One of the biggest fears that doctors have in taking our first jobs is that the opportunity might not work out. For many professions, moving to a new position is expected. The administration at one of the local hospitals has turnover every few months. I think that the CFO position there has been occupied by five different people in five years!
If doctors cycled through jobs like this, then there would be no hope for us. Many medical specialties require long term care of our patients in order to establish a repoire and to build a successful practice. Unfortunately we do sometimes find ourselves in a job hunting scenario even though we did our best to pick the right job.
Here are five reasons that I’ve seen attributed to physician turnover:
Work schedule not compatible with the doctor.
Everyone can claim to be willing to work hard. If we made it through medical school, we probably have worked hard at some points by in our lives. But we also know that slackers exist everywhere, even in medical school. We all know that one person who seemed to do the minimum to get by—maybe you are that person.
Nonetheless, the work-life demand in any job situation truly implies nothing about the character of a doctor, but rather that the arrangement may not be suitable for both parties. Most employers will hopefully delineate the job expectations a priori, but the employee may not know what she wants for herself. Life goals simply change over time.
I knew an emergency room physician who complained bitterly about working overnight shifts. She made all attempts to switch out those shifts with her coworkers. Eventually she left the area and hopefully moved on to a work arrangement that better suited her needs.
Compensation not what was expected
Compensation is always a sticky subject, since doctors aren’t trained to be be greedy (unlike those of you all in finance!). Physician compensation depends on the region and the specialty, but most doctors I’ve met don’t really understand how they’re paid. This includes doctors who have been working for decades!
The dynamics of medical compensation depends on insurers, the employer-employee arrangement, and the terms of the contracts. Sometimes the employee may feel that she isn’t getting a fair share of the revenue. Sometimes the employer feels that the employee isn’t pulling her weight enough. I’ve known doctors who weren’t offered partnership, and the junior associate opts to find greener pastures elsewhere.
Sometimes the compensation structure isn’t amenable for either party, and the junior associate starts looking for a new job.
Lack of growth potential
Medicine, like most other professions, becomes a routine for many of us. After so many years of medical practice, the common diseases that present are relatively easy to diagnose. While boredom isn’t necessarily what most doctors complain of in their first jobs, sometimes routine can indeed be tedious. Perhaps the work situation doesn’t utilize one’s level of training fully. Perhaps the cost of providing that higher level of care prohibits that doctor from offering her services.
I’ve known several doctors who ended up returning to academia after working in the private sector, citing that they wanted more of a challenge in their medical practice. Cases like these show that money is not always the sole motivator to justify a work arrangement.
Position is no longer available
One of the most devastating situations for anyone to hear is that their services are no longer needed. Sometimes the driver is financial demand. Let’s say your group contracts with the local hospital. The hospital ends up in financial distress and closes it doors. All of its employees and contractors are out of luck. This happened several years ago at St. Vincent’s Hospital in New York City—the hospital simply closed it doors.
Alternatively, you may be working in a specialty group as a new hire, but the senior partners decide to sell the group to private equity. The new owners of your medical practice may decide to downsize and eliminate the new hires—suddenly the younger doctors end up losing their jobs.
Chronic malcontent
This is a touchy topic. It’s human nature to gripe. School, homework, jobs, other people, you name it and there is a way to complain about it. The dynamics of healthcare give us all the reasons in the world to be unhappy.
I’ve interviewed dozens of M.D. applicants in my profession, and over a hundred support staff thus far in my career. Many of these doctors and medical professionals have cycled through a surprisingly high number of jobs in what would otherwise seem like a limited working career. I always hope that their turnover rate is caused by bad employers, but that is unfortunately not always the case. There are also people who have chronically unhappy about their situation. The reasons for malcontent may actually be trivial, but they become magnified and used almost as excuses to find another job.
While there are legitimate reasons why some jobs don’t work out, chronic malcontent is essentially a personality conflict. These are the most difficult to resolve, since the inherent problem is with the doctor herself.
What other reasons do you attribute to doctor attrition?
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Congratulations! After a decade of slaving away in your medical training, you’ve got your first job offer in hand! If you’re really lucky, you might have several offers to evaluate. But wait, there’s all this legalese and gibberish—nothing makes sense!
