Medical Residents and the “Business” of Medicine
By John Hawkins
Physicians, it is generally conceded, are typically scientists by temperament and training rather than businessmen or businesswomen. Their focus through high school, college, medical school, and residency training usually is math, chemistry, biology, anatomy and related scientific fields.
When they actually become practicing physicians, however, their world changes. They soon realize that medicine is part art, part science and, to an often unsettling degree, part business.
The business part begins when they must choose their first practice after training. According to Merritt Hawkins’ 2015 Survey of Final-Year Medical Residents, 44% of medical residents received some type of training or instruction regarding the business side of medicine in medical school or residency, but the majority (56%) did not. They therefore often are not well equipped to evaluate contracts, bonus structures and related business matters that are critical to evaluating a practice opportunity. The Merritt Hawkins survey referenced above indicates that 39% of residents are unprepared for the business side of medicine, while 51% are somewhat prepared and only 10% are very prepared.
What this often leads to is turnover, as residents realize too late that their first job selection after residency was not an appropriate one.
Merritt Hawkins’ survey indicates that the first factor residents consider when evaluating a practice opportunity is geographic location and the second is lifestyle. What can get left out of the equation are the nuts and bolts contractual issues of an opportunity, including schedules, number of patients to be seen, salary, relative value units (RVUs) and other bonus metrics, governance requirements and related matters that may dictate the quality of the practice. When misunderstandings or conflicts arise over these issues, newly trained doctors may seek greener pastures elsewhere.
For this reason, hospitals, medical groups, Federally Qualified Health Centers (FQHCs) and other facilities that recruit medical residents should take particular care to educate residents about the business side of medicine throughout the recruiting process. Prior to scheduling an interview residents should have a clear idea in writing what the specific expectations are for the practice: hours to be kept, number of patients to be seen, performance evaluation methods, etc. The latter factor is of increasing importance as physician reimbursement transitions from volume-based to value-based metrics. When residents have a clear, defined understanding of the parameters of a practice, misunderstandings can be avoided and retention rates improved.
In addition, Merritt Hawkins’ 2015 Survey of Final-Year Medical Residents can be a useful resource for facilities that recruit residents, and I would be happy to email a copy of the survey to those requesting it. What best practices have you discovered for recruiting physicians just out of training?
John Hawkins is Senior Vice President of Merritt Hawkins, the nation’s leading physician search and consulting firm and a company of AMN Healthcare, the largest healthcare workforce solutions company in the United States. He can be reached at firstname.lastname@example.org or at 800-306-1330.