The Resident Job Hunt: The Good & Bad About Hospital Employment

Recently I was precepting a 2nd year family medicine resident who was doing her rural family medicine rotation in my clinic. I am an old style family doctor who has done the full spectrum of care during my career including surgical obstetrics.

I was delighted to discover she also wanted to do traditional family medicine with obstetrics, and that she wanted to practice in a rural Northern Indiana community where she grew up. Since I also returned to my home county to practice in Northern Indiana 25 years ago, I immediately took a liking to her passion and vision for her future.

As we discussed things further, she admitted she was relatively unprepared for the business aspect of her job search that included several regional hospitals near her home town. We notably recognized here need for some business coaching from someone who understood physicians. She even stated: "you should come and do a noon conference about this sometime".

We had a nice discussion about the some of the benefits of hospital employment but also reviewed some of the downsides. I thought it would be good to share this coaching session with you today.

Let's not assume anything, and let me start from the beginning by describing the the recruitment that now heavily occurs in the 2nd year and sometimes even the first year of a family doctor's 3 year program.

Introduction

As second-year family medicine residents near the end of their training, they stand at a crucial crossroads in their careers. Many are considering the next step: transitioning from training to full-fledged medical practice. While traditional employment with a hospital may seem like the natural path, it's essential for all residents to be aware of the potential downsides associated with this route. Business coaching from an experienced physician can play a pivotal role in guiding residents to make informed decisions about their career paths.

The Appeal of Hospital Employment

Hospital employment offers stability, benefits, and a structured environment that appeals to many medical professionals, including family medicine residents. The allure of a predictable schedule, a steady salary, and access to institutional resources can be enticing, especially for those who have invested years in their medical education.

The Downsides Unveiled:

1. Limited Autonomy: One of the significant downsides of traditional hospital employment is the limited autonomy physicians have over their practice. Hospital policies and protocols can dictate treatment plans, patient interaction time, and even the choice of medications. For family medicine practitioners who value personalized patient care, this can be frustrating and may hinder their ability to tailor treatments to individual patient needs.

2. Bureaucratic Hurdles: Hospitals are complex organizations with layers of bureaucracy. Physicians often find themselves entangled in administrative tasks, paperwork, and meetings. The time spent navigating these bureaucratic hurdles could be better spent on patient care, professional development, or even personal life.

3. Financial Constraints: While hospital employment offers a steady income, it may come at the cost of potential earning potential. Physicians employed by hospitals might have limited control over their billing, and they may miss out on the financial benefits of running an independent practice or working as an independent contractor through their micro-corporation.

4. Innovation and Flexibility: Hospitals might be slow to adopt new technologies and treatment methods due to organizational inertia. This can stifle a physician's ability to stay at the forefront of medical advancements. Additionally, hospital-employed physicians might have limited flexibility in choosing their practice location or the patient population they serve.

5. Patient Load and Time Constraints: Hospital-employed physicians often face a higher patient load due to the demands of the institution. This can lead to shorter appointment times, reduced patient-physician interaction, and potentially compromised quality of care.

The Role of Business Coaching

Business coaching can provide invaluable guidance to second-year family medicine residents as they contemplate their career paths. A skilled coach can help residents explore alternative options, such as setting up an independent practice, starting professional micro-corporations, joining a private clinic, or exploring telemedicine opportunities. Through personalized coaching, residents can learn about business fundamentals, financial planning, and the practicalities of running a micro-medical practice.

Coaches can also assist in weighing the pros and cons of traditional hospital employment, encouraging residents to consider their long-term goals and personal values. By fostering a deeper understanding of the healthcare industry's landscape, business coaches empower residents to make informed decisions that align with their aspirations.

Conclusion

As second-year family medicine residents move closer to embarking on their medical careers, they should carefully evaluate the potential downsides of traditional hospital employment. With the assistance of business coaching, these residents can gain insights into alternative career paths, assess their options objectively, and make choices that pave the way for a fulfilling and successful medical practice that aligns with their professional and personal goals.

I invite you to consider four next steps that you can take with SimpliMD as a result of this post:

1. Download my free guide on teaching, mentoring, and coaching for doctors.
2. Check out my SimpliMD Coaching program options here. My coaching is for all types of doctors from attendings to residents.
3. consider becoming a SimpliMD member and joining our community of doctors who are the practical business school journey to micro-business competency.
4. Join me in Dallas-Fort Worth at 7:30pm CST for live teaching to a group of residents about "Are You Ready to Take Control Of Your Professional Future" This will be live streamed on Facebook and you will have the opportunity to join us virtually if you are unable to attend in person. 

Tod