Newly-minted physicians have between fifty and one hundred job offers to sift through before the starch even wears out of their lab coats, according to a new survey by Merritt Hawkins, and the majority will choose employment with a larger practice, hospital, or health system over entering a solo private practice. As an ongoing shortage of physicians, driven in part by the burden of mandates such as meaningful use and the expense of EHR adoption, begins to put the squeeze on care availability, new trends in physician employment are changing the way healthcare is delivered in the United States.
“Unlike virtually any other type of professional in today’s economy, newly trained doctors are being recruited like blue chip athletes,” said Mark Smith, president of Merritt Hawkins. “There are simply not enough physicians coming out of training to fill all the available openings.”
The organization asked more than 1200 medical residents about to graduate into the job market, about recruitment opportunities and their future plans. More than 60 percent of the residents had received more than fifty solicitations from recruiters in the last year of residency, while 46 percent were flooded with more than one hundred job offers.
The overwhelming number of offers may have something to do with the extraordinarily low percentages of new recruits choosing what have become challenging career paths: solo practice or employment in a rural area. Just two percent of respondents were interested in opening up their own practice, while a mere three percent would consider seeking a position in a community with less than 25,000 people. More than two-thirds of new physicians headed straight for larger medical practices in more urban areas.
These decisions are contributing to the growing shortage of care in rural areas, which is compounded by an increasing number of elderly patients, more patients becoming eligible for care under the Affordable Care Act and Medicaid expansions, and the prevalence of chronic diseases. In Colorado, for example, some rural counties would need to increase their physician population by more than 100% to meet basic state benchmarks for the ratio of providers to patients.
But that might not happen if the urban employment trend continues. “The days of new doctors hanging out a shingle in an independent solo practice are over,” Smith said. “Most new doctors prefer to be employed and let a hospital or medical group handle the business end of medical practice.”
Yet even physicians who secure a place in a hospital or group setting are not entirely happy with their choice. A quarter of residents indicated that if they had the option to start over again, they wouldn’t even choose the medical field at all. Physician dissatisfaction is at an all-time high, driven by everything from an overwhelming number of EHR alerts that interrupt patient care and frustrate technology users to the coming of ICD-10, which is placing a considerable strain on hearts and wallets alike.
Employed physicians might not have to worry about cooking their own books, but they complain instead about being treated as cogs in a machine, losing autonomy, and being mismanaged by executive staff. A March survey by the former American College of Physician Executives, now the American Association for Physician Leadership, found that many employed physicians gripe at corporate culture clashes, a lack of financial incentives, and disinterest in their opinions from organizational leaders.
“With declining reimbursement, increasing paperwork, and the uncertainty of health reform, many physicians are under duress today,” added Smith. “It is not surprising that many newly trained doctors are concerned about what awaits them.”