Job-hunting in a recession: It may take some searching
■ Physician jobs are out there but they may not be easy to find. Physicians, recruiters and other experts offer some tips for broadening your search strategy.
By Victoria Stagg Elliott — Posted Sept. 7, 2009
When Dan Lis, MD, finished his residency in pediatrics at Sinai Health System in Chicago about a year ago, the last thing he expected was to end up unemployed.
He took some time off after his residency. But he has been job hunting for the past couple months, working with several recruiters and scouring Web sites for opportunities.
"I have been speaking with people I know. They can't believe I'm looking for a job and having a hard time," he said.
More physicians than ever are seeking employment rather than opening a solo practice. But finding the right job has become more challenging because the usually resilient health sector has not been immune from economic turmoil in this recession.
"It's a lot more difficult for all of us than it has been in the past," said Laura Inverarity, DO, who recently finished a fellowship at Rush University Medical Center in Chicago and is starting a job as an anesthesiologist at Advocate Good Shepherd Hospital in Barrington, Ill. "I got lucky."
The list of challenges is long. Physicians are finding that switching jobs or finding one after completing training requires more networking than in prior years. It might mean having to work in a different area of the country or a type of setting. A locum tenens job may be necessary. Home-owning physicians might have to handle two mortgages or sell their houses at a loss. And doctors hoping for less call and a greater work-life balance might have to relax those requirements, too.
Dr. Lis does not have a piece of property tying him down, but he wants to stay in Chicago. He said he feels happiest in a big-city environment. However, he might soon start a locum tenens position in a small Midwest town.
"I want to get out there and start practicing," he said.
Recession taking its toll
In this economic downturn, some hospitals and group medical practices have implemented hiring freezes. Doctors who would have retired have not because investments that would allow them to do so have declined in value. Many physicians who have a job are staying put to see how health system reform will turn out.
"It would be shortsighted to say that the economy has not had an effect," said Tommy Bohannon, senior director of recruiting, development and training with physician placement firm Merritt Hawkins & Associates in Irving, Texas. "A certain number of physicians are hunkering down and are going to wait and see what happens, even though they may be really unhappy professionally."
Physician turnover dipped to 6.1% in 2008 from a high of 6.7% in 2006, according to the "2008 Physician Retention Survey" released April 15 by St. Louis-based Cejka Search, an executive and physician search organization.
"It's a small change, but these numbers are showing the trend of stability," said Brian McCartie, Cejka's regional vice president. "Physicians are gravitating more to security and to not taking a large amount of risk."
Complicating the situation further is the fact that physicians, like many Americans, have become less able to sell their homes. Downturns in the housing market may mean a physician is limited to searching in a smaller geographic area.
According to the Cejka survey, 53% of companies looking to hire a physician said the candidate's ability to sell a home was a significant barrier. "We're seeing a lot of candidates interview for positions and not take them when they realize what the move will cost," McCartie said.
Ensuring that spouses can find jobs also is having an impact on recruiting.
"We have seen at least a 15% decline in the number of candidates applying for our positions. People are a little more reluctant to make a change. They have concerns about selling their homes, moving to a new community and the effects on their spouses," said Tammy Jamison, director of physician and executive recruitment at Lehigh Valley Health Network in Allentown, Pa. She also is president of the National Assn. of Physician Recruiters.
The newest generation of physicians also has different expectations for where work will fit into their lives. They're less willing to accept positions that don't have some work-life balance.
"People are focused on lifestyle and the call schedule and the volume," said Jason Dees, DO, a Mississippi family physician who has been hiring physicians for his practice, New Albany Medical Group.
The flip side of this search for lifestyle balance is that more jobs are available in specialties that traditionally involve more call. For example, recruiters said they have many positions to fill in general surgery and primary care. But fewer jobs, they said, are available in specialties that allow more set hours.
The number of searches that Merritt Hawkins recruiters carried out for family physicians increased 132%, from 257 during April 1, 2005, to March 31, 2006, to 595 from the same 12 months in 2008-2009. Searches for internists and pediatricians also grew significantly.
"There is such a growing demand for primary care physicians," said Dr. Dees, the new physician board member of the American Academy of Family Physicians.
Jobs can be had
Those who have found jobs in recent months say it sometimes takes hard work and compromise. It requires networking and perhaps hunting outside the comfort zone. And a house may have to be sold for less than it would have two years ago.
Although physicians traditionally work within 100 miles of where they trained, experts say searching farther afield may be necessary. Recruiters say all geographic regions need physicians. While large urban centers, which have seen fewer physician shortages, have much tougher markets to crack, non-urban areas still have a great need.
"There's still a fairly significant maldistribution of physicians," McCartie said.
For example, 26% of Merritt Hawkins' physician searches between April 1, 2008 and March 31 were for positions in communities larger than 100,000. That's a significant decrease from the 40% in that category for those dates during 2005-2006. About 39% of the most recent searches were for positions in communities smaller than 25,000, an increase from the 27% reported for the earlier searches.
Successful job-hunters say networking is more important than ever to uncover the hidden job market. This means letting anyone involved in hiring know you are looking, even if you do not know them personally.
Michelle Powers, MD a pathology resident at Washington University School of Medicine in St. Louis is about a year a way from finishing her program but already has a couple job offers.
She knew she wanted to work in Oklahoma or Texas, so she used the online membership directories of the College of American Pathologists and other medical societies to find e-mail addresses of physicians working in those states.
She contacted about 75 doctors, introducing herself and including her resume. This lead to numerous offers of advice, several leads, four interviews and two offers. "There are a lot of opportunities that are not advertised," Dr. Powers said.
In addition, while this may be a tough time to sell a house or other residential property, it is possible to do so, although it requires extra effort. Robert Mitchell, MD, a cardiologist and vascular medicine specialist had to sell his house before moving from practicing academic medicine at Duke University Health System in Durham, N.C., to private practice in Kalispell, Mont. He looked at other houses for sale in the area and priced his $10,000 lower. He had the place re-painted and inspected. All necessary repairs were made and the inspection report given to potential buyers. The place sold within a day, and he has a new home in Kalispell under a lease-to-buy agreement.
Nonclinical jobs also are attracting more interest from physicians. Some in this category, such as medical writing and pharmaceutical industry jobs, have dried up. But positions in areas such as health system consulting are on the rise.
"Within the last three or four weeks, 50 physicians have contacted me saying they would like to get some career counseling or mentorship," said Joseph Kim, MD, MPH, who runs various Web sites, including one focused on nonclinical opportunities for physicians (link).
"A lot of people are searching. There's all this talk about health system reform, and a lot of physicians are coming to me with questions about whether this kind of transition makes the most sense," Dr. Kim said.
In some cases, the perks for changing jobs are getting better. Recruiters say some companies are offering to cover mortgages for a certain period, and, according to Merritt Hawkins, most jobs are offering relocation allowances. A growing number of positions also come with signing bonuses: 85% did between April 1, 2008 and March 31. That's up from 58% offering the perk during the 2005-2006 period.
The size of bonuses being offered grew, too: with an average $24,850 now, up from $20,480.