Predictors of physician employment satisfaction and turnover

Medical students and residents are woefully unprepared to choose the right job after completing their training. Career planning and transitioning is part of the hidden curriculum.

Here are the 6Rs of career planning and transitioning.

The result is that 50% of graduating physicians leave their first job within 2 years at a cost of up to $1M in direct and indirect costs to the employer.

Instead, career planning and transitioning should be a mandatory offering to students and residents.

Here are 10 numbers illustrating the state of the physician workforce:

1. The U.S. could see a shortage of up to 86,000 physicians by 2036, according to a report from Association of American Medical Colleges.

2. Optum is the largest employer of physicians in the U.S., with almost 90,000 employed or affiliated physicians.

3. Around 71,309 physicians left the workforce from 2021 through 2022, according to Definitive Healthcare's analysis of medical claims, which is 6% of the overall workforce.

4. More than 77% of U.S. physicians are employed by hospitals, health systems or corporate entities, according to an Avalere study sponsored by Physicians Advocacy Institute.

5. From 2022 to 2023, the percentage of employed physicians grew by 5.1% — with 19,100 physicians becoming employees of hospitals or corporate entities, according to the Avalere report.

6. As of Jan. 1, physician practice ownership by corporations, which includes payers, private equity firms and large pharmacy chains, hit 30.1%, surpassing ownership by hospitals and health systems for the first time.

7. Younger physicians in particular, many of whom are facing higher debts and a more unstable workforce, are looking to employment. A total of 85% of physicians 40 and younger work for an employer, according to Medscape's 2023 "Young Physician Compensation Report.

8. Around 26% of physicians are considering leaving their primary roles as physicians to pivot to nonclinical careers, according to Medscape's "Physicians and Nonclinical Careers Report 2023."

9. Forty percent of active physicians in the U.S. will be 65 or older in the next 10 years, according to a 2021 report by the Association of American Medical Colleges.

10. Fourteen percent of male physicians and 16% percent of female physicians said their burnout is so severe that they are considering leaving medicine, according to Medscape's "Physician Burnout & Depression Report" for 2024.

The predictors of first job physician satisfaction are:

1. Burnout during medical school and residency
2. Specialty choice satisfaction
3. Financial and debt status
4. Organizational culture and fit
5. Employed v independent practice
6. Job search platform performance
7. Rural v urban site selection
8. Red v Blue state selection
9. Perks and benefits
10. State based employment rules and regulations e.g. restrictive covenants
11. Family support and agreement with decision
12. Available non-clinical career or intrapreneurial opportunities

Not providing students and residents with the knowledge, skills, attitudes and competencies they need to achieve career satisfaction and success is educational malpractice.

The American Medical Association launched a five-year, $15 million grant initiative aimed at improving residency training, including projects supporting emerging technologies. It's time for the 7th competency:

Medical Practice Entrepreneurship: Residents must be able to demonstrate they can deliver state of the art care using a valid business model

We can do better.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack