Only 26 percent of 18- to 24-year-olds say they are happy, according to a Harris Poll in the September-October AARP magazine, with 55 percent of them saying they're frustrated by work. But that may be changing if my research about millennial physicians is any indication.
Early this year, I sent a three-section questionnaire to the 147 emergency medicine residency programs listed in the Society for Academic Emergency Medicine's directory, requesting that it be distributed to all residents, preferably third- and fourth-year students. The response rate was just more than eight percent, based on approximately 3,100 residents in their junior and senior years combined. This wasn't a state-of-the-art research project with control groups, and the conclusions drawn are mine based on the information collected.
A whopping 81 percent ranked lifestyle as most important, with nine percent ranking position profile first, and eight percent ranking compensation first. Compensation was second most important to 67 percent of respondents, with position profile at 17 percent and lifestyle at 13 percent. The least important category, chosen by 73 percent of respondents, was position profile, with 13 percent choosing compensation and only two percent choosing lifestyle as least important. The Millennial physician is considerably more concerned with his time off the job than on. And these physicians have a lot to say about the parameters of their job search.
I also asked them to rate 14 job search parameters in order of importance. The results showed a distinct leaning toward lifestyle as a primary motivating factor. The parameters were:
- Geographic location
- Peer group of physician colleagues
- Partnership opportunity
- Equal equity ownership opportunity
- Proximity to major airport
- Hourly income
- ED trauma level
- Proximity to recreational venues
- Shift length
- Incentive income (based on production)
- ED volume
- Schools for kids
- Spouse's job
Location, location, location was the number one choice of 67 percent of respondents with 88 percent putting it into their top two choices. This is such an overwhelmingly obvious response that I think we are looking at an entire generation of young physicians who place their primary emphasis on location and lifestyle. Will this change over time? It might; my experience has shown that a large number of physicians change their priorities after three to five years of work experience. Some decide to chase a title while others seek higher earnings or better lifestyle, and all are more open about where they go to get it. But, of course, that was over the past 20 years; that may be changing now.
Hourly income was of primary concern for 29 percent, with more than 69 percent putting it into their top three. Fifty percent also put ED volume and trauma level as one of their top three. A peer group of residency trained physicians was the primary position-related item important enough to feature in the top three for more than 67 percent of physicians. Also of importance was shift length, with 54 percent placing it in the top three positions of importance.
Noticeably missing in the top three were both partnership and equal equity ownership potential with less than four percent placing these in the top two positions of importance, and a few respondents leaving these two items off their lists altogether. Equally interesting were the incentive income results. Not one physician rated it as most important, with less than 36 percent putting it into the second or third level of importance. In contrast, hourly income was ranked in the top three by 69 percent of physicians, demonstrating a desire for guaranteed compensation. This is backed up by the 58 percent placing benefits in the top three positions of importance. I believe this shows a stronger desire for employee status than independent contractor status or partnership. This is the exact opposite of what physicians graduating between 1997 and 2007 were seeking. Their catch phrase was “fee-for-service,” and their favorite word was “partnership.” It seems pretty clear that attitudes are changing in this area as well. Young physicians seem to be seeking guarantees with their incomes as opposed to relying on their own abilities to move patients and generate billing in order to earn.
The spouse's job was the number one concern for 37 percent of the physicians and in the top three for more than 48 percent. I believe this demonstrates a rise in dual-income physician families as well as an increase of female physicians with husbands who work. With this category figuring so highly in the primary importance ranking, I would surmise that physicians consider the spouse's job more difficult to find than their own, and have a willingness to defer to the spouse when it comes to selecting a job market. This also could be showing an understanding on the part of the physician respondents that the emergency medicine job market is wide open. Schools figured into the top three choices of importance for 52 percent of physicians, with 48 percent spread fairly evenly across the board from fourth to last place.
Proximity to major airports figured prominently in the top three for 31 percent of physicians, with an equal amount of respondents placing it in the fifth position. Also note the strong showing for proximity to recreational venues: Half placed this in their top three categories of importance, with more than 37 percent ranking it in their top two. Interest in time off the job is important for a large percentage of young physicians.
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