The Satisfaction of Employed and Self-Employed MDs

More and more physicians are being forced to decide whether they should stay self-employed in private practice or become an employee. While there are clear downsides to both, each position offers its own benefits that some physicians prefer.

After surveying more than 4,600 employed and self-employed physicians, Medscape learned that job satisfaction is about equal among both parties. More than half (52%) of surveyed self-employed physicians had been previously employed, but only 29% had been previous owners or partners.

For those who made the switch one way or another, about 70% of physicians who left employment for self-employment are happier now. Only 9% who went to self-employment are unhappier now. About half of physicians who left self-employment for employment are happier now, and about a quarter are unhappier now.

After switching to employment, 56% of previously self-employed physicians said their work-life balance had improved.

While more female physicians are more employed than self-employed, the reverse is true for males. Sue Cejka, managing partner at Grant Cooper Healthcare, noted this was more due to age than gender—there are more female doctors in the younger age category. More than twice as many physicians under 40 are employed versus self-employed. In the over-40 age group, more physicians are self-employed, according to Medscape.

According to survey comments, while some doctors made the move to employment willingly, others were forced into it because they were going broke or their physician group was bought out. The chief reason physicians sought employment was financial challenges of private practice (38%). Other reasons included not having to worry about billing, office management, and administrative issues (29%), and working shorter, more regular hours (19%).

Employed doctors said the major benefits of employment included not having to run the practice (58%) and eliminating aggravation of billing and collecting payments. Guaranteed income was also in the top 3 for many surveyed.

Of the top 6 reasons doctors gave for disliking their employment, 5 involved the loss of autonomy. Physicians cited reasons like loss of input into management decisions, being let go at any time, and no control over hiring and firing administrative staff.

Half of employed physicians reported being satisfied with their incomes while 22% were unsatisfied. Another 46% said their satisfaction increased when they went from being self-employed to being employed. Satisfaction reflected either a higher income, more regular income, or the fact that doctors had to do less work for the same income.

Slightly more than half (53%) of physicians who were previously self-employed felt that patient care was superior now that they were employed, while 37% felt it was about the same.

A majority of physicians are planning on staying put with just 11% reporting they plan to make a change. And 38% said they may change their job situation, but it was possible they’d make peace with it and remain in the current status.