Episode 8: 40 Year Survey (Transcript)

SPEAKER_00: Welcome to the Heroes of Healthcare podcast. Special edition. I'm your host, Ted Wayne. We have a very interesting interview today hosted by Roger Bonds, CEO of PhysicianCareerAdvisor.com. He will be interviewing Olivia DiAngelo Reed of Jackson & Coker and reviewing the Jackson & Coker 40-year Career Change Survey. Roger has advised physicians on their career for over three decades. He has reviewed over 3,000 physician employment contracts and physician partnership agreements with private practice hospitals, academia and managed care companies. He speaks at medical seminars and conferences with over 2,000 presentations, attended by over 150,000 medical and health care professionals. We're excited to have Roger here talking with Olivia, so let's jump right in.

SPEAKER_02: Hi, I'm Roger Bonds with PhysicianCareerAdvisor.com. And today on Heroes of Healthcare, interviewing Olivia DiAngelo Reed. She's the Vice President with Jackson & Coker. One of the luxuries of having a company who has been around as long as Jackson & Coker, they can determine trends over the years. We're going to discuss this 40-year trend that we've seen and what entices physicians about their careers. Olivia, welcome. I'm so glad to see you again.

SPEAKER_01: Thank you for having me.

SPEAKER_02: Yeah, there have been a number of changes over the years. What are the most important ones that you've noticed in the survey data?

SPEAKER_01: Yeah, so this survey has been really interesting to see what has shifted in a physician's mind over time. When I was looking at the survey, one of the things that immediately stood out to me is that in 1987, when the survey began, hospital facilities were the number one most important factor in a physician's choice for where they wanted to practice. Now the hospital facilities, it's eighth on the list. So it has moved tremendously. Part of the reason why we believe that has happened is because back in 1987, hospital facilities were of greatest concern because they needed to make sure that the facility they were operating in or they were working in had the best technology and had the best staff. Now, because of the joint commission, joint commission certifications have made it to where hospital facilities are all operating under a certain code. Therefore, hospital facilities are not as important to think about on the list because they all operate under a certain level of standards. So they've all kind of risen to the occasion and it's moved down on the list.

SPEAKER_02: And it has made such a difference. I've worked with physicians all of these years and to see that there is just a view of the hospitals overall, even if it's a rural hospital, they're not as worried about it as they used to be. So now they're much more flexible, which is wonderful because they can decide in different locations that they might want to have their career. So other changes that we've seen, the immediate income changed dramatically. I wonder why that's changed so much and what their interests are.

SPEAKER_01: The only thing that we can determine and what we think this explains is in 1987, many physicians, they own their own practices. Therefore, that immediate return on investment wasn't something they were thinking about. They knew that they were putting equity into their practice and in 30 years, they would be able to draw from that equity. Now, many of them are employed by hospitals directly. They're part of physician groups. Therefore, they want that immediate income now. They don't want to wait 30 years for it. They realize that if we are going to make money, if we're going to pay off our debt, we want to do it now and we want to see those numbers now. So we believe that that's why the immediate income has risen from the very last factor on the list to number three.

SPEAKER_02: Yeah, it is amazing. We can now see on the most recent physician income survey, the salary surveys, that the youngest physician just coming out of training, they're looking at, well, what's the median? What's the average? I want that number. It used to be that they would be okay if they're making $100,000 less. And now it's not one affair number right away. And that is dramatically different. And now you've explained why.

SPEAKER_01: Yeah, and hospitals must become very competitive. It has been a little tougher for some rural communities that maybe don't have access to the same funds that some of the bigger metro communities have because this is something that's very important to physicians and it's

SPEAKER_02: made things very, very competitive. Absolutely. And thinking about the rural hospitals compared to the metro overall lifestyle is just shot to the top. Why is that number one now?

SPEAKER_01: Well, I think overall lifestyle has always been important, but to your point, it was third on the list back in 1987. And now since then, in 2007, and then today, it has become the number one factor. So if you are a physician recruiter and you're thinking about how you are going to entice a physician to come to your hospital, you really have to sell what that overall lifestyle is going to look like. What are the opportunities for their families to get involved in activities in the community? If they are an active person, you need to talk about what outdoor activities might be available to them. If they're a foodie, what great restaurants are in the area. I think that as a society, we've shifted and we're trying to enjoy life much more now and we're trying to live that life. So knowing what motivates the physician, what activities they're interested in, and then talking about how your area can allow them to participate in those activities outside of work is very,

SPEAKER_02: very important. Yeah, I think you're absolutely right. And also the physicians, you know, let's say a generation ago, they were going for the career. Now, where could they practice medicine, their best skills and best location professionally? And now it's so much more balanced, just in our society overall. And so they're thinking about if they have a significant other, they're thinking about their kids, they're thinking about where they want to be now, but maybe where they want to be long term. And that's lifestyle. They understand that the position, the job, is the center of their life. That's true. This is where it's been so many hours, but then there's all the rest to give you that lifestyle. Exactly. The Ford's

SPEAKER_01: the lifestyle that you want to have. Another thing to mention is that in 1987, both spouses typically didn't work. In today's world and since 2007, it's very common for two spouses to work. Therefore, those hours outside of work are very precious. And that overall lifestyle in the area is now very, very important to both spouses. I can appreciate that. And we

SPEAKER_02: also have some of these spouses that, even if they're not working at the moment, they plan to be, and if someone's trying to attract them to the hospital, they need to think about the significant other, what is he or he looking for. Something else on the survey that's new that we see in the most recent edition is that the malpractice rates are now extremely important to the physicians. I wonder why that's now even coming to the picture.

SPEAKER_01: Well, nowadays it's very important for the employers to cover the malpractice of the physicians who are working for them. So the physician is expecting that. Not only are they expecting that as being an employed physician at that hospital or with that group, are they expecting their malpractice coverage to be paid for? They are also expecting the tail coverage to be paid for. So that is a question that every single physician recruiter really needs to be able to have an answer to. And if your facility doesn't cover malpractice or doesn't cover tail coverage, it's something you should definitely look into and or be able to explain the reasoning why, because that's very important to these physicians.

SPEAKER_02: The tail covers can be a big cost to a physician. And they know that now. Physicians are so much better informed than they used to be. They're networking. This is partially because of the internet. They're setting up for themselves. The vast majority of employers do cover tail. The small practice doesn't cover the tail. They say, oh, nobody covers their tails. No, it's just the opposite. They've asked the majority. And the physicians, they know better how to shop for these opportunities. So whether it's a small hospital's not covering tail or a small practice is not covering tail, realize you may not be able to recruit the best physicians

SPEAKER_01: just because of that. Exactly. And kind of the motto with tail coverage, because it extends the life of the policy that was in place when the physician was working, it's to cover the tail of the facility as well as cover the tail of the physician. So it's something that it really is mutually beneficial to both parties and hospitals really do need

SPEAKER_02: to make sure that they cover that. Yeah, it's so interesting that they forget that small detail. Why do they want the tail to cover themselves? Exactly. And then also we'll cover the former employee. So, well, Olivia, it's been so good to see you again. We've covered quite a bit here. There's more in that survey data, but I think you did a wonderful job of hitting the highlights. And everyone, we appreciate your time today. And we hope this was helpful. Thank you. Thank you for these insights, which are really

SPEAKER_00: valuable for our physician community. If you enjoyed this information, please look out for the other topics we'll be covering with Roger. If you want to learn more, visit physiciancareeradvisor.com. Thanks for joining us on this special edition of the Heroes of Healthcare podcast. We'll see you soon.