New research from MGMA and Jackson Physician Search found physicians who completed training in the last six years stayed in their first jobs for an average of just two years. When the question was asked of all physicians (regardless of how long ago they completed training), the average first job tenure was six years. When you consider the time it typically takes for new physicians to reach productivity, it’s easy to see why healthcare employers are increasingly concerned by the trend of shrinking tenure. While organizations explore strategies to improve retention among newly trained physicians, what can residents and fellows do to break the cycle?
The Importance of First Physician Job Tenure
While expectations about how long to stay with an employer have evolved in every industry, for physicians, the impact of shrinking tenure can be especially harmful–not just to the healthcare organization and its patients but to the physicians themselves. This is because most physician job contracts have a minimum term length of two years. Those big signing bonuses and/or loan repayments you hear about are only paid if the physician fulfills his or her commitment to the organization and stays for the entire contractual term. If physicians leave before they have completed their obligations, they will be asked to pay back the organization all or part of any bonuses they have accepted.
Additionally, the physician job search and changing physician jobs can be stressful! So, financial implications aside, most new physicians would prefer to find the right fit the first time rather than start another job search just two years later.
Examining First Physician Job Search Priorities
To increase the chances of finding the right fit, residents and fellows must carefully establish their job search priorities. The new research from MGMA and Jackson Physician Search found compensation and location to be the most critical factors driving new physicians’ first job search decisions. After years of living on a resident’s salary, often while starting families and carrying considerable student debt, it’s understandable that new physicians are looking for the best offer they can find in the location of their choosing. However, they quickly learn that the most competitive compensation is often not found in the most popular cities. This is one reason candidates should expand their job search radius to include other parts of the state or region.
Asking the Right Questions
The hyper-focus on compensation and location often causes residents and fellows to neglect other factors that may have an equal, if not greater, impact on their ultimate job satisfaction. In the new research, the most frequently cited reason physicians gave for leaving their first jobs is due to practice ownership and governance models. This suggests many physicians are accepting jobs without fully understanding the implications of the types of organizations they are joining.
Young physicians need to ask questions about how the organization makes decisions, structures communication, and how well they retain physicians. Candidates should request sufficient time during the on-site interview to speak with people at all levels of the organization–not just the practice administrator but the physicians and support staff as well. In a smaller organization, the physician should ask to meet with the CEO and other executives. Ask questions about tenure, autonomy, job satisfaction, career advancement opportunities, and work-life balance.
Evaluate the Big Picture
There is so much more to a job opportunity than compensation, and it’s often untrue to think the rest won’t matter as long as the money is there. The research shows us this is simply not the case. And even for those who insist on prioritizing compensation, when we peel back the layers on that impressive initial offer, we often discover a practice that is offering a lower base has an income potential that is just as good as, if not better than, the one with the higher starting salary or big recruitment bonus. Seeing the big picture is difficult, but candidates should make fully informed decisions so they can ultimately choose a first physician job that lasts.
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