BY JACKIE LAM
We all know money can't buy happiness, but a higher salary does seem to make for happier EPs, at least in our latest salary survey.
The salary category with the largest percentage of very satisfied EPs was $325,001-$350,000 at a whopping 51 percent (up from 39% in 2015). This group also saw the lowest percentage of very dissatisfied EPs: zero percent, a decrease from four percent in 2015. The runner-up surprisingly was not the highest salary range but those making $150,001-175,000, 49 percent of whom said they were very satisfied with their careers, a big increase from 31 percent in 2015. No EPs in this salary range reported extreme dissatisfaction, down from nine percent two years ago.
It's intuitive to associate low salary with low career satisfaction, but that just wasn't the case in our survey: The percentage of EPs who were very satisfied with their careers is way higher at 52 percent in the under $100,000 a year cohort than other income ranges in 2015. Fast forward to 2017, this group fell a few notches in career satisfaction—only 45 percent said they were very satisfied, and those very dissatisfied rose from zero percent to 1.3 percent. EPs making $175,001-$200,000 reported a decline in career satisfaction, with only 23 percent saying they were very satisfied compared with 33 percent in 2015, and seven percent reporting feeling very dissatisfied, up from five percent in our previous survey.
EPs were generally less satisfied with their careers than they were when we surveyed them two years ago, but that likely comes as no surprise with articles about burnout everywhere you turn. That's reflected in our latest salary survey: Forty percent of EPs reported feeling very satisfied with their careers in 2015 compared with only 38 percent in 2017. The percentage of EPs somewhat satisfied with their careers, however, inched up from 35 percent to 36 percent in two years, as did the percentage of those who were neutral on the topic: 11% in 2017 v. 10% in 2015. As in 2015, 10 percent of EPs said they were somewhat dissatisfied with their careers, but those saying they were very dissatisfied with their careers rose a little—six percent in 2017 compared with five percent in 2015.
Gender also seemed to affect career satisfaction. Male and female EPs were still about equally satisfied with their careers in 2017, but male EPs reported feeling very or somewhat satisfied at 86 percent v. 84 percent in 2015. Fewer female EPs felt the same, decreasing from 81 percent to 79 percent. The level of dissatisfaction remained the same between the two years for both genders; more women, however, were very or somewhat dissatisfied at 13 percent compared with nine percent of men in 2017.
Advanced age correlated with higher career satisfaction in 2015, and that trend continued in 2017. The percentage of those between 26 and 30 years old who were very or somewhat satisfied with their jobs stayed the same at four percent, still the lowest across all age groups. EPs aged 31 to 40 years saw a sharp decline in satisfaction, however: Only 17 percent of them and 26 percent of those 36 to 40 said they were very or somewhat satisfied, compared with 25 percent and 38 percent in 2015, respectively. The 31-35 age group ranked second in career satisfaction in our last survey, but lost that place in 2017 to the 41-45 cohort (34% v. 33% in 2015). All age ranges over 41 saw an increase in the percentage of those very or somewhat satisfied in 2017, with EPs over 60 reporting the highest percentage at 36 percent v. 26 percent in 2015.
Surprisingly, career dissatisfaction decreased among younger EPs but increased among their older colleagues. The percentage of those very or somewhat dissatisfied fell from two percent to zero percent in 26-to-30-year-olds, from 22 percent to 18 percent for those aged 31 to 35 years, and from 27 percent to 26 percent in the 36-40 group. Every age group over age 41—except for those 46-50—reported a higher percentage of dissatisfaction in 2017 compared with two years ago. The 41-45 group overtook the 46-50 group, which held the highest percentage in 2015. About 42 percent said they felt very or somewhat dissatisfied with their careers, up from 38 percent in 2015.
It's unclear whether board certification affects EPs' career satisfaction one way or another, but non-board-certified EPs seem to be happier with their careers than board-certified ones. Board-certified and non-board-certified EPs experienced an increase in career satisfaction, with those reporting feeling very or somewhat satisfied rising to 83 percent and 89 percent, respectively, in 2017. The gap between the two widened considerably in two years, however: About the same percentage of board-certified and non-board-certified EPs were very or somewhat satisfied with their careers in 2015—82 percent and 83 percent, respectively—amounting to a one-percent difference, but that disparity stretched to six percent in 2017.
The shake-up is also evident in our survey's work environment data. EPs at freestanding EDs ranked highest in career satisfaction, with 89 percent of them reporting feeling very or somewhat satisfied v. 86 percent in 2015. Those in academia were dethroned as the most satisfied group, falling to second place in 2017. More hospital EPs were very or somewhat satisfied in 2017 at 85 percent, up from 82 percent. There were only four critical care responses, so it would be unfair to make an inference with this group.
Not as many or as drastic changes were found in our data about the type of hospital where EPs work. Those in university institutions still had the highest career satisfaction at 88 percent in 2017, even though it decreased from 90 percent in 2015. Those working in nonprofit community hospitals were the second-highest at 85 percent in 2017 v. 81 percent in 2015, surpassing the previous runner-up, physicians in nonprofit private hospitals, 85 percent of whom reported feeling very or somewhat satisfied compared with 84 percent in 2015. The satisfaction level among for-profit community hospital employees stayed the same at 82 percent, but inched up slightly for physicians in for-profit private hospitals to 81 percent (80 percent in 2015). Satisfaction among EPs at VA/military hospitals also climbed from 80 percent to 82 percent in our last survey.
EPs certainly enjoy their work—the more patients they see, the happier they are. More than 85 percent of those who worked in EDs that had more than 30,000 visits a year said they were very or somewhat satisfied with their careers compared with 84 percent in 2015, and they tied for first place with EPs in EDs with 15,001-20,000 annual visits (85% v. 83% in 2015). They were closely followed by physicians in EDs with 20,001-25,000, 84 percent of whom reported feeling very or somewhat satisfied with their jobs (up from 81 percent two years ago).
Our survey found that those seeing fewer patients were unhappiest with their jobs. EPs working in EDs that saw 5,000-10,000 visits per year had the highest dissatisfaction rate; 14 percent said they felt very or somewhat dissatisfied v. 12 percent two years before. It's important to note, however, that dissatisfaction decreased across all groups in this category in 2017.
No matter the employer type, however, EPs seemed to be getting happier. Those working for independent groups were the most satisfied, with 86 percent of them saying so compared with 84 percent in 2015. Close to 84 percent of EPs employed by hospitals reported feeling very or somewhat satisfied (82% in 2015), as did 83 percent of those who worked for contract management or staffing groups (82% in 2015) and 83 percent of locum tenens EPs (78% in 2015).
EPs in urban areas still led in career satisfaction at 86 percent, unchanged from 2015, but their suburban peers were quickly catching up at 85 percent (v. 81%), closing the previous gap of five percent to one percent. Those working in rural areas also reported improved satisfaction, with 82 percent saying they were very or somewhat satisfied with their careers compared with 78 percent before. The picture for remote EPs, however, shifted just as dramatically: Only 59 percent felt very or somewhat satisfied in 2017 v. 100 percent in 2015.
We'll leave you with one piece of good news: EPs were becoming more satisfied with their careers regardless of where they practiced. The Mountain area (AZ, CO, ID, MT, NV, NM, UT, WY) stood out with the highest percentage of EPs reporting feeling satisfied at 92 percent v. 85 percent in 2015, followed by the West North Central and East South Central areas both at 90 percent (previously 89% and 80%, respectively). Other regions, including the Northeast (CT, ME, MA, NH, RI, VT), Mid-Atlantic (NJ, NY, PA), East North Central (IL, IN, MI, OH, WI), and West South Central (AR, LA, OK, TX), all experienced an increase in career satisfaction. The exceptions were the South Atlantic (DE, DC, FL, GA, MD, NC, SC, VA, WV), which saw a slight dip in that from 85 to 84 percent , and the Pacific (AK, CA, HI, OR, WA), which experienced a bigger drop from 84 percent to 80 percent.
Next month: Then and Now: How Satisfied Are Emergency Physicians with their Employers? We'll cross-reference career satisfaction data with employer, years in practice, age, title, and more. We'll also publish that article ahead of print in our enews. Sign up for the enews (completely free!) at http://bit.ly/EMNenews.
Ms. Lam is the associate editor of Emergency Medicine News.