physician business ideas - An Innovative Take on Doctor Recruiting

I was looking at a February issue of the New England Journal of Medicine. More specifically, I was scanning the Classified Advertising Section devoted to recruiting young doctors.

There’s a story here.. Here’s a countdown of number of ads run for each specialty

Number of Ads for Various Specialties

Internal Medicine 99
Cardiology 46
Internal Medicine- Hospitalist 44
Gastroenterology 24
Nephrology 17
Hematology-Oncology 17
Pulmonology 16
Infectious Disease 16
Family Medicine 14
Neurology 7
Pediatrics 7
Rheumatology 7
Primary Care 6
Psychatry 5
Geriatrics 4
Ob-Gyn 3
Emergency Room Physicians 3
Endocrinology 3
Radiology 2
Orthopedic Surgery 2
Anesthesiology 1
Critical Care Medicine 1
Dermatology 1
Occupational Medicine 1
Opthalmology 1
Pathology 1
Radiology Oncology 1
Transplant Surgeon 1
General Surgery 1
Urgent Care 1
Total 352

This list indicates,

• A high demand for primary care physicians – 177 of 352, or 50 %.

• Nearly as high a demand for medical sub-specialists -- 143 of 352, or 41%.

• A low demand for proceduralists and hospital-based specialists – ophthalmologists,
general surgeons, orthopedists, pathologists, radiologists, transplant surgeons, 7 of 352, 2%. This is surprising since hospitals, particularly these specialists, are purported to be in demand by hospitals.

• Only one ad for dermatologists, which I am told, is one of the specialties most in demand among medical students, because of its relatively high income, limited hours, no weekend calls, and low practice exposure -- might indicate positions for dermatologists are filled from within dermatology residency programs through personal networking.

What’s going on here? Is high demand for primary care because of lack of medical students entering primary care specialists? Are primary care doctors becoming hospitalists because hospitals have found hospitalists to be such a valuable commodity? Is there a shortage of medical specialists – or is the aging populations simply increasing the need for them? Do the proceduralists and hospital-based specialists already have job promises before completing their residencies? Perhaps it’s a little of all of the above.

In any event, to give this blog a more human quality, I’ve created a fictitious story of a young internist just finishing residency. I base this story on information from a “2006 Survey of Final Year Medical Residents “from Merritt, Hawkins, and Associates, the nation’s largest physician recruiting firm (merritthawkins.com.)

You’re 30 years old and in the final year of your internal medicine residency. It’s been long haul – college, medical school, residency, and fellowship – and you’ve grown weary of delayed gratification.

As a general internist, you’re in demand. You’ve received over 60 inquiries about job opportunities. But you’ve yet to accept any offers. You’ve investigated many opportunities on your own -- mostly through the Internet and personal networking – and to a much lesser extent in the advertising sections of medical journals.

You’ve spent most of this year weighing the job opportunities. Your top four considerations are geographic location, a good financial package, adequate call coverage, and loan forgiveness. As far as practice settings, you prefer a single specialty group, partnership, multispecialty group, or hospital employment – in that order. You would prefer to be in a community of at least 100,000 population. For you and overwhelming number of your other colleagues, rural or small town practice is not attractive.

You’d like to be paid on a salary with production, though a straight salary or an income guarantee aren’t out of the question. You expect compensation in the neighborhood of $125,000 to $175,000. but you’re told some or your internal medicine colleagues are pulling down $200,000. In any event, you need a decent income to help pay off your personal educational debt which is nearly $100,000.

You feel you are “very” prepared to handle the “business side” of your medical career – employment contracts, compensation arrangements, and other facets of employment. You’ve prepared through personal research and talking to your buddies. Your medical school offered a few courses in practice management and even an MD-MBA program, but you were disinclined to take them. You still consider yourself a physician, not a businessman.

Despite the demand for general internists, you worry constantly about finding a good job, earning a decent income, having free time available, and to a much lesser extent, about picking a locale where malpractice rates are low. Still, if you had it to do over again, you’d pick medicine as a career.

You know demand is growing for primary care in general, even two-thirds of your medical school classmates chose residences in surgical, diagnostic, or hospital-based specialties. As a well-trained general internist and primary care physicians, you know you have multiple options, such as becoming a sought-after hospitalists, you’re in a buyer’s market, and you’re optimistic about your future. All you really seek is a decent well-balanced life in an attractive city, with time off to enjoy your life, your wife, and your family. Is that asking too much?