Employed or self-employed? A look at which doctors have it best

Medscape survey assesses satisfaction for self-employed and employed doctors

A new Medscape Medical News report finds that "self-employed" and "employed" physicians are about equally satisfied with their jobs, but 25% of doctors who switched from self-employment to employment said the move made them less happy.  

For the survey, researchers asked more than 4,600 U.S. physicians questions about their work environment and job satisfaction. The survey was aimed at gleaning a better understanding how a flood of mergers and acquisitions may have affected newly hospital-employed physicians' job satisfaction.

Medscape definitely an "employed" physician as one that does not a run a private practice; employers of these physicians included hospitals, outpatient clinics, academic or government organizations, and private practices.

How satisfaction rates compare

Overall, 74% of self-employed physicians reported being satisfied with their work environment, while 73% of employed physicians were satisfied with their environments. However, self-employed doctors were slightly more satisfied with their current practice situation: 65% of self-employed doctors reported feeling satisfied, compared with 59% of employed doctors.

The 'Three C's' of successful physician engagement

Among physicians who moved from self-employment to employment, about 49% of physicians say they are happier now, while 25% said they were less happy. By comparison, 70% of doctors who moved from employment to self-employment said they were happier, and just 9% said they were less happy.

How the workplaces compare

According to the survey, doctors chose employment over self-employment for various reasons:

  • 38% of physicians said they chose it greater financial security;
  • 29% chose it to have less paperwork; and
  • 19% chose it because they were looking for better work-life balance.

"I think that as doctors settle in with employment and start to realize that it's not as bad as they thought it would be, they accommodate," says Tommy Bohannon, a vice president at physician search firm Merritt Hawkins. He added that today, "the expectation is that they're going to work for someone and be an employee… candidates in training now never view themselves as small business owners."

Culture change for hospital-employed docs used to private practices

Employed physicians typically work shorter and more regular hours than self-employed doctors. Overall, 54% of employed doctors said they were satisfied with their new work-life balance. Among doctors who moved from self-employment to employment, 56% say their work-life balance improved after the move.

But the newfound free time comes at the cost of some autonomy, according to the survey. About 36% of employed doctors do not believe that their input is considered when big decisions are made, and 44% say they are treated more like an employee than a partner.

Moreover, 32% of employed doctors cited their lack of control over their work schedule, and 27% cited a lack of autonomy at work as their biggest complaints.

Generally, the loss of control of their work life "is the biggest complaint we hear [from employed doctors, but] I think it's more the perception of loss of autonomy than the actual loss of autonomy," Bohannon says, adding, "I suspect that as years go by, we'll see more doctors reporting that they are satisfied in employed settings, because they didn't come in with a preconceived notion that it was going to be a nightmare" (Kane, Medscape Medical News, 3/11; Kane, Medscape Medical News, 3/11).


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