The people most impacted during job search, in my opinion, are specialists who will complete training years from now, as many GI/cardio etc like to have an NP/PA improve access, follow a basic intake and chrinic management protocol while padding their income, rather than sharing with a new doc, which will reveal itself as less job openings in those fields. As a point of primary access, most patients generally choose an MD/DO. NP/PA prefer the ability to have a narrower focus and have a doc to run plans/labs by. The big exception to this is psych, where they can hang up a shingle, manage anxiety/depression/add all they want and of course refer all the complicated axis 2 stuff to an actual psychiatrist, which will be a real joy to new psychiatrists.
With that said admins will always look at the bottom line and that complicates things. Fortunatly in terms of population health and “getting it” we do alot for ourpatients that translates into what we manage in the office (fee for service) or quality if we are transitioned to some pop health/quality BS metric (I think)...
In regards to finding a job:
- pick city
- google hospitals/groups in city
- call them, interview, prepare offers, and negotiate as you are in demand
Which city apparently doesnt have jobs? You may be low balled in a super saturated place (ie Chicago which apparently has lots of residency programs and people who would want to stay).
In regards to our profession, my vote is for not extending our conferences to those whose professional organizations say that are better at half the price. Wanna attend? Then you need MD/DO or med school acceptance. Rethink access to us for clinical training and finally refuse to sign charts and supervise anyone. Im nice to everyone I work with but I will not train nonmedstudents/residents. Refer to yourself as a physician, spell out your credentials and training path to new patients. If I refer someone to a specialist and they see a Midlevel first, I generally begin to look for a plan B for future referrals, unless I really like/trust the person seeing them. Reward colleagues in the community who give legit intro access. In a huge healthcare system and big brother is watching? Give a blanket referral form and casually mention the local GI group in town that can get them in in a week and see them via a real doc (that was my go to in residency)....not an issue now, thank God. Dont let the weeny, health care medical home/provider/everyone gets a trophy propaganda from residency/med school filter into your brain. Its true that physicians should not be arrogant, but we must be secure in what we can do and what it took to get there, and protect/respect it.
You said it, not me.
