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N INE OF EVERY 10 new physician roles that Texas-based physician recruitment firm Merritt Hawkins sought to fill from April 2013 to March 2014 were created specifically for employed professionals, according to the company's 2014 Review of Physician and Advanced Practitioner Recruiting Incentives. The same survey reports that 64 percent of physician respondents were employed by hospitals. A decade earlier, only 11 percent said they were hospital employees. "The magnifying glass has been on [the employed-physician trend] for the past two, three or maybe even four years," says Kurt Mosley, Vice President of Strategic Alliances for Merritt Hawkins, an AMN Healthcare company, "but the trend actually started in the mid-1990s." A Complicated Undertaking Multiple factors — including assistance paying off student loan debt and increased financial security as payment models evolve under the Affordable Care Act — contribute to physicians' preference for employment over private practice. Nevertheless, many employment choices revolve around the desire to attain a balance between work and personal life. Finding that balance can be a challenge for new physicians who choose to enter solo practice — starting a business while simultaneously launching a medical career. For physicians who hang out their shingle to go it alone, a myriad of business-related anxieties await, from implementing the latest International Statistical Classification of Diseases and Related Health Problems (ICD-10) to interviewing and hiring staff. "[Physicians] want to come in and see patients," says Cheryl DeVita, Senior Search Consultant with St. Louis-based recruit- ment firm Cejka Search. "They don't want to have to concern themselves with running a business. Those types of things [could be] taking away from time when they could be seeing patients." Checks and Balances A 2014 Medscape survey of 4,600 physicians found that 54 percent of employed physicians reported being satisfied with their work-life balance, with a similar number, 56 percent, report- ing that this balance improved when they became employed. Belonging to a larger practice or medical system often allows physicians to have set schedules. Shared on-call responsibilities and an opportunity to act as part of a team in a collaborative environment also hold appeal. "Thirty years ago [practicing medicine] was like real estate — all about location, location, location," Mosley says. "Now, it's lifestyle, lifestyle, lifestyle." Tech-savvy physicians may also be drawn to the idea of belonging to organizations that can better afford to bring in upgraded equipment and implement technological advances. But employment isn't without its drawbacks. Employed physicians frequently deal with non-compete agreements, performance-based pay scales and a loss of autonomy. "There are downsides," Mosley says. "[Employed physicians] are no longer in charge. They have to be flexible. Doctors who become employed have also said that there is more paperwork to do than when they were independent." How Lifestyle Drives the Employed-physician Model By Valerie Lauer AS THE BUSINESS OF PRACTICING MEDICINE BECOMES MORE COMPLEX, PHYSICIANS CONTINUE TURNING TO EMPLOYED POSITIONS TO ACHIEVE A HIGHER QUALITY OF LIFE AND GREATER PROFESSIONAL SATISFACTION — ALTHOUGH EXPERTS SAY THE MIGRATION MAY BE SLOWING. The Pursuit of Balance — 2 6 | Cleveland/Akron/Canton MD NEWS ■ M D N E W S . CO M ■ S E P T E M B E R /O C T O B E R 2 0 1 5