I’ll take it even a step further, and say that there aren’t that many appealing *clinical* jobs, even if you’ve finished a residency.
I’m six years into a career in rheumatology. My first hospital job was a horrible experience (nasty, godawful admin that treated me like garbage and shorted me on RVUs, thus vastly underpaying me) that made me never ever want to be employed by a hospital again. Job #2 basically never happened - it was at a small solo rheumatology PP where I moved across the country only to have the idiot rheumatologist who owned the practice decide she didn’t actually want to hire someone else after I got there. Job #3 was at a corrupt ****show of a multispecialty PP with incompetent leadership, doctors who were drinking and doing drugs while seeing patients, other docs who had apparently groped patients and staff previously, etc. I left after 10 months and the PP imploded shortly thereafter.
It’s only now - 6 years and 4 jobs in - that I’ve found a really good job where I’m paid well, and where I’m happy. But the first three jobs were complete trash.
It is very common to have to go through at least one job to get to a job that is sustainable. I actually enjoyed my first job in private practice, but the support/referral base wasn't sustainable so I left. I now work in academics and it is great.
My wife's first job was horrible. Showed up day 1 pregnant and employer lied about health coverage. She wasn't eligible for health insurance until 6 months after she started employment. Yes, the employer knew that she was pregnant when she was given this misinformation. We had to pay thousands of dollars out of pocket for COBRA. Very stressful finding out you don't have health insurance while pregnant. We were at the beach the first weekend after moving to the area and she gets called by her boss asking why she wasn't in clinic. She was told that she wouldn't cover weekend clinic for the first two months while getting acclimated. We had to leave the beach and she had to show up to work for a job she just started. Two months roll around and she gets her first paycheck, only to realize that she making 20% less than expect. She wanted to work 0.8 FTE because of the upcoming delivery of baby and that was specified within the contract. The employer took the agreed upon salary (which was straight up garbage...10th percentile), and paid her 80% of that agreed upon amount. She was essentially working at less than 5th percentile...in APRN/PA range.
Within two months we knew that we have to make an escape plan. Then boom, COVID comes around and nobody is hiring. My wife's employer then brings everyone into the office at 6PM on a Friday and tells them that they all would have to sign a new contract (with an additional 20% reduction in pay, as well as other other modifications to non-competes and other items), and return the contract before the business open on Monday or they would be terminated. Very shrewd, as the employer knew that none of the staff would have any other job options because of the hiring freeze and nobody would have the opportunity to contact employment lawyers because they don't typically work over the weekend. Fortunately, we personally knew our contract lawyer and he was willing to make modifications to the proposed contract, which was frustratingly accepted by the employer. My wife took the 20% paycut during COVID, now making less than $100,000/year.
Finally, other employers begin to hire. My wife gets a job paying 50th percentile by her new employer. The following year she is over 90th percentile nationally in RVU. Her pay jumps from under $100,000 to close to $400,000. Think about that for a second. Same work, same city, less headaches, nearly four times the pay.
BUT THAT'S NOT ALL! Within 3 months of my wife working at her next job, she gets served a lawsuit threat by her prior employer stating that she violated her non-compete. My wife worked outside of the 10 mile radius of her prior employer, but the employer stated that he had other offices within that radius. She was told that she had immediately stop working and provide all of the compensation earned while working for the new provider to the prior employer's lawyer so that money can be retrieved. My wife ends up working with our contract lawyer as well as an army of lawyers through her current employer who threatened a counter suit. It wasn't until then that it was finally over.
You won't find a bigger supporter of abolishing non-compete clauses. Nobody in the world has to put up with that type of nonsense. Physicians are TRAPPED into these relationships because of their high loan burdens, and there are times that are is absolutely no way out.
