Employed vs Self-employed Physicians: Who's Happier? These Are the Tradeoffs

Leigh Page

Disclosures

June 14, 2016

In This Article

Male/Female Differences in Employment

Female physicians are somewhat more likely to be employed than their male counterparts. Women make up 37% of employed physicians, which is higher than their 33% share of physicians overall.

Some female physicians may be attracted by the work/life balance more likely to be found in employment—predictable hours, often without call responsibilities, Greg Mertz says. "Some employers allow part-time and job-share arrangements, typically in primary care, which is less likely to be possible in private practice," he says.

You can't generalize about female physicians, but it's possible that a greater percentage prioritize work/life balance than do men, Marc Mertz says. "It does seem to be true that many women value other responsibilities beyond work, which are related to family, and they do seek predictable hours," he says.

Women are somewhat less likely to be happy with employment than men. More than one half (58%) of employed male physicians are satisfied with work, whereas the rate for women is 7 percentage points lower (51%). The satisfaction rate is much higher among self-employed physicians, with both sexes tied at a 62% rate.

Why the gender gap among employed physicians? "Many female physicians opted for employed status because they wanted a better work/life balance, and they may have been disappointed with the schedule they got," Greg Mertz says.

Employed Physicians Mourn Lack of Autonomy

When asked what they didn't like about their work, employed physicians often cited lack of control and autonomy. These categories included limited influence in decision-making (cited by 35%), less control over work and their schedules (28%), too many rules (26%), being "bossed around" (22%), and less autonomy (20%).

One reason for lack of autonomy is that hospitals have been standardizing operations, Greg Mertz says. As a result, the modern healthcare organization has a plethora of rules and multilayered hierarchies that can get in the way efficient patient care, he says.

"These organizations have a variety of structures, policies, and procedures that physicians are expected to follow," Marc Mertz says. "Employed physicians often have to work extra hours at the end of the day to document, close EHR records and orders, and fill out paperwork," he says.

He adds that employed physicians in hospitals often are required to join committees and attend a lot of meetings, but this is less of a problem for employed physicians practicing in the community.

Many employed physicians don't feel that they have collaborative relationships with management. Whereas almost one half (48%) feel personally in alliance with their employer's goals, only one third (34%) feel they're treated more like a partner than an employee.

There's a limit to how much authority employed physicians can have, Marc Mertz says. "By definition, employed physicians are not partners," he says. "But you can still give them meaningful roles in group governance, such as setting up physician leadership councils."

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