Quality of LIfe

Many doctors leave their first position after 2 years. Why?

A lot of doctors start a job search with 2 criteria – how much money they wish to earn and where they wish to live.

This is the easiest way to narrow down a job search, but it’s not the best way.

It is not guaranteed to lead you to the Ideal Job – one that gives you quality time with your family and enough money to do the things you love to do.

Instead, you need to consider two things that will make the biggest impact on your quality of life: Community Need and Earning Potential.


Community Need

  • You want a viable practice for the long term. Choose a community where your specialty is needed.
  • If the position is at a hospital or hospital-sponsored, did they do a community needs assessment?
  • If not, find out the community’s population and “draw area” and also the number of practicing specialists in the community. As a rule of thumb, it takes 100,000 people to support 1 neurosurgeon and half that to support 1 neurologist. Example: Anytown has a population of 50,000 and a draw area of 250,000. Using the rule of thumb, the community can support 6 neurologists and 3 neurosurgeons.
  • Also look at how many practice the same subspecialty. Most communities will not be of sufficient size to support a doctor who only does his subspecialty, so be realistic about the percentage of your practice you expect to devote to it.
  • Other factors, such as number of doctors retiring in the near future, play a role as well.  It’s a good idea to ask your recruiter.

Earning Potential

Location has an enormous influence on the viability of your medical practice.

The following types of communities tend to be saturated with doctors:

  • Large Metropolitan Areas (e.g., New York, Chicago, LA, San Francisco)
  • Cities with Medical Schools (e.g., Philadelphia, Boston, Baltimore, Houston)
  • Coastal / Beach / Resort Communities (e.g., Florida, Malibu, Hawaii)

So what’s wrong with that? Wouldn’t the fact that lots of people want to live there be a good thing? Not always.

Consequences of taking a job in a saturated market:

  • Lower reimbursements. You have no bargaining power with the insurers. You don’t like the reimbursement they are offering you? They can find another specialist who will take it. You are living in your chosen community, but you can’t afford to enjoy it.
  • Lack of adequate referrals. Too many doctors are fighting over the same piece of pie. In order to get enough cases to meet your financial obligations, you need to cover multiple hospitals and/or satellite offices. You never see your family because you spend all your time going from one place to another.
  • Business failure. Ultimately, many doctors end up closing up shop and hunting for a new job. Sadder, but wiser.

You can have it all.

Look for a community with the following features:

  • Population to support your specialty
  • Acceptable amount of managed care
  • Good reimbursements
  • Reasonable competition
  • A mix of cultural and recreational activities
  • Your favorite hobby
  • Good schools and housing
  • Reasonable cost of living
  • A place where you are comfortable raising your family

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