A survey run by Medscape to determine whether doctors in private practice or doctors employed by corporations were better off, garnered responses by more than 4600 doctors. Here are some results.
Female doctors vs. Male doctors
Among female physicians, more are employed than self-employed. The reverse is true for men; more male physicians are self-employed than employed.
Sue Cejka, Managing Partner at Grant Cooper Healthcare, a physician/executive recruitment firm based in St. Louis, Missouri, notes that the greater percentage of women who are employed is more related to age than gender, because there are more female doctors in the younger age category.
Doctors Under 40 years old
Less than half are self-employed. Over 40, more physicians are self-employed.
The ideal of having a private practice is more prevalent among doctors who began practicing many years ago. Because of the changes in healthcare in recent years, it has become more and more difficult for physician practices to remain profitable while independent.
The grass often looks greener to doctors who switch from self-employment to employment, and vice versa. More than half (52%) of our self-employed respondents had previously been employed, while a smaller percentage (29%) of employed doctors had previously been owners or partners. Some doctors made the change because they thought they’d be better off, while others had little choice in the matter when the practice where they worked was acquired.
“A new wave of employment started about 9 years ago,” says Cejka. “Many private physicians’ practices were acquired by hospitals. Employment and consolidation continue to occur.”
Additionally, more young physicians head right for employment. Being in private practice doesn’t have the lure that it once did.
It’s no surprise that about 49% of employed doctors are either working in a hospital or are in a group now owned by a hospital. “Multispecialty groups are a more natural alignment and a natural fit with part of large systems,” says Cejka.
But other venues are also big employers. Approximately 21% of doctors are employed by private groups, typically large private groups with a few owners but also a number of employed physicians.
Other employment venues include community health centers, corporate laboratories, correction institutions, military bases, and nursing homes.
The financial challenges of private practice played a huge role in prompting more than a third of physicians (38%) to seek employment. Not having to worry about billing, office management, and administrative issues was the key motivator for about 29% of respondents, and working shorter and more regular hours had the strongest pull for 19% of employed doctors.
Reasons for employment
- Room for academics and research in conjunction to clinical care
- Decreased financial burden
- More time off
- Decreased billing paper work
- Practice sold to hospital or corporation
- Improved life-work balance
Doctors gain security, but face:
- Loss of control in decision making
- Loss of autonomy
- No input into management decisions
- Loss of influence
- Large set of stringent rules
About 70% of physicians who left employment in favor of self-employment are happier now. Only 9% who went to self-employment are unhappier now.
Sue Cejka gave another reason why some employed doctors may feel unhappier now. Although most probably expected to lose some autonomy and control, the reality is tougher than anticipated. “All humans think that if they move into a large organization, they’ll get all the good things and none of the bad things,” says Cejka. “Reality is different.”
In contrast, less than half (49%) of physicians who left self-employment for employment are happier now, and a quarter (25%) are unhappier now. Those results fit with the knowledge that many physicians had no choice in becoming employed.
Changing jobs is a big decision; it involves risk and may also require relocation. Most doctors are planning to remain where they are. Only 11% are definitely planning to make a change, either to another locale or back to self-employment. And while about 38% say that they may change their job situation at some point, it’s possible that they will make peace with it and remain where they are.
How does this apply to you?
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