In my survey of millennial physicians, 79 percent of respondents preferred using electronic medical records (EMR) for charting and documentation. Fifteen percent preferred dictation, and five percent like to use scribes. Several preferred hospital-wide EMR systems for consistency, with one noting that he prefers an electronic chart because he can type faster than he can write.
Fifty-four percent said they would not work in an ED that was not computerized, although 46 percent said they would consider it. It's interesting that five percent wrote in the scribe option, showing that these doctors want to ease their workload.
When asked if they would prefer to be an employee or an independent contractor, 68 percent chose employee status, and 32 percent chose independent contractor. A few wrote in that they were unsure of the difference. This remains an issue with some groups and even hospital employers. Millennial doctors are definitely leaning away from the independent contractor status for a guarantee of benefits and tax status. Benefits are significant for independent contractors, but the physician has to shoulder the business side himself.
Sixty-three percent of respondents preferred partnership, although 38 percent said they just wanted to work shifts. This is a change from a decade ago when more than 90 percent of the physician graduates I worked with wanted partnership. Partnership means responsibility, and more are choosing to forego that path.
A trend away from doctors wanting a lot of responsibility was revealed with only 54 percent saying they wanted equity ownership while 42 percent opted for limited partnership. Six percent were unsure. Of those who preferred equity ownership, 64 percent wanted to work their way in over a few years while only 31 percent wanted a buy-in. Five percent were undecided. It is significant that a third chose to put their money into a practice. Is the concept of sweat equity becoming dated?
I also asked respondents if they preferred private sector employment or an academic career path, and this was the biggest surprise of all. Fewer than 10 percent of graduates over the past 20 years pursued academics, but 42 percent are now seeking an academic career, and 58 percent are choosing the private sector. Academic physicians work fewer clinical hours.
Of those who want academics, 85 percent said they would prefer to teach rather than do research or both. None chose research as a preference. It seems a large portion of millennial physicians prefer the structure and guaranteed income of an academic career.
I also asked if respondents were willing to consider working for a national contract group for an hourly salary or for performance-based pay, given that the location and salary were good. Ninety percent said they would work for a group for an hourly wage, but only 67 percent were willing to do so for performance-based income. The location of the job is far more important than the actual employer structure. When I asked these physicians what else was important to them in a practice profile, the most popular answer was location, but they also mentioned specialty consult support, equal scheduling, colleagues, flexible hours, patient mix, longevity and stability of contract, good malpractice and tail coverage, and an effective peer review system.
Many mentioned quality of life and benefits, and some mentioned the hospital itself, the quality of care for admitted patients, academic prestige, and an opportunity to be involved in hospital-wide administration. Others mentioned colleagues to collaborate with, supportive staff, tail insurance, no restrictive covenants, good rapport with co-workers, opportunities to pursue interests outside of medicine, and access to ultrasound.
Overall, employers must provide computerized EDs to attract millennial physicians and a more guaranteed income model. Scribes are also a significant draw, as are strong benefit packages and shift equity. Though some millennial physicians are interested in partnership and equity ownership potential, they are primarily looking for a stable, flexible environment that will allow them to put their emphasis on lifestyle.
Next month: The last in this series with a report on how ill-ennial physicians communicate. A hint: Ninety percent do not use Twitter.
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