Physician Employment Is A Great Option
I have been an employed physician for over 20 years. Having started out in private practice, I made the change in order to simplify my life. At the time, I had two small children and my wife was fighting breast cancer. Focusing on taking care of patients, and collecting a benefit-loaded paycheck every two weeks was a quick and easy way to reduce complexity in my life.
It was a great choice, and I still work for the same hospital employer. They are my preferred organization to align within my community.
As physicians, we get to choose the healthcare team jersey we want to wear. In contrast to the medical school and residency match process, our lives as attending physicians are marked by the professional freedom to move about the world with little restriction.
Honeymoon Is Over
However, nearly 10 years ago, progressive employment and healthcare economy changes began to intrude in my idyllic primary care world.
The aggressive interjection of 3rd parties into medicine led to the erosion of control over my personal and professional worlds. There is a mesmerizing process that unfolds as the goalposts are gradually moved imperceptively by management. Most of us acquiesce for the good of the team, convincing ourselves that each step is the new normal. Professional growth and development seem to demand this adaptability. We tend to put our heads down and simply work harder.
The Slow Fade
We are conditioned to this mentality in our training. Adapt, work harder, and trust the process of professional development.
Sadly, for many physicians there is a slow fade associated with this process. We experience and accept an increasing loss of clinical autonomy, the fatigue of working hard every day, and the disempowering awareness that others control us.
We conform dutifully, collect our paychecks, and focus our attention on personal pleasures outside of medicine. Areas that we can control and which often provide meaning. This allows us to escape the pressures of medicine. But over time, even our personal life can become a victim to the time thief of medicine. Working at home after finishing patients at the clinic has become normative to too many physicians (thank you EMR’s).
We dream of regaining our freedom from this form of indentured servanthood.
Loss of Control
For me the last straw came when I was unilaterally asked to take a pay cut through a corporate contract restructuring process that did not take into account my individuality and fair market value as a physician. I was asked to sign or find a new job.
I believe many employed physicians can identify with feeling a loss of professional and personal autonomy which necessitates a need to make a change. Odds are either you or your spouse has thought it or said it.
Misery and Conversations
With the recent economic downturn, many physicians are having these thoughts and conversations in their homes.
But the thought of job change just seems too massive to undertake, so most of us shrink back into employed physician zombie-land believing that there are no good options.
Instead many choose to focus on the weekends, vacations, and time out of the clinic. You might even dream about retirement, rationalizing that your current high income is worth the misery. It seems to be a fair exchange for when you walk away from medicine and are set free to do what YOU want, when YOU want.
I believe physicians are meant for more than this sad compromise.
Looking for Solutions
Based on my personal experience, I believe you do have freedom restoring options available now, but you are simply unaware of them.
Thankfully when I hit this wall, I met with healthcare consultants to consider all my possibilities. They helped me to see beyond what I knew and opened the door to unseen opportunities.
The following is a summary of the options we discussed, and are the same options available to you:
1. Leave medicine altogether
This is a radical option, but provides a clean break for you.
2. Migrate to Private Practice
This option provides the maximum control over your professional world, but is becoming a shrinking option in a sea of 3rd parties who control healthcare.
3. Change Jobs
Finding a new employer who is better for your life is always an option due to the increasing physician shortage.
4. Become A Medical Contractor
Contracted physician work usually providers satisfying personal and professional boundaries that reduce the tension between home and work.
5. Employment Lite
This is a version of contracted professional services. In essence, you stay in your current position but switch out contractual terms to more favorably provide you personal and professional autonomy.
Employment Lite is where I migrated to and I love it.
Visually it looks like this illustration. It is called a Professional Services Agreement (PSA), but is known as an Employment Lite arrangement. It involves you forming your own Professional Corporation (PC).
Although it is lesser-known, I believe it to be a great fit for many physicians who prefer the safe harbor of employment.
It allowed me to do the following, and I suggest you consider it for the same reasons:
1. No job change
- I did not have to move, nor change my team jersey.
2. Invisible Transition
- My patients, staff, hospital, and peers were unaware of the transition, it was invisible to all except administration.
3. Restoration
- It restored autonomy to my professional and personal life.
4. More Dollars
- Without having to work harder or work more hours, the new structure increased my retained income and increased my retirement funding.
5. Professional Support[the_ad id=”471″]
- Outsourcing the work to an experienced agency was a wise move. I paid a comprehensive professional team to organize, create, and support the needed structure on my behalf. Building a structure to maximize my professional and personal worlds simultaneously led to unexpected positive synergy. Having a professional team to negotiate and support the transition during the conversations with my employer’s legal department added credibility and power as well.
6. Simplicity
- I simplified the ongoing management of my new work-home structure through an agency that took care of it all elements. No more need for separate legal, accounting, bank, insurance, investment, retirement sources. Now it was all in one location. Every team member worked in unison on my behalf.
If you are an employed physician who is tired of being controlled, I encourage you to consider these options but especially consider employment lite.
Dr Inc.
