a guaranteed income for the first 12-18 months, then moves to a payment model partly based on productivity. When employed physicians don't meet productivity requirements, "they can be let go," Dr Block says.

5. Putting Too Much Faith in Recruiters

A physician recruiter can be a valuable asset for busy residents who need help deciding what kind of job they want. At no cost, recruiters can help you look for job openings and deal with the organizations offering the jobs.

But they do have some distinct limitations: Even the largest recruiters have access to only a fraction of the total number of jobs available. Also, their interests are aligned with the employers who pay them, which may blunt their usefulness when new physicians start negotiating for a job.

There are several hundred physician-recruiting firms—from large companies like Merritt Hawkins and Jackson & Coker to small operations dealing with certain specialties or regions. In addition, health systems, hospitals, and some large practices also have their own in-house recruiters who may work in tandem with independent recruiters.

Residents and fellows first get acquainted with recruiters when answering job ads or by direct solicitations from them. According to the Merritt Hawkins survey of final-year residents, 63% had been contacted more than 50 times by recruiters and others about openings, and 46% had been contacted 100 or more times.

New physicians are expected to form a relationship with one or two recruiters but no more than that. The thinking goes that organizations that are contacted by several recruiters on behalf of the same doctor will assume that the doctor has problems being hired, and they'll lose interest.

For all that recruiters can do to help you polish your CV and introduce you and your family to a community, they're not much help in negotiating employment contracts due to their loyalty to their client, who is, after all, paying the bill. "Recruiters can usually answer basic questions about the contract, but their incentive is to get the deal signed," says Ericka Adler, an attorney in Lincolnwood, Illinois, who specializes in physician contracts.

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