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ReMARKS
Sacrifice as a Career Booster
In today’s troubled economy, it may be time to consider taking on
less-desirable job responsibilities to improve your marketability.
less-desirable job responsibilities to improve your marketability.
By david witte
In a perfect world, as a reward for all the hard work of medical school, you
would be able to have a well-paying career with a perfectly balanced life in a
fabulous community. Unfortunately, the world of medicine is not perfect.
Potential employers have their dream list, too, built on their own
all-too-important needs. The dichotomy of physicians’ desires for quality lifestyles against hospitals’ needs for medical services is the biggest battle non-metropolitan hospitals
face. Physicians are increasingly placing more emphasis on their quality of
life and limiting their availability for certain tasks. Hospitals, however,
still have the same coverage needs they have always had, if not more. As the
economy becomes more unpredictable, hospitals are going to have to be more
particular about whom they hire. As a consequence, some physicians will find it
harder to get their ideal jobs, while others are going to be rewarded better
than ever.
The difference? The ones getting the great offers are going to be the ones
willing to give a little.
Pediatrics is an example of a specialty that has attracted a significant number
of providers who do not meet the needs of a large number of communities. A
hospital recruiter emailed me this week: “Tell me what I have to do to get a pediatric candidate!” A recruiter for a multi-specialty group in North Carolina desperately needs a
pediatrician who will take C-section call; after six months of looking, she
still hasn’t found one. A fairly large pediatric group in Arkansas has everything in place
including the patient base, but no candidates on the horizon. The problem these
facilities are having is that they need someone to take call, cover deliveries
and C-sections, and work full-time; yet a large percentage of candidates want
to work part-time or on an all outpatient basis.
Physicians' wants vs. employers' needs
A random survey of 100 pediatric jobs listed with The Curare Group, Inc., found
only two that had no on-call responsibilities and just two more in which the
physicians were not expected to attend C-section call. A complementary survey
of 100 pediatricians who were actively seeking jobs between January and October
2008 showed that 43 percent of potential candidates were interested only in
outpatient-only or part-time jobs. Only 19 percent were definitely willing to
take call and attend C-sections and 38 percent were unsure as to their
willingness to take call or would do so under certain circumstances. While this is not entirely scientific, it does show the detachment of the
workforce from community need. Regardless of the type of work the unknown 38
percent are willing to do, nearly half of active pediatric candidates are
unwilling to meet the needs of 96 percent of the jobs. Because of this trend,
the 19 percent of pediatricians willing to take call will see more and
higher-paying offers—much higher paying, in fact. Five years ago $110,000 per year was considered a
good offer for a pediatrician. Now, pediatricians who are willing to take call
will get offers in excess of $160,000 per year—a gain that outpaces inflation, which has hovered at 4 to 5 percent per year
during that time frame.
Family practice and internal medicine went through a similar retooling about
eight years ago. More and more family physicians wanted to do strictly office
work. At the same time, a significant number of internists began yearning for
more regular hours and less call. The market responded to them and essentially
created a new specialty, “the hospitalist.” This new way of practicing has given two specialties the opportunity to work
together to the benefit of both providers. It has allowed smaller communities
to attract both specialties by providing the lifestyle each desire with the
opportunity to maximize the strengths of their training. The downside is that
more and more primary care physicians expect a hospitalist program, which makes
it even harder for rural hospitals—without the means for such programs—to recruit family practitioners or internal medicine physicians. As such, “traditional” family physicians and internists have become far more valuable than they were
in “pre-hospitalist” times. Financial offers for primary care providers who are willing to do both
outpatient and inpatient work have skyrocketed in the last four years, and as
competition for this dwindling group of doctors increases the offers will
continue to increase.
Nearly every specialty is experiencing a disparity of some sort between what the
market needs and what the physicians want to do; the coverage needs of
hospitals have not changed, but physician’s attitudes toward practicing have. Many communities in the upper-Midwest need
surgeons who can handle emergency C-section calls, yet the number of surgeons
willing to take those cases remains insignificant. Small communities all over
the country are unable to find family physicians willing to do OB (besides the “on-call” component this brings to the job, many FPs also want no part of OB because of
liability issues). These small hospitals also do not have the volume to hire an
OB/GYN, so they are closing their OB departments. Between subspecialty training
and doing hospitalist work, general internists have become an extremely rare
commodity. General internists have seen offers go from $120,000 per year to
upwards of $180,000; family physicians can now command upwards of $160,000 to
$200,000 per year, depending on what services they are willing to provide and
where they are willing to go. Nearly every specialty has seen offers increase similarly, for the right people.
Extra effort=extra rewards
Aside from an overall increase in salary offers, what does this mean for you
when looking for a job? What it does not mean is that if you want a part-time pediatric job, you will
not be able to find it; you will. What it does mean is that if you are willing
to do the work others are not, you can be rewarded handsomely. When hospitals
or groups are unable to attract the right candidates, they start putting better
and better deals on the table to attract the skills they need. This means that
if you are willing to accept more responsibility, you will find more job offers
in more locations with better terms. When you are looking at changing jobs or
taking your first job out of residency, give some thought to taking on what
other candidates might consider to be undesirable responsibilities. Look at
ways you can provide a needed service and how to exploit that in the
marketplace. Think about offering to take an extra couple days of call as a
regular component of your schedule, or talk to potential employers or trusted
recruiting professionals about the services that are lacking in your desired
area. Then find out what it will take to obtain an additional skill-set to fill
one of those niches. It may be just a matter of short-term CME. If you do that, you may find out you
can get a much better and more rewarding job than you expected, without having
to sacrifice all that much of your lifestyle. And in the end, you’ll be closer to that “perfect world” scenario than the doctor who refused to compromise.
END
Dave Witte has seventeen years recruiting experience at The Curare Group, Inc.,
a physician recruiting firm located in Bloomington, IN. Reach him at (800)
909-4883 or dmw@physicianrecruiting.com.
