Improving the Hospital Medicine Job Market

by Joshua Allen-Dicker, MD, MPH

BEST COMP PACKAGE IN THE REGION!
Sign On Bonus and Relocation!
NO procedures, NO night call, NO ICU!
Only 15 minutes north of the City!

Each day, my inbox brings me promises of a new life. One with an amazing salary, close to a metropolitan area, and in a town with the best school system in the state. I could have it all! There’s just one problem (aside from my high level of satisfaction with my current position): these announcements often tell me little to nothing about the actual jobs they are advertising.

As faculty co-sponsor for our residency program’s Hospital Medicine Interest Group, I often act as a resource for residents and field questions about job searches: “I’d like to move to ____. How do I start my job search?” “I’m flexible about location, but ___ is really important to me in a job—where do I start?” Among other advice, I often encourage applicants to network at regional and national meetings and to focus on improving and marketing their strengths. Surely well-qualified applicants should have no problem finding interested hospital medicine groups. I used to think that the rest would be easy.

In making this assumption, I failed to anticipate a pretty significant problem: in the fastest growing medical specialty, finding openings for hospital medicine positions can be simple, but job listings often look so similar that applicants have no way of telling them apart or figuring out which will best fit their interests. If they were looking for a job in Southern California, how could they find the time to interview for all 12 positions listed on a physician career website? If they were looking for a job where they could grow their quality improvement skillset, where would they even start?

Take a moment right now, and think of all that you love about your job. Is it the culture of the hospital medicine group? The collegial relationship with hospital administration? The ability to get out in time to have dinner with your family? Or is it that you always feel supported in your mission to provide high quality and safe patient care? Now, flip to the last page of your favorite hospital medicine publication or pull up a physician career listing website. Try to find a posting that describes something remotely similar to what you just pictured in your head—my guess is that you can’t.

Today’s physician job listings focus mostly on salary and the number of shifts required per month. That’s it. Some job listings actually post more details about the hospital’s town than the hospital itself. The substance of the job, those things you envisioned in the exercise above, feels like an afterthought. In an unofficial review of hospital medicine job listings, I never saw anything about how a group scored on the AHRQ’s Culture of Safety Survey, or how many of the Key Principles and Characteristics of an Effective Hospital Medicine Group the organization met. There was no data about job satisfaction scores, retention rates, or the number of weekends/holidays one should expect to work.

It is probably unreasonable to expect a career advertisement to contain everything about a job that we need or want to know, however our current approach feels like it is lacking the attention and maturity worthy of our profession. After all, can you imagine what it would be like if job applicants took the same approach of vague information and egregious use of the caps lock?

BEST HOSPITALIST!
Team work, clinical acumen, nice to nurses!
NEVER late, NEVER calls out sick, NEVER forgets to bill!
Arrives early to work in the morning!

Just as a good physician is more than someone who remembers to bill and arrives on time, we know that there is more to a hospital medicine group than what we are currently advertising—we owe hospital medicine applicants more than what we’re currently giving them.

In fact, a well-functioning job marketplace could benefit employers as well. If hospital medicine groups provide more information about a job upfront, they might have an easier time recruiting physicians who best fit their needs. On the flip side, better informed applicants may be more likely find a job best suited to their interests, raising subsequent physician job satisfaction and decreasing costly physician turnover.

So where do we start? First, we should acknowledge that this is uncharted territory—by my quick review, no other medical specialty has yet implemented a more substantive approach to job advertising. Second, we should re-think how we brand ourselves. What can we tell applicants that will differentiate our programs from the competition? Third, we should be thinking about what applicants want to know, and how much of it is reasonable to collect and share. Improving the hospital medicine marketplace is a collective responsibility: I envision the need for engagement and innovation on both the group- and national organization-levels.

Hospital medicine is an amazing career choice with diverse opportunities. However, in today’s job market, hospital medicine groups are missing out on a key recruitment opportunity. We are more than just empty advertisements. Let’s learn how to effectively communicate just how special our hospital medicine groups really are.

Joshua Allen-Dicker, MD, MPH is a hospitalist at Beth Israel Deaconess Medical Center and Instructor in Medicine at Harvard Medical School, both in Boston, Massachusetts. He received his medical degree at New York University School of Medicine and obtained his Master of Public Health from Harvard School of Public Health. He completed both his internship and residency in internal medicine at Beth Israel Deaconess Medical Center. Josh now serves on Team Hospitalist for The Hospitalist news magazine, as well the Society of Hospital Medicine’s Physicians in Training and Annual Meeting Committees. Follow him on Twitter @DrJoshuaAD.

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