Flexibility and Your First Physician Job

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As most residency programs don’t include an elective entitled “Negotiating your dream job,” many first time physician job seekers understandably feel a bit overwhelmed as their training comes to a close. To assuage these concerns, many may feel the need to draft up a list of the “non-negotiables” essential to their first physician job.

At the same time, a first job search begets a certain degree of flexibility, as seemingly paramount characteristics lose their significance on a second or third look.  Flexibility during the process allows a new physician a well-rounded view, minimizing the risk of missing out on an (almost) perfect job, save a few check marks.

So what aspects of your physician job search can you relax? Read on to learn more.

Show me the compensation

With mounting student loan debt, child care costs, and even thoughts of a well-deserved indulgence on many new physicians’ minds, it’s important to have a long term strategy when heading to the negotiating table. While some incoming junior physician’s salary may not be the stuff of your wildest dreams, consider the non-salary benefits. Comprehensive benefits— including employer matching retirement programs, education stipends, and family leave— may recoup a lower initial salary, if you know to negotiate for them.

First time physicians should always keep in mind that negotiations do not stop after signing on to a new position. Many physicians leave a lot of money on the table by not re-negotiating their compensation a few years down the line. Always read the fine print of your contract, and ensure that the subject can be broached a year or two down the line. At this point, you’ve likely shown your worth to your employer and should feel confident justifying your pay increase.

As physicians, it’s up to us to remain aware of the average compensation in our specialties and geographical areas. That way we won’t price ourselves out of a job market, or accept compensation that doesn’t align with the value of the care we provide.

Location, location, location

There are a number of reasons that you may be eyeing a particular city or region for your first physician job. Many new physicians cite family obligations, their love of a particular area of the country, or a desire to have access to a particular patient population. However, few of us are alone in our preferences; many other new graduates will have their eyes on the same prize, especially if the job is located in a popular city or suburb.

Unless there is absolutely no wiggle room, many new physicians will need to cast a broad net, or come to terms with sacrificing a number of priorities for an ideal location. Sought after locations often come with lower salaries, higher cost of living, and intense competition from other physician groups and university medical centers.

Many of us may be pleasantly surprised by the amenities smaller towns and more rural locations have to offer, especially if you can convince family members of their charm. Consider negotiating a position for a spouse if he/she works in the health care field and visit with your family to get their buy-in. At the very least, remember that a host of amenities are (at most) a couple hours’ drive away. Ultimately, you may find yourself a better competitor for the large city jobs a few years down the line after you’ve gained some experience.

Finding “just right”

Some graduating residents may be drawn to large practice groups, and others to small. However, there can be much more to a group size than meets the eye. While a large multi-specialty group may seem impersonal and stifling to some, as a new physician, you may be primarily working in ancillary locations where you practice in a small office or in a community hospital. On the other hand, taking a position in in a small practice can feel more expansive if the group collaborates regularly with other practices in town or contracts with a large medical center.

When I started my first physician job in a rural setting, I sought out physicians with deep roots in the community to get a better feel of the practice area. These physicians ultimately became mentors, who were able to guide me through the steep learning curve that is the first few years of practice. In other words, don’t write off an opportunity on size alone; instead think outside the box to determine if the practice is flexible enough to fit your unique needs.

When flexibility is over-rated:

While flexibility is important in choosing your first physician job, by no means you should you let go of the essentials characteristics that define your job search.  One area to remain firm is the culture of your group. You will be spending countless hours in your new physician job and it’s crucial that the time does not quickly contribute to burn out.

Monitor how your physician colleagues are treated. Is there adequate support staff to help manage and streamline patient care? Is there room for physician growth within the practice and opportunities for mentorship? Does the group put time and money— not just platitudes—into continuing education and quality improvement initiatives?

Ask to speak with current physicians in the group, and if possible, physicians who have left the group to get a better sense of the work culture so you can make an informed decision.

Learn to bend, but don’t break

As the saying goes, the enemy of good is better. There are numerous physician jobs out there that could be an excellent fit. Don’t let rigid ideas of perfection limit your ability to see the gems that could be right in front of you. Be flexible to find your first physician job!