Jackson Physicians

How to Navigate Your Physician Job Resignation

Sun, 01 Oct 2023 17:56:03 GMT

Every year, approximately seven percent of physicians resign for a variety of reasons. They move to a new physician job with higher earning potential or for growth opportunities; they relocate to be closer to family; they accept a physician job with better hours or lower stress. Whatever the reason, physicians may struggle to tell their supervisor and peers of their decision during these times, as a physician vacancy can create more work and challenges for those remaining at the organization until a new physician is recruited in their place.

Overall, the process of resigning can be awkward and difficult to navigate. As Vice President of Recruitment for Jackson Physician Search, Midwest Division, I often speak with physicians who have recently given notice or plan to resign as soon as they have an offer. The following are steps I always remind them to consider.

Know Your Physician Job Contract

First, know your obligations to your current employer. In fact, you should revisit your physician contract before you even begin looking for a new physician job. A strict non-compete clause or salary/bonus repayment requirements may significantly impact the geography or timeline of your physician job search. For example, I worked with one Gastroenterologist in St. Louis whose non-compete terms severely limited his options in the city. Yet, he was unwilling to relocate his young family. Because he knew the strict terms of his contract, we were able to think outside the box and find him an opportunity based in the satellite office of a St. Louis employer – just outside the non-compete radius. His employer was sorry to see him go but remained on good terms because he adhered to the contract.

Another factor is the potential repayment of your guaranteed salary or bonus. The contract likely specifies that if physicians leave before working to meet the salary guarantee, they are responsible for paying some portion of it back. If you have not yet met these marks, you may want to consider holding off on your resignation.

Provide Ample Notice and Deliver the News In-Person

Physicians should provide at least as much notice as their contracts require, but 90 days is best practice. Hiring a physician can take up to a year or longer, so the more notice you provide will help your current employer better prepare for your absence.

You will need to compose a letter of resignation that documents your decision to leave and your expected last day of employment. While this serves as your formal notice, it should be delivered in a face-to-face meeting with your supervisor after you verbally share the news. Disclose your decision respectfully and express gratitude for all you have learned from the opportunity. If asked, it is okay to be somewhat transparent about your reasons for leaving without becoming emotional or pointing fingers. Save the details for an exit interview and offer cooperation in whatever capacity is needed as you prepare for your departure.

Preserve Relationships

Ask your supervisor for guidance on how to share the news of your departure. He or she may want to make the announcement or leave it to you to deliver the news as you see fit. Make sure you also have clear direction on if and how to notify patients of your impending departure. Be careful not to ask or encourage patients to visit you at your new place of employment. Physicians will most likely be instructed not to disclose any information about the new employer.

Other physicians and staff may have their own feelings about your resignation, but do your best to stay positive. Be cautious not to speak negatively about your current employer or dwell on your reasons for leaving. Ensure your peers know you have enjoyed working with them, and if desired, make a plan to stay in touch.

Continue to give 100% throughout your notice period, and make sure you are available to ease the transition process, whether training your replacement or providing your supervisor with a comprehensive list of your responsibilities. Your behavior in your final weeks of employment will be how you are remembered, so take care to do your best, be respectful, and preserve the relationships you have built.

Enjoy the Physician Job Journey

A physician’s career will likely involve several professional moves. While it can be challenging to move on, it is often a necessary step for job satisfaction and professional development. Your employer will likely be disappointed to learn of your decision to leave, but this doesn’t mean the bridge is burned. As long as you adhere to the terms of your contract, respectfully disclose the news, and remain helpful as you work out your notice period, you can move on with the knowledge that you have done everything in your power to leave on good terms, filled with gratitude for this step of your professional journey.

Whether you have already given notice or are contemplating doing so, the team at Jackson Physician Search can help you navigate the process of finding a new opportunity. Reach out to a recruiter today or start searching physician jobs online now.

About Tara Osseck

With more than 15 years of experience in the healthcare industry, Tara Osseck specializes in matching healthcare organizations with physicians who are a strong fit for the role and the culture. Her healthcare career began as a physician liaison. It quickly expanded to include physician recruitment, strategic planning, and business development, working for various hospitals throughout Memphis, Tennessee, and St. Louis, Missouri. Based in St. Louis, Osseck leads the firm’s Midwest Division, placing providers across the Midwest and Upper Midwest. She earned a bachelor’s degree from Truman State University and a master’s in health care administration and management from The University of Memphis.

Fact or Fiction? 4 Assumptions About Rural Physician Jobs

Tue, 06 Jun 2023 22:06:12 GMT

Demand for physicians in rural areas has never been greater. According to the AAMC , 20% of the US population lives in rural areas, but only 11% of physicians work there — and that figure is likely to decrease. Due to a projected increase in physician retirements , the number of practicing rural physicians will decrease by 25% by 2030. Additionally, the number of medical school students from rural areas is steadily declining, meaning the group most likely to practice in rural areas is shrinking.

As the Regional Vice President of Recruiting for Jackson Physician Search, Western Division, I often speak to physicians who are hesitant to consider rural practice opportunities. They have preconceived ideas about what life in rural medicine may be like, but the reality is not necessarily what they assume. In most cases, rural physicians earn competitive compensation, have a healthy work-life balance, and experience greater autonomy than their urban and suburban counterparts. They also have an opportunity to make a real difference in the lives of patients, who often have limited access to healthcare.

Keep reading to find out if some common assumptions about rural physician jobs are fact or fiction.

Rural vs. Remote Physician Jobs

Before addressing the common assumptions about rural physician jobs, it’s important to note that the term “rural” can be defined in a number of ways. The Health Resources and Services Administration uses a combination of definitions to determine which organizations are eligible for rural health funding. A community with a population below 2,500 is considered rural, but rural can also describe a town with up to 49,999 people if the area is not attached to a larger metropolitan area.

It’s important to understand the definition of rural that is being used when discussing rural physician jobs, as the opportunities and challenges of working in a rural setting can vary depending on which definition of “rural” is being used. For example, a “rural physician job” might refer to a family medicine physician serving as the sole provider for a remote community of 2,000 people. However, it might also refer to a general surgeon at a regional hospital in a town of 30,000. While both of these are “rural physician jobs,” the lives of each physician will be considerably different. Often, the fears physicians have about rural jobs may be legitimate concerns in smaller, remote areas but are less likely to be true in other rural communities.

Assumption #1: Lack of Amenities in Rural Physician Jobs

One of the most common concerns I hear from physicians about practicing in a rural setting is that they will not have access to the same amenities they are used to — good schools, popular stores, quality restaurants, etc. While these things may be harder to come by in truly remote locations, many rural communities have a variety of popular chain stores, restaurants, movie theaters, and public and private schools. However, it is true that some rural communities may not have as many options as urban areas.

On the other hand, rural communities often make up for not being as commercialized with outdoor recreation and beautiful scenery. Many nature enthusiasts find rural physician jobs ideally situated near parks, rivers, mountains, etc., which are perfect for fishing, rafting, hiking, or skiing.

Fact or Fiction? While there may be some truth in the assumption that rural communities have fewer amenities, it largely depends on the size of the community, proximity to other towns, and availability of transportation, i.e., an airport. It is important to do your research and visit the community before making a decision about whether to work there. Many times, physicians considering rural opportunities are surprised by the variety of options for shopping, dining, entertainment, and education.

Assumption #2: Rural Physicians Never Get a Day Off

Physicians are often concerned that, as the sole provider of care in the community, they will work around the clock. The truth, however, is that rural physicians often have better work-life balance than urban physicians. A joint rural physician recruitment study from Jackson Physician Search and LocumTenens.com reported 46% of rural physicians said “improved work-life balance” was one of the top factors influencing their decisions to work in rural medicine.

In most rural jobs, call is shared among multiple physicians. Even in remote areas where one physician may be the sole provider of care, administrators recognize the need to provide support in the form of an advanced practice provider or locum. Regardless, physicians should review the contract and confirm there is a limit to how many days per month they are expected to be on call.

Fact or fiction? This assumption is largely fiction. Rural physicians often work at a slower pace, see fewer patients per day, and have more control over their schedules. Preventing burnout is a high priority for rural administrators, so they usually do whatever is needed to ensure physicians have a healthy work-life balance.

Assumption #3: Rural Physicians Have a Broader Scope of Practice

Physicians often correctly assume that practicing in a rural setting means they must be comfortable providing a wider range of services than they might see in an urban setting. Rural physicians are often the first point of contact for patients of all ages dealing with a wide variety of medical issues. In an urban setting, a provider might be quick to refer patients to a specialist for specific conditions. However, in a rural setting, there may be fewer specialists available, so rural physicians must be able to treat a wider range of conditions.

This can be a challenge, but it also presents an opportunity for rural physicians to gain experience and expertise in a variety of areas. Rural physicians must be able to think critically and make decisions on their own without the benefit of immediate access to specialists. They must also be able to work closely with patients and their families to provide comprehensive care. As a result, rural physicians often have closer relationships with patients and their families. They may have more opportunities for community involvement and a greater ability to make a real difference in the lives of their patients.

Fact or fiction? This truth about rural medicine presents a growth opportunity for physicians at any stage of their careers. Because there are fewer specialists in rural areas, primary care physicians practice at the top of their licenses, which would be less likely in an urban setting.

Assumption #4: Compensation is Extreme in Rural Physician Jobs

Ideas about rural physician compensation vary, but they tend to be extreme. Some have heard about huge bonuses and loan repayment and think all rural physician jobs come with big compensation packages. Others tend to think that, without the high volume of patients seen by urban physicians, rural jobs won’t have the same earning potential. In this case, the truth lies somewhere in between.

Indeed, many rural jobs come with sweeteners such as signing bonuses, housing assistance, or loan repayment. Rural health organizations are eligible for government-funded grants that can be used for these purposes. Additionally, individual physicians may also be eligible for government-funded loan repayment programs when they work for qualifying organizations.

As for patient volume and income potential, this can vary depending on a number of factors. Volume may be lower, but rural physicians have little to no competition for patients. According to a 2022 study by the Medical Group Management Association , the median annual compensation for physicians in rural areas was $207,210, compared to $200,000 for physicians in urban areas.

Fact or fiction? The idea that rural physicians always earn significantly more or less than physicians working in metro areas is fiction. However, overall, rural physician compensation is competitive with urban physician compensation. In addition to higher salaries, rural physicians may also be eligible for recruitment incentives such as large sign-on bonuses, housing assistance, and loan repayment. When you consider the lower cost of living in rural communities, the overall financial picture for rural physicians is very attractive.

The Rewards of Rural Physician Jobs

Practicing rural medicine is not without challenges; however, the rewards may carry more weight. Rural physicians often earn higher salaries, enjoy a better work-life balance, and experience more autonomy than their urban and suburban counterparts. They also may feel more professional fulfillment as they are stepping up to provide care in the communities that need it most.

If you are interested in learning more about the challenges and rewards of rural physician jobs, the recruitment team at Jackson Physician Search is eager to assist. Reach out today to learn more, or start searching for rural physician jobs online now.

About Helen Falkner

As the daughter of a physician, and an Iowa native, Helen has witnessed firsthand the impact that a great physician can have on a community. She joined Jackson Physician Search at the company’s headquarters in Alpharetta, GA, as an entry-level Research Consultant in 2012. Through her consistent success as both an individual contributor and manager, Falkner progressed quickly to Partner in 2018 and assumed her role as Regional Vice President of Recruiting for JPS’s Western Division in October of 2020. In January 2021, she relocated to the firm’s Denver office and leads a team of successful physician recruiters while actively continuing to recruit for her clients.

Physician Compensation 101: What Residency Didn’t Teach You

Mon, 04 Apr 2022 08:21:48 GMT

Show me the money. While most physicians don’t go into medicine solely for the high compensation, the six-figure income doesn’t exactly hurt. That said, physician compensation can range significantly depending on a number of factors. A physician’s specialty obviously impacts income, as does geographical location, but what many residents don’t know is how the different types of physician compensation models can also influence income.

Residents spend years learning their profession, but when it comes to getting paid, many have no idea what to expect. Sure, they may have seen average salaries referenced online or heard their attendings talk about what they earn, but as for what part of the compensation is guaranteed versus what is based on production or a percentage of profits–these details aren’t typically shared.

The complexities of physician compensation models could be covered by a semester-long class in medical school. Instead, it is often left to physician recruiters to explain the various nuances of how a physician gets paid–perhaps while presenting a resident with their first offer of employment!

So, in an effort to introduce the concepts earlier in the physician job search process, we present to you this primer on the two primary physician compensation models.

Hospital Employed Physician Compensation Model

According to a 2021 report from consulting firm Avalere Health, 69% of working physicians are employed by hospitals or other corporate entities, a figure accelerating significantly as a result of the COVID-19 pandemic. These physicians, when first hired by a large healthcare organization or hospital group, typically receive a guaranteed base salary for a set time period (one or two years) and then, presumably after the physician has established enough patients to be productive, compensation shifts to a productivity-based model.

Productivity is measured using wRVUs (work Relative Value Units) which are accrued for every exam or procedure a physician performs. The Centers for Medicare and Medicaid Services assign an RVU for each Current Procedural Terminology (CPT) code. The more complex the procedure, the greater the corresponding wRVU.

Accrued wRVUs are multiplied by an established dollar amount to calculate how much a physician earns. Some compensation plans offer a sliding scale to incent physicians to accrue more RVUs, that is, to be more productive. For example, the first 4,000 wRVUs are paid at a conversion factor of $40 per RVU, and then, the next 4,001-8,000 wRVUs are paid at $42 per wRVU. The amount employers will pay per wRVU varies, however, Medicare sets the amount they will reimburse per total RVU (total RVU takes into consideration an organization’s expenses and insurance), which is typically lower than what is billed to private insurance. For 2022, the Medicare rate per total RVU is $33.59.

Are you starting to see why a course in med school might be necessary to fully understand physician compensation models? In lieu of that, you can find further details in this Definitive Guide to Physician RVU Compensation from the advisory group Physicians Thrive.

As most physicians are employed by large health systems or hospital groups, it is worth digging into the nuances of wRVU compensation models, but at a high level, here is what you need to know.

Pros

The salary guarantee offers stability for new physicians and alleviates the pressure to ramp up in an unreasonable amount of time.
Productivity-based compensation gives physicians a sense of control over their income. The harder they work, the more income they will receive.
RVU compensation is typically not impacted by how much or how little the organization is able to collect from patients or their insurance companies. The payer mix also does not impact the physician’s income.

Cons

wRVUs do not account for time spent on administrative work, meetings, mentoring other physicians, and other tasks without a CPT code.
RVU-based compensation can create a culture of competition that prevents physicians from collaborating and supporting each other.
Productivity-based physician compensation puts a physician’s focus on the quantity of procedures rather than the quality of care. Some reports suggest this type of compensation is at odds with the movement toward Value Based Care.

Questions to Ask

Is the salary guarantee a minimum base or is it also a cap? That is to say, if a physician exceeds wRVU expectations during the guarantee period, can they receive more than the base salary?

How many wRVUs do most physicians in this practice produce? How does the productivity of physicians here compare to national norms?

Is there a cap on RVU bonuses?

Private Practice Physician Compensation Model

“While the percentage of physicians in private practice is waning, it is still an attractive option for many residents, especially those with an interest in business or those who simply want more autonomy in their work,” says Director of Recruiting Katie Moeller. Like hospital-employed physicians, physicians hired by a private practice may also receive a salary guarantee, but the expectation is that the physician will eventually become a partner whose income will be largely tied to the performance of the overall practice. For this reason, physicians want to be sure they are joining a practice that is financially viable.

Private practices, like any business, calculate profitability by deducting expenses from revenue. Profits are then distributed among the partners, perhaps with some percentage paid as bonuses to non-partner physicians.

When interviewing for private practice physician jobs, physicians should look beyond the initial salary offered and focus on the specifics of the track to partnership and the details of how the practice is run, including its expenses. The efficiency of the practice has a direct impact on how much the partners earn, so it is important to ask questions.

Pros

Physicians in private practice have a clear view of the factors contributing to their income, that is, the revenue and expenses of the practice. Once a partner, the physician will have some role in influencing those factors in order to increase income.
Unlimited income potential. Employed physicians are limited to the hospital’s bonus structure, but as a practice owner, you have the ability to grow your business to the level you need to achieve the income you want.

Cons

Research shows that Medicare reimburses physician services billed by hospitals at a higher rate than those billed by independent practices. This is one of many reasons hospitals can afford to pay higher starting salaries.
Because Medicare reimburses at a lower rate than private insurers, the practice’s patient mix will impact its profits, and thus, partner income.
Practicing medicine is already a stressful job. Physician partners in private practice have the added stress of running a business.

Questions to Ask

As noted, physician compensation will be tied to how well the practice performs, so ask enough questions to gain a full understanding.

How busy is the practice? What is the patient mix?

How effective is the billing department in collecting payment?

What are the overhead costs? How are staff levels determined? What salaries are given to administrators?

What can I expect to earn as a partner? Are there any opportunities for ancillary income, such as investing in an outpatient surgery center, real estate, or imaging? Is there a “buy-in” cost associated with becoming a partner?

Do all physician owners hold equal shares in the business?

Is there an accelerated track to partnership?

Are the partners currently considering selling to a hospital or corporate entity?

Why You Should Do Further Research on Physician Compensation Models

As residents and fellows enter the physician job search, it is important to have an understanding of physician compensation models. You have invested considerably in training to become a physician, and now that your training is complete, you are more than ready to reap the rewards. However, it can be difficult to weigh employment offers if you don’t have a clear understanding of how physicians are compensated beyond those first years when a minimum is likely guaranteed.

A good physician recruiter has invaluable insight to share with you regarding physician compensation. Physician recruitment firms often have access to proprietary data about physician compensation, bonuses, production, benefits, and time off. They can help you interpret this data to better understand what you can expect depending on your specialty, location, and other circumstances. Physician recruiters can also share what trends they are seeing in the market that may not yet appear in the data.

A physician recruiter can provide a wealth of information to better set your expectations in the beginning and more effectively negotiate your physician contract as your search comes to a close. The more information you have, the more confident you will feel when ultimately making your decision.

If you are embarking on a physician job search, the team at Jackson Physician Search is eager to share our insight with you and ensure you are set up for success. Search physician jobs now or contact us today.

Timeline of a Resident’s Job Search

Sun, 14 Mar 2021 08:21:48 GMT

If you are among the group of future physicians entering or already in residency, the fast-paced, all-consuming nature of it can leave you with little time to think about where all your hard work is leading — or, more importantly, where you want it to take you. Therefore, residents must make the first physician job search an ongoing priority to ensure the light at the end of the residency tunnel is a destination of your own choosing.

So, do new residents need to start the job search tomorrow? Most recruiters will advise residents to begin their search 12-24 months before completing training. However, starting early may improve the odds of finding a job in which you will want to stay. Studies show that half of all physicians leave their first jobs within five years, and half of that group leaves during the first two. If residents stick to the following timeline (based on a three-year residency), they will surely find themselves with more choices than they would have otherwise. It also means they will have ample time to learn what they ideally want from an employer and find a job that meets those needs.

Resident Job Search Tasks in the First Year(s)

Pre-assess the Physician Job Market

For new residents, the first step in a physician job search is simply researching the market. Anyone with an eye on healthcare headlines knows that staffing shortages continue to plague the industry. While some regions struggle more than others, physicians and other healthcare providers are in high demand nationwide.

This knowledge should give you confidence about your future physician job search (and future job security). However, this doesn’t mean the physician job search is easy or that circumstances are the same for every specialty and in every location. They are not. A recent report from Jackson Physician Search uses our 2022 placement data and observations from several recruitment leaders to identify physician hiring trends in the marketplace. According to the report, primary care physicians see the greatest demand, along with specialists who are willing to treat broad panels of patients. Rural healthcare organizations have more urgent needs than organizations in urban and suburban areas.

Of course, we may see trends shift slightly or change altogether before you move on to the more active stages of your search, but now is the time to find credible sources on the subject and start paying attention.

Identify Your Priorities

Now is the time to consider what matters most in your first physician job . Compensation and location are obviously important, but where does work-life balance fit in? What about culture, the scope of practice, and growth opportunities? Of course, you want it all, but you need to consider where you are willing to compromise. Talk to attending physicians about their lifestyles and what they like and dislike about their jobs. What are the things they wish they had known when they were searching for their first physician jobs?

Reach Out to a Recruiter

Introduce yourself to a respected physician recruiter and ask them what to expect in each stage of the search. He or she can provide details on a typical job search timeline for your specialty and answer questions about the physician interview process, physician compensation models , or physician employment contracts .

If you have determined that location is a priority, ask the recruiter about the job market in your preferred city. If you have any special circumstances, such as a visa requirement or a physician spouse who will also be applying to jobs, share this with the recruiter and ask for advice. Physician recruiters are usually happy to connect with residents and answer questions about what lies ahead. Don’t hesitate to reach out — by phone, email, or LinkedIn — and ask for advice.

Resident Job Search Tasks in the Second Year

Browse Physician Job Boards

You may not be ready to apply to physician jobs just yet, but it’s a good time to start browsing physician job boards for jobs in your specialty in the locations of interest to you. This helps you to assess the market and set realistic expectations. Set up job alerts for jobs matching your specific search criteria. If a job or employer seems particularly perfect — and your specialty is in high demand — it may be worth sending the recruiter an email expressing interest.

Gather Documents

Before you begin applying to physician jobs, you need a polished CV, a targeted cover letter (that will be tailored to specific jobs), and a list of professional references who have agreed to serve as your reference. Once you have these three things prepared and perfected , you are ready to start actively applying for physician jobs.

Resident Job Search Tasks in the Final Year

Reconnect with a Recruiter

Now is the time to reconnect with any recruiters you may have introduced yourself to over the years. Let him or her know that you will complete your training in 12 months and are actively searching for a job. Talk to them about what you are looking for, and be clear about what is a must-have versus a nice-to-have. Be open to his or her feedback. If they suggest a location or type of organization you had not previously considered, it is likely because it aligns with what you have said is important to you. Keep an open mind.

Browse and Submit

Remember those job alerts you set up last year? It’s time to start paying attention. Tweak your search parameters if needed, and when a job arrives in your inbox, that seems to match 70% of what you want, go ahead and express your interest. By applying, you are not promising to attend an on-site interview; you simply agree to have a conversation in which you will learn more about the opportunity.

Attend On-Site Visits

Ideally, by the third or fourth month of your final year, you have scheduled or even attended several on-site visits with potential employers. You may have even found an organization that seems like a good fit. Make sure when you visit an organization, you have an opportunity to meet not only the administration but your potential colleagues as well. Look for red flags , and don’t be afraid to ask direct questions to reveal more about the organization’s culture. You’ll also want to explore the community, perhaps with a realtor, but also on your own. If dining and shopping are important to you, spend some time downtown. If you enjoy the outdoors, ask someone to direct you to the nearest park or popular hiking spots.

Understand Your Contract

When an organization extends an offer, you’ll want to work with your physician recruiter to understand and perhaps negotiate the terms. Before signing any physician employment contract , you may want an attorney to review it. You will address any concerns through your recruiter.

Licensing and Credentialing

Signing the contract feels like it should be the last step, and yet, it can take several months to obtain a medical license with the state, and then, you still need credentials for the specific hospital. The process won’t be labor intensive for you, but it will take time — time you must allow for when setting your job search timeline. Ideally, you are signing a contract in March if you hope to start your job in July.

A Resident’s Job Search Starts Today

Each resident will have a slightly different timeline than what is outlined here, but let this be a guide for the stages of your search, and if nothing else, take away this — it is never too early to begin your first physician job search. From the time you begin your residency, consider yourself in the research stage. Learn about the market, discover your own priorities, and ask questions of physicians in various stages of their careers.

If you are conducting ongoing job search research, you will likely know when it is time to begin the other job search tasks, such as reaching out to a recruiter, preparing your CV and other materials, and setting up an online job search. Those who know what to expect and are prepared for the search will ultimately have more options available to them and have a greater chance of finding a first physician job that meets their needs.

If you are in any stage of residency and have questions about what lies ahead, the recruiters at Jackson Physician Search would love to hear from you. Reach out today for insights about the market and what to expect in your search. We also recommend you download the Physician Job Search Playbook , and when you’re ready, start searching for physician jobs online .