While a $40,000 signing bonus and half-a-million yearly salary might have you rushing to sign on the dotted line, every job-seeking physician must weight several non-financial considerations to ensure the position is the right fit. Primarily deciding based on financial factors is not always in your best interest; a position that offers more “intangibles,” even with a lower paycheck, may lead to more fulfilling work.
Read on to learn some of the non-financial considerations you should consider before taking your next job.
Opportunities for career growth
The ubiquitous question, “Where do you see yourself in 5, 10, and 15 years?” should guide your job search. Physicians must always be cognizant of this question and ensure their next opportunity is in line with the answer. While “growth” generally refers to your career trajectory, it is also intimately tied to the practice opportunity. Ask not only about the patient population and referral sources but also about the business model and its financial stability.
Just as important is getting a sense of your practice’s interest in your professional future: is there an opportunity for mentorship with senior physicians if you are starting your career? Is there time carved out to pursue research, teaching, or professional development? Be sure to ask current physicians about these intangible benefits to get a better sense of the lay of the land. Be honest about how this will affect your career goals, and don’t be shy to negotiate for time and resources to achieve these goals.
You will be spending a significant amount of time with your colleagues, not only in the office and hospital but also at work functions and serve as a representative of your practice in the community. You’ll be cross covering for their patients on call and when they are on vacation. Find out early if this is a relationship that you will grow and mature for years to come or sour over time. Find out if there is a collaborative work culture and how physicians, staff, and patients interact.
Does a colleague always dump patients on Friday at 5 pm when he or she is not on call? Is the administrative and support staff efficient, professional, and easy to work? Is there a culture of blame in which unavoidable wait times, a shortfall of billable procedures, or are daily patient visits used to penalize physicians? These are crucial questions to ask, as what you find can significantly affect your work quality of life while caring for your patients.
About 16% of physicians work in the academic setting; the rest work in private practice or employed settings. Those choosing academics will likely do so due to their interest in teaching, research, and the desire to treat more complex or specialized patient populations. Choosing between private practice and the employed setting is not as clear-cut, even though the number of employed physicians is rising. Many graduating residents and fellows (and even some more seasoned physicians) are not as familiar with the pros and cons of these different settings.
Solo practice and partnership tracks allow for physician entrepreneurship while the employed physician trades this autonomy for more job security, the bureaucracy of large organizations, and often a larger paycheck. Within these major classifications, there are other areas of difference, such as choosing between multi-specialty group practices, hospital employment, and more. Understanding how these different organizations work, the leadership styles and the physician evaluation process will be essential to determine if the job is the right fit for your career and life.
The local community
Every once in a while, after seeing your forty new patients per day, tackling administrative duties, and every other day call, you will resurface for a few moments to appreciate your local surroundings. All kidding aside, after a decade a more of training, you owe it to yourself to build in some work-life balance and enjoy the community that surrounds you.
You will want to make sure the local community has excellent schools if you have school-age children, safe neighborhoods, fun restaurants, art, and sporting activities to enjoy in your spare time. Spend a night in town after your interview to get a feel for the area to see if it is a place you can build a life, not just a career. Ensuring your family is on board and that your spouse or significant other is happy with the new environment is key to maintaining your sanity outside of your work hours.
Non-compete clauses and the “legalese”
While many physicians work past retirement age, many of us will not keep the same position. On average, physicians stay less than five years in their first position. Ignoring non-financial considerations is likely a significant contributor. Regardless, it’s best to be aware of the repercussions of leaving your job earlier than you expect, even if it seems too good to be true now.
Always read the fine print (and even better, get a lawyer to read the fine print) regarding the consequences of terminating your employment early (generally before two years for most contracts). Such fine print can be significant if you have bought into a partnership track or start with a guaranteed salary and do not meet benchmark requirements in productivity. Even if you stay longer than the minimum required, many contracts require a non-compete clause ensuring that you cannot work in the local area for a pre-determined time period. Ensure you are comfortable with these stipulations and that they will not cause undue harm to your career or financial security.
Choosing your next job should always take into account more than just financial constraints. Make a list of the non-negotiables in work and career— and don’t shortchange your goals in service to a paycheck. Most physicians work well over the standard 40-hour work week and still take their work home with them; it’s in our best interest to ensure we choose our work environment wisely. Take stock of the non-financial considerations of your job opportunities now, so you can focus on caring for your patients later.