Physician
Employment Trends
By Wendy
Abdo, Staff Writer, Pinnacle Health Group and
Michael P. Broxterman, COO, Pinnacle Health Group
Over the past twenty years, physicians generally have not had any difficulty in finding desirable employment. However, during the next several years, there will be important trends in the medical industry that will affect the careers and future earning power of most physicians practicing in the United States. Consequently, it will be important to keep these trends in mind before entering the job market in order to maximize your fullest potential.
A physician's purchasing power is dictated by such things as the supply of physicians in the industry, early retirement and its effects on the job market, the increased need for health care services, compensation and malpractice trends, increased volume of patients needing care, and the immigration issues surrounding foreign doctors. Additionally, the geographical region you practice in will also make a substantial impact on your purchasing power. By reviewing each trend, you can keep abreast of all issues affecting the medical industry.
Ten Important Trends to Keep in Mind
Trend
#1: Overall Growth of Physician Employment
According to the U. S. Department of Labor, in 2000, there
were approximately 598,000 physician jobs in the United States.
Seventy percent of these jobs were office-based practices
and 20 percent were hospitals-based positions. The rest worked
in government positions for such agencies as veterans' hospitals
and public health services. Their projections indicate that
overall physician employment is expected to grow about 10
to 20 percent by 2010 .
Trend
#2: Early Retirement
According to the American Medical Association, 38 percent
of physicians in the United States 50 years of age or older
plan to retire within the next three years. Why are these
physicians opting for early retirement? The primary reason
is frustration due to managed care regulations ; however,
doctors also retire early due to advancing age, disabilities,
or the wish to do something different with their lives.
Trend
#3: Growth Pains In The Suburbs
Today we have an increased need for health care services.
The fastest growing areas are the suburbs, which are situated
outside of major cities. People tend to move to these regions
because it offers them a reduced crime rate, less traffic,
better schooling, and lower living expenses while, at the
same time, provides them the opportunity of being closer to
the amenities of larger metropolitan areas. These communities
are growing at such an astonishing rate that they have an
immediate and desperate need for physicians. As these communities
continue to grow, we should expect a greater demand for physicians
in these areas. So expect more physicians to locate in the
surrounding outlying areas rather than within city limits.
Trend
#4: Physician Compensation
From 2000 to 2001, most physicians enjoyed increased compensation.
However, recent compensation trends reveal a leveling off
of physician compensation. Though tendencies in income will
vary depending on the specialty, overall compensation for
most physicians will remain the same except for in-demand
specialties, which will show an increase. According to an
MGMA report, a number of specialties experienced a decrease
in compensation in 2002 for the first time in several years.
Among these specialties were invasive and noninvasive cardiologists
who reported a lower income. Compensation for these physicians
had declined by 6.17 percent for invasive cardiologists and
3.9 percent for noninvasive cardiologists.
Trend
#5: Malpractice
Malpractice lawsuits have increased in a number of states
and have influenced the way doctors practice. As a result,
some physicians have taken a volume approach to their work
as opposed to a consultative approach. Their goal is to increase
profit and keep costs down. Ever rising malpractice premiums
cause many physicians to relocate to states with lower premiums.
Other doctors consider revising their list of medical services
that they offer to patients. Residents and young doctors respond
to this problem by steering clear of states that are threatened
by the malpractice crisis.
Trend
#6: Managed Care
Managed care is the result of increased pressures to reduce
health care costs, and this has had an adverse effect on doctors.
An ever-increasing number of Americans are being enrolled
in managed care plans through their employers, Medicaid, and
Medicare. An MGMA study found that 56 percent of physicians
listed managed care as their biggest frustration. Rather than
hiring an additional physician to compensate for an increase
in patients, existing doctors must see more patients to make
up for their reduced income, which puts greater demands on
them.
Trend
#7: Foreign Doctors
Immigration issues are also an important factor in the medical
industry. United States medical schools are limiting student
enrollment, as foreign-trained doctors have significantly
increased the number of physicians working within the United
States. Some experts believe that this trend will lead to
an oversupply of physicians. However, these doctors are often
willing to practice in underserved areas such as rural America
and inner city locations where there is a corresponding need
for physicians.
Trend
#8: Quality of Life
Physicians continue to choose specialties that enable them
to have a higher quality of life. What specific activities
constitute a higher quality of life? While each physician
is unique, a dominant trend is that doctors are seeking more
free time to spend with family and friends and in other recreational
pursuits. According to an article in Medical Economics Magazine,
some young doctors have taken significant pay cuts to work
for community health centers rather than tackling the more
time-consuming demands of private practices. As younger physicians
move into the medical industry, expect quality of life to
become an ever-increasing consideration.
Trend
#9: Maldistribution
Many rural and inner-city communities see increasing physician
shortages. In a study done by COGME, top reasons for this
geographic maldistribution of physicians include professional
isolation in a non-collegial setting, income reduction due
to increased number of uninsured in area, lack of physical
and cultural amenities, and the difficulty family members
face in finding employment in the underserved community. Unless
these issues are addressed, physician maldistribution will
continue to be a problem.
Trend
#10: Physician Turnover
Residents and doctors are changing jobs more often in the
search for better opportunities. According to recent studies,
over 10 percent of the physician workforce change jobs annually.
Why? Some top reasons include professional dissatisfaction,
tightening controls in how they practice medicine, and diminished
job security. As job change becomes more of a standard practice
in all industries, this will also affect the medical profession,
especially with immerging young doctors and residents.
Overall, the supply of physicians is tightening, job opportunities are increasing, and job attractiveness is decreasing. As the market acclimates to these changes, expect to see a continual demand for physicians and a difficulty in recruiting the right person for the right opportunity, especially in smaller towns.
These
issues are just a few of the many factors involved in the
future outlook of physician employment trends. It is vital
that physicians and residents are aware of up-and-coming developments
that will influence their future. Medical students, in particular,
need to periodically review annual surveys and significant
trends in the industry that will aid them in making informed
decisions on their choice of specialty and give them essential
facts pertaining to the best geographical locations to practice
in given their background, skills, and compensation requirements.
_____________________________
1 U.
S. Department of Labor. Bureau of Labor Statistics. Retrieved
October 22, 2003, from
http://www.bls.gov/oco/ocos074.htm.
2 American Medical Association. Physicians enticed into early
retirement. Retrieved September 11, 2003, from http://www.ama-assn.org/sci-pubs/amnews/pick_00/prl20724.htm.
3 Physician Spring. Physician Employment Trends. Retrieved
September 11, 2003, from http://www.physicianrecruiting.com/trends.shtml.
4 Medical Group Management Association. Physician compensation
increases nominal in 2002; Some specialties report declines.
Retrieved September 11, 2003, from http://www.mgma.com/press/phycomp03.cfm.
Physicians Weekly. Physicians To Americans: Liability Crisis
is Affecting Care. Retrieved October 14, 2003, from 5 http://physweekly.com/article.asp?issueid=60&articleid=517.
6 The Commonwealth Fund. Health Care Coverage and Access Program
Picker/Commonwealth Program on Health Care Quality and Managed
Care. Retrieved September 11, 2003, from http://www.cmwf.org/progsumm/coverage.asp.
7 AAMC Newsroom. Reporter: Treating Physicians' Career Woes.
Retrieved October 14, 2003, from http://www.aamc.org/newsroom/reporter/july2000/woes.htm.
8 Center For Immigration Studies. Foreign-trained doctors
swelling ranks in U.S. Retrieved September 11, 2003, from
http://www.cis.org/katz1999.html.
9 Medical Economics Company. Medical Economics Magazine: Young
Doctors Face a Steep Climb. Retrieved October 14, 2003, from
http://www.findarticles.com/cf_0/m3229/16_78/78401578/p1/article.jhtml?term=+Physicians++Finance.
10 Council on Graduate Medical Education (COGME). The Council
on Graduate Medical Education 2002 Summary Report to the U.S.
Congress and the Secretary Department of Health and Human
Services. Retrieved October 14, 2003, from http://www.cogme.gov/2002summary.htm.
11 HealthLeaders. 5-Minute Consult. Retrieved October 14,
2003, from http://www.healthleaders.com/magazine/feature1.php?contentid=35884&CE_Session=46f2128bef48eb3712891b78100187dc.
