Self-employed versus Employed Doctors

Medscape surveyed 5000 doctors to find out how they felt about their work and to compare self-employed with employed physicians.   (Medscape Survey)   Employed physicians may feel less financial and management pressure; but self-employed ones may perceive greater autonomy.  Only 18% of female physicians and 22% of male ones report being self-employed.  Only 11% of doctors under age 40 are self-employed, but there is also a trend among older physicians near retirement to become employed, as they seek to ease out of working.  27% of employed physicians were previously self-employed, whereas only 13% of self-employed doctors were formerly employed, but the trends in switching are lessening.  Among employed physicians, 32% work at a hospital, 19% in a single-specialty group, 15% in a multispecialty group and only 2% in solo practice; for self-employed doctors the comparable numbers are 19%, 32%, 9% and 31%.  Primary reasons for choosing employment are financial security and less risk, cited by 36%, work/life balance by 26% and less administrative work by 15%.  The physicians who are employed say they most like not having to run a practice, to deal with insurers and they appreciate the even, consistent financial payments and benefits.  Things they don’t like include loss of control and autonomy and limited income growth potential.

Overall, 63% of self-employed doctors say they are happy with work and 55% of employed ones, but both rates have declined since 2014, for self-employed clinicians from 74% and for employed from 73%.  Self-employed males and females are equally happy, but employed women are more satisfied than employed men.  71% of those who switched from employed to self-employed status said satisfaction improved compared to only 40% for those who went the reverse direction.  Most employed physicians have some variable component to their compensation, usually based on productivity.  Both sets of doctors report equal satisfaction with their compensation.  About 60% of employed doctors say they never or rarely disagree with their leadership about patient care, but more report conflict over workplace policy, usually in regard to other staff.  37% say they frequently or occasionally are pressured to make patient care decisions they disagree with and 14% say their employer puts financial interests ahead of patient care.  40% of employed doctors report satisfaction with their EHR compared to 31% of self-employed ones.  Both types of physicians report equal pride and sense of accomplishment in their work, at 81%.