From undergraduate school to medical school, medical school to residency, and then residency to fellowship, the life of a physician in training may feel a bit nomadic. When the time comes to search for that first physician job, residents are often eager to settle down in a specific location. Maybe they’d like to return to where they grew up; perhaps they want to find a job near a spouse’s family; maybe they’ve always dreamed of living in a big city, near the ocean, or serving in a rural community. There is no shortage of options. 

As Regional Vice President of Recruiting for Jackson Physician Search Eastern Division, I regularly speak to physicians searching for jobs in a new location. While many are residents seeking their first jobs, physicians at all stages of their careers may contemplate relocation at one point or another. No matter their career phase, it’s not uncommon for a relocating physician to have their hearts set on a specific city and to primarily consider opportunities within a set radius of the targeted spot. While I understand the inclination, I advise all physicians to keep an open mind and consider each option, as job satisfaction depends on various components beyond location. 

There are certainly multiple factors to consider when weighing a job offer — scope of work, compensation package, cultural fit, growth opportunities, and, of course, location. While location should not be the only consideration, it is likely the one that will have the most direct impact on your family. That said, when weighing the pros and cons of an opportunity’s location, be sure to ask yourself the following:

Physician Job Relocation Question #1: How is the patient demand in this area?

Physicians determined to work in a big city are often surprised to learn that while the cost of living is higher, their income potential could be lower than in less populated areas. This is because the market is likely to be more saturated; metropolitan areas typically have enough physicians to serve the needs of patients, so acquiring new patients can be tough. Employers may offer a salary guarantee to new physicians for the first year or two; however, in that timeframe, the physician will need to cultivate an adequate patient base to meet productivity goals afterward. Establishing this solid patient base is often less challenging in a less populated area with fewer physicians in your specialty. 

Physician Job Relocation Question #2: What are the available housing options?

When interviewing with a potential employer, you’ll want to find out what the housing market is like in the area. Are you likely to be able to buy or build a house that meets the needs of you and your family? If the ideal inventory is limited, are there good rental options available? If you and your spouse decide you would rather reside outside the immediate area, do circumstances allow you to do so? How far of a commute is acceptable? Plan to discuss these inquiries with the employer and meet with a realtor during your on-site visit to give you a well-informed understanding of your options. 

Physician Job Relocation Question #3: Could my spouse find employment here too?

Whether relocating to a large city or exploring jobs in rural medicine, physicians will typically need to consider the employment needs of their partners as well. If your spouse also works in healthcare, the potential employer may be able to help him or her secure a job. Alternatively, perhaps the spouse can work remotely but will need to travel somewhat frequently; this leads to another consideration–what amenities, such as an airport, are easily accessible? Whatever your partner’s profession, you’ll want to be sure you both have the opportunities and resources to thrive in your new location.

Physician Job Relocation Question #4: Does the location provide access to the amenities I want and need?

Restaurants, shopping, entertainment–you’ll want to check out the selection of it all, from your favorite chains to various new options in or near the town. Also, think about your hobbies and favorite vacation spots. Whether you love to hike and ski or are a theater buff and collector of couture, you may wish to confirm you can continue pursuing these interests wherever you consider relocating. Lastly, as mentioned before, consider how often you and your family travel by plane and decide if it is critical to have easy access to an international airport. 

Physician Relocation Question #5: How are the schools?

Depending on your stage of life, the quality of educational options may be a consideration when relocating. Physicians with school-age children or younger will want to evaluate the public school system and potentially explore private school options. Physicians moving to bigger cities can expect to find more choices when it comes to education, but the smaller communities also offer quality education. If you’d like, you can ask your potential employer to arrange a school tour while you are in town. An in-person visit to a school may provide a clearer picture than a scoring system on a website.  

Building a Career and a Life

There are multiple factors to consider before accepting a job and signing a physician contract, but the location is certainly a major part of the equation. Don’t judge an area based solely on internet research, but instead plan a visit to the community and ask questions about the patient demand (and income potential) in the area, housing availability, employment options for your spouse, access to amenities, and, if applicable, education needs. These considerations will help you determine if the location has the potential to be a good long-term fit for you and your family. But remember, if the job itself is not a good fit culturally, location alone is not guaranteed to satisfy you. So, evaluate your compatibility with the workplace thoroughly during the interview process and trust your physician recruiter to guide you to positions that will be a good match.  

Are you considering relocation and a new physician job? The recruitment team at Jackson Physician Search can help you assess the physician job market in your target location and prepare you for the next steps. Reach out today or start your physician job search online now.

About Neal Waters

Neal’s career began in retained physician search more than 15 years ago. Early on, he recognized the strain that an entire community feels when there is a shortage of physicians to meet patient demand. Since his first successful placement, Neal’s passion for identifying the best providers for each healthcare organization with which he recruits has grown.

Neal serves as Regional Vice President of Recruiting. In his role, he serves as a mentor to a growing team of Jackson Physician Search recruiters. He also enjoys collaborating with in-house recruiters dedicated to optimizing their physician recruitment and candidate acquisition strategies. Likewise, Neal specializes in helping physicians — especially residents and those early in their careers — advance their professional careers by finding the right fit.

The past decade has seen a significant shift in the percentage of physicians in private practice versus those employed by a health system. According to data from Avalere and reported by the Primary Care Collaborative, 74% of physicians were employed by a hospital or health system in 2022. This figure was up from 69% the previous year, largely due to the accelerating trend of hospitals and health systems acquiring private practices. So what does this trend mean for physicians? Which scenario provides the better physician career option? 

For residents evaluating their physician career choices, it’s important to understand the differences and weigh the pros and cons of both against their specific needs. As Regional VP of Physician Recruitment for Jackson Physician Search’s Midwest Division, I regularly place candidates in jobs with both types of organizations. Many times, the candidate applies to a specific job already knowing his or her preference for a private practice or health system. However, the candidate is sometimes open to both, and after a series of questions, it becomes clear that he or she may be better suited for one over the other. 

Whether I’m working with a resident looking for his or her first physician job or a physician who is considering a job change from one setting to another, I’ll conduct exploratory conversations with them to discover which setting is best suited to their current and future needs. Below you’ll see some of the questions I ask to help them — and potentially you — find the best fit. 

Are you business-minded? Do you see yourself as an entrepreneur?

If the idea of running a business feels like an exciting challenge, you will likely enjoy the partnership track at a private practice. Physician partners in private practice are involved in every aspect of the business. In addition to providing patient care, they must consider budgets, staffing, marketing, and more. As partners, physicians have a say in how the business is run, so if something isn’t working well or they have an idea to increase profitability, they have the potential authority to make a change and reap the benefits. That said, if the change does not have the desired effect, they will directly feel that impact as well. 

While it behooves every physician to have an understanding of the business of healthcare if the idea of running a business is an intimidating prospect and/or you would prefer to focus exclusively on patient care, hospital or health system employment may be a better fit for you. 

What are your immediate physician compensation needs? How important is loan repayment?

Physician compensation models can be complex, and it is important to look at the complete package in order to evaluate different offers fairly. When looking solely at starting salaries, hospitals and health systems typically come in higher, as they often have more capital than private practices. Whichever the setting, however, physicians are expected to offset their salaries with their own productivity. If a new physician fails to offset his or her expenses fully, the organization may expect payment for the difference. This is more common in a private practice setting, but it can happen in hospitals and health systems as well. 

Indeed, income in the early years may be higher with a hospital or health system, but earning potential is greater in the long term with a private practice. This is because, as a partner, your income is based on the group’s profits, and you (and your partners) have the power to grow the business in ways limited only by your own imagination. 

In the 2023 compensation report from Medscape, self-employed physicians reported an average income of approximately 30 thousand dollars higher than that reported by employed physicians. Still, hospitals and health systems may be more attractive to newer physicians due to higher starting salaries and bigger recruitment incentives. Hospitals also typically have more options for loan repayment, especially if the organization has non-profit status.

What kind of work-life balance do you want — now and in the future?

Some physicians feel work-life balance is more attainable in a hospital or health system setting where they can focus on clinical care and have fewer administrative responsibilities. There are also typically more physicians and other providers available to share call duty and provide coverage when taking time off. In a private practice, where physicians’ incomes are directly tied to revenue, physicians may be more motivated and incentivized to work as much as possible to increase revenue, which can have a negative impact on work-life balance. 

On the other hand, physicians working at a private practice may eventually have more flexibility than their employed peers. As they gain seniority, partners will have the freedom to set their own schedules and take as much time off as they desire — as long as they understand it will directly impact how much they earn.

How important is physician autonomy? 

Past research suggests physicians prioritize autonomy in their work. For example, in a 2022 Rural Physician Recruitment survey, autonomy was the aspect of an employer’s culture that physicians (both urban and rural) cared about most. Other studies on physician burnout suggest a lack of autonomy is one of the primary causes of rising burnout. 

As partners in private practices, physicians have more of a say over all aspects of how the business is run, whereas in a hospital or health system, physicians will always have another entity making policy decisions that may directly impact their compensation and/or how they deliver patient care. For physicians seeking their first jobs, the idea of someone else making those decisions can provide security, but this may change once they’ve gained some experience and industry knowledge. 

Certainly, there are pros and cons to consider in both private practice and health system employment. The security that comes with hospital employment is often attractive to physicians starting out in their careers. Still, it is not unusual for them to seek a change — typically after three to five years of employment. Fortunately, I work with all types of employers, from small private practices to major health systems, from rural FQHCs to larger physician-owned groups. Whatever you envision for your physician career, I am eager to help you find the opportunity that provides the best fit. 

Whether you know your preferred practice setting or are exploring all of your options, the recruitment team at Jackson Physician Search is eager to assist. We have clients of all types and sizes in every region of the country that are looking for physicians like you. Reach out today to learn more, or start searching for physician jobs online now.

About Tara Osseck

With more than 15 years of experience in the healthcare industry, Tara Osseck specializes in matching healthcare organizations with physicians who are a strong fit for the role and the culture. Her healthcare career began as a physician liaison and quickly expanded to include physician recruitment, strategic planning, and business development, working for various hospitals throughout Memphis, Tennessee, and St. Louis, Missouri. Based in St. Louis, Osseck leads the firm’s Midwest Division, placing providers across the Midwest and Upper Midwest. She earned a bachelor’s degree from Truman State University and a master’s degree in health care administration and management from The University of Memphis.

Demand for physicians is high, and those beginning a physician job search should feel confident about their prospects. That said, physicians must still treat the physician job search with the respect it deserves, putting in the necessary research and preparation to find the employer and job for which they are best suited. As RVP of Recruiting for Jackson Physician Search’s Eastern Division, my team and I work tirelessly to help physicians understand the job search process and walk them through what is expected each step of the way. 

One aspect of the process that candidates always have questions about is the on-site interview. Candidates conducting their first physician job search may have heard stories from peers about employers rolling out the red carpet for candidates. While this can and does happen to some degree, I always stress to physicians that while yes, they are being recruited, they still have to make a good impression in order to get an offer. That said, candidates should prepare for the interview and treat the process the same as they would if the job market was not in their favor. 

When counseling candidates on the physician interview process, I emphasize the importance of setting a timeline, following basic interview etiquette, and preparing to make a decision. 

Physician Interview Timeline for Residents

For residents embarking on their first physician job search, I advise beginning 18 months to two years before the completion of training, but this is not to say the job search will take that amount of time. On the contrary, it’s not unusual for residents, especially in high-demand specialties, to accept offers with a start date a year or more into the future. So, absolutely start early, but when you are ready to begin interviewing, accept interview invitations from only those opportunities in which you are genuinely interested. On-site interviews are time-consuming for both parties and expensive for the employer, so be judicious with your acceptance. 

While residents may feel like they have endless amounts of time before they need to make a decision, once they begin on-site interviews, the resident’s job search should be nearing its end. I advise candidates to aim to schedule on-site interviews with their top three choices over a condensed time frame — ideally no more than six weeks. This allows candidates to interview with the employers they are most interested in and easily compare each to the other before making an informed decision. The candidate who interviews with one employer in November, a second in February, and a third in March will have a difficult time comparing, and worse, if they decide the November opportunity was ideal, the job is unlikely to still be available in April. 

Of course, even when interviewing over a condensed time period, there are no guarantees that an opportunity will still be available even six weeks later. So, if a candidate really connects with an employer and feels this job meets 80% of his or her criteria, my advice is to accept the offer, even if it means canceling other scheduled interviews. 

Physician Interview Etiquette for All

Once I have assisted a candidate in setting up an on-site physician interview, I will schedule a pre-interview phone call to ensure they know exactly what to expect and what is expected of them. In most cases, I have been to the facility and experienced it in much the same way the candidates will, so I can be very specific about what to expect, who they will meet, and what questions they might have. I also go over what is expected of them, from how to dress to what to bring and what not to say. Some of what I say is obvious, but based on feedback I have received from clients over the years, I have learned not to assume! 

• Arrive on time. If you have questions about your itinerary, ask them in advance. 
• Dress professionally. While standards for professional dress have relaxed some over the years, candidates should err on the conservative side. Absolutely no scrubs!
• Bring printed copies of CVs and a list of references. This makes it easy for interviewers to ask questions about your education and experience and shows enthusiasm for the opportunity.
• Ask thoughtful questions that demonstrate you have done some research on the organization and the role it serves in the community. 
• Be respectful and kind to everyone you meet, from the C-suite to the support staff. 
• Think before you speak. Candidates must be self-aware enough not to speak or react in ways that may insult the interviewer. For example, if the facility’s equipment is older or less impressive than what you are used to, there is no need to comment. However, you should provide that feedback to your recruiter later. 
• Do not discuss other opportunities or offers you may have. Employers know physicians are in high demand, and they assume you have options. 
• In social situations, take cues from your peers. If other physicians are ordering a beer or a glass of wine, it is okay to do the same. However, practice moderation and use good judgment. 

Preparing to Make a Decision Post-Physician Interview

If an employer is impressed with a candidate, they are likely to extend an offer quickly, so candidates should be prepared to make a decision. For some, accepting an offer without exploring other options will be unthinkable, and that’s okay as long as they recognize the opportunity may not wait for them. 

Still, others may feel ready to move forward, but if they want to have an attorney review the physician contract, this can slow things down considerably. Before interviews, I ask candidates if they plan to involve an attorney. If the answer is yes, I advise them to go ahead and identify who they plan to hire and gain a commitment from the attorney to review and provide feedback quickly. I also remind them that attorneys will always find something objectionable, and they must decide for themselves if it is worth challenging. 

Most importantly, I counsel candidates to prepare themselves to make decisions and avoid “paralysis by analysis.” There is no such thing as a perfect job, and candidates searching for opportunities that match 100% of their criteria will find themselves waiting for something that is unlikely to come. Physicians are trained in decision-making, and when it comes to job opportunities, they must trust their instincts and be prepared to say “yes” or “no” without hesitation or regret. 

The on-site physician interview is an intense experience designed to give both employer and candidate a chance to get to know each other and determine if there is a good fit. With our guidance, physicians will know exactly what to expect at their interview and can prepare accordingly. 

Whether you are a resident seeking your first physician job or an established physician pursuing a new challenge, the recruitment team at Jackson Physician Search can help you assess the physician job market in your target location and prepare you for the next steps. Reach out today or start your physician job search online now.

About Neal Waters

Neal’s career began in retained physician search more than 15 years ago. Early on, he recognized the strain that an entire community feels when there is a shortage of physicians to meet patient demand. Since his first successful placement, Neal’s passion for identifying the best providers for each healthcare organization with which he recruits has grown.

Neal serves as Regional Vice President of Recruiting. In his role, he serves as a mentor to a growing team of Jackson Physician Search recruiters. He also enjoys collaborating with in-house recruiters who are dedicated to optimizing their physician recruitment and candidate acquisition strategies. Likewise, Neal specializes in helping physicians — especially residents and those early in their careers — advance their professional careers by finding the right fit.