We recently published an article about taking charge of your physician career to avoid burnout. To aid you in that effort, it is time to focus on the major factors to consider when determining your next career move. One of the most significant considerations is the practice setting and the size of the organization that you will be joining. There is no steadfast rule about any size or setting that is better than another, but your success is based on which factors fall within your personal comfort zone. Another consideration is where you want to practice medicine from a geographic perspective. Whether you are drawn to the pace and lifestyle in a rural community or prefer the hustle and bustle of a larger metropolitan area, the location you decide upon will impact your success and happiness.
Let’s take a look at key things to consider when choosing a practice setting and the type of organization you want to work for.
Practice Settings/Size Considerations
Lines of Communication
When you practice in a smaller setting, you will learn pretty quickly that there are very few layers of management to navigate. In fact, as early as the first interview, you will most likely be meeting and negotiating directly with the CEO, and you will have a relationship with the Board of Directors. Another thing you will experience early on is that contracts are negotiated and approved much faster than in a large system or hospital setting. When changes within the practice or clinical setting need to be made, they are usually approved quickly, or even better right on the spot. Depending on the setting you choose, you may have decision-making authority, and autonomy means fewer meetings, memos, and managers.
One advantage a larger setting has over choosing to work in a small practice or clinical environment is access to more resources. In a large setting, you don’t have to make all the decisions and can focus more on patient care, instead of being embroiled in day-to-day operations. The trade-off in a larger setting, are layers of bureaucracy to navigate to make necessary changes in the process, or having administrators looking over your shoulder. An added consideration is that you will have access to other voices in the organization when challenges crop up, or when you need a sounding board when handling a particularly challenging case.
Having a Voice in the Organization
To dig a little deeper into the communication differences between a large and small practice setting, you need to consider how involved you want to be in how the organization operates. For some, having a voice in how the healthcare organization is managed is an important motivator. Being looked upon as a key stakeholder can be the boost your career needs, especially if you have spent most of your career as one physician among hundreds. Many, if not most, physicians are natural leaders, and at some point in their career, may want to feel a greater sense of ownership in the workplace. Those opportunities exist with higher frequency when you are practicing in a smaller setting.
For a physician practicing in a larger setting, there will be less reliance on you being in a leadership role. In a larger system, leadership responsibilities are typically handled by an administrative-level of the organization. That is not to say, physicians who are seeking leadership responsibilities, won’t find them in a larger setting. Quite the contrary, if you express a desire to get more involved in a leadership capacity, a large organization has the resources to help you prepare and plan for an eventual transition into that role.
Everyone wants to feel motivated and excited about going to work every day. As a physician, you are impacting the lives of others, and your career should never feel like you are punching a clock and going through the motions. When you are practicing in a smaller setting, we have already referred to the leadership role you have as one of the key stakeholders. Part of that role is having a significant influence on making it a great place to work. You can shape how everyone perceives the work environment, both staff and the patients you are serving. Today, more than ever before, workplace culture is playing a pivotal role in combatting burnout and achieving the highest levels of patient care. Good workplace culture will include having open and honest communication at all levels of the organization, mutual respect on display at all times, and an environment of accountability.
In a larger practice setting, you may not have as much personal impact on the organizational workplace culture, but you can help shape the environment within your area of responsibility. Having choices in where to practice medicine, means your job search can be to find a setting with other physicians and administrators that share your values and belief systems. Your career in medicine is stressful enough without having to deal with a toxic workplace environment. To be sure, toxic workplaces exist in practices of all shapes and sizes. Your choice, in either case, is to play a role in changing the culture, and if that isn’t possible, it may be time for a change.
When you choose to practice medicine in a smaller community setting, you are immediately achieving status in the community that you won’t find when you are one of many. There are many feel-good stories about the impact a physician has on the small or rural community they serve, and that in itself can be an incredible boost to your self-esteem and reignite your passion for medicine. A smaller community setting also allows you to be on a first-name basis with all of your patients, and that is not always the case.
Being a big fish in a small community pond is not for everyone. With that type of status, you may have expectations to play a more significant role in the community than you are comfortable doing. In a larger setting, you are still a big fish, but in an ocean. Community involvement is always going to be encouraged, but in a large setting, you have the opportunity to choose your level of involvement, and on the terms of your choosing.
Choosing a Location That Fits Your Lifestyle
Where you decide to practice medicine, from a geographic standpoint, often plays a role in the size of the practice setting. Obviously, if your desire is to go country, then you will most likely be practicing in a smaller clinical environment. If city life is your thing, you will have more opportunities to choose from. Ultimately, only you can determine what location provides you the best opportunity for success and happiness.
Choosing a Location Based on Pay
In the past, physicians who were looking for the biggest payday, would typically try and find a position with a large hospital or health system. While still valid in many cases, smaller systems and rural community systems have had to adjust their pay rates to compete for physician candidates. Luring doctors to a small community with the idyllic slower pace of life, less noise, lower crime rates, and plentiful outdoor activities used to be the main pitch. Today pay rates in these settings are on the rise. Another consideration for many small communities is a lower cost of living, which means keeping more of the money earned.
For those that may not be interested in outdoor life, practicing medicine in a larger urban center will provide you with more practice options. Finding an opportunity that best fits your lifestyle is much easier when you have more than one or two options to choose from. Another benefit of having multiple choices within a geographic area is that competition affords you with negotiating leverage to secure your best compensation and scheduling package.
Supporting Your Work/Life Balance
As a physician, no one has to tell you about the stress that accompanies your career choice. Balancing that stress by choosing to practice in an off-beat location can be your golden ticket to a better quality of life. Imagine spending your day off going for a hike in the woods rather than the concrete jungle. Or, think of relaxing in your backyard instead of on a balcony with the blare of sirens and honking horns every three minutes. The pace and allure of being closer to nature is often the perfect balance to the stress of practicing medicine.
Many physicians were born and raised in large cities and can’t imagine living anywhere else. For some, spending a weekend afternoon riding on a tractor to cut a five-acre lawn is not their idea of relaxation. Instead, having everything you could ever need within walking distance or a short cab ride away is the perfect lifestyle. Living in a metropolitan area not only provides you with more career options, but greater access to museums, art galleries, restaurants, and shopping. There are pros and cons to every location you choose, but the key is making the choice that is the best one for you and your family.
Family and Lifestyle Options
Up to this point, our focus has been you, the physician, and making a career choice based on your needs. Obviously, deciding where to practice medicine is a family decision. Things to consider are dependent on whether or not your spouse works and the number of opportunities that will be available for them. Physicians with children of any age, have to think about the quality of schools, the quality and quantity of activities to get involved in, the safety of the community, and more.
More populated localities will always have an abundance of career opportunities for working families. For the physician who doesn’t want their spouse to work, either due to preference or family obligations, the cost of living, and the proliferation of remote work options make smaller communities a viable option.
When you set out to find a new career opportunity, one thing you might notice is that the best option for you and your loved ones is not always the most obvious place. You can find hidden gems in all corners of our vast country, and sometimes when you dig a little deeper, the right position isn’t always your first choice.
When exploring options for your next career opportunity, a knowledgeable recruiter can help you identify opportunities you may not otherwise know about. A trusted, recruitment professional has established relationships across the country and can help you identify the reasons why a particular opportunity is the best one for you and your family.
Take your career search to another level by reaching out to the recruitment professionals at Jackson Physician Search today. With a nationwide reach and access to hospitals, health systems, and practices of all sizes, your JPS recruiter can help you find the perfect opportunity.