Employed Doctors: Love the Paycheck, Hate the Rules

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The Impact of Gender and Age

More women doctors are employed than are self-employed: Among employed physicians, 38% are women and 62% are men; among self-employed physicians, 22% are women and 78% are men.

However, according to Sue Cejka, Managing Partner at Grant Cooper Healthcare, a physician/executive recruitment firm based in St. Louis, Missouri, this is more age-related than gender-related; there are more female physicians in the younger age category, while there are more self-employed docs in older categories. The dream and goal of private practice has lost allure to younger doctors, and of physicians under 40, employment beats self-employment (30% vs 12%); whereas over 40, fewer physicians are employed than are self-employed (49% vs 65%).

What Attracted Doctors to Employment?

The shift to employment among physicians has been on the rise in recent years. Estimates of employment range from about 25% to about 59%, depending on specialty, with about 50% of internists being employed.[1]

"Hospitals started the trend of buying up physician practices around 9 years ago," says Cejka. "Additionally, it's gotten much more difficult for independent practices to compete."

The challenges of private practice -- lower reimbursements, time spent on office management -- played a huge role in prompting more than a third of physicians (38%) to seek employment. Working shorter and more regular hours had the strongest pull for 29% of employed doctors, and not having to worry about billing and administrative issues was the key motivator for about 19% of respondents.

Some doctors noted other reasons as well: "I believe that the employment model reduces profit incentive in providing care"; "I love academic medicine and research in addition to patient care."

Once employed, the major benefit, cited by 58% of physicians, was not having to run the practice. Of note, getting a guaranteed income was ranked third, not first.

Respondents also cited these benefits: "academic opportunities"; "when I'm off, I'm off!"; "more vacation time and no loss of income during vacation"; "the chance to work with incredibly bright colleagues"; and "a chance to work with a world-class stroke team."

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