Several years ago, before the stress of a medical career sprinkled gray hairs across my beard, I boarded an airplane for an all-expenses-paid trip to a medium-sized city in the Midwest. I felt like a king. A driver and private car waited to take me to a five-star hotel where a steak dinner and other expenses were covered by my future employer. If they are willing to spend this kind of money for the interview, I thought, I can’t imagine what they do for their employees.
But once I signed on to the job, the early promise of that interview day luxury didn’t quite hold up. The salary was livable and the benefits were solid, but the wine-and-dine flair that had lured me to a strange new city was gone, replaced by an odd assortment of perks and freebies. My new employer offered to help me purchase a home, but the closing cost credit was only applicable to a swath of homes in a distressed neighborhood surrounding the hospital. They would repay some of my student loans, but only if I promised not to leave within three years. And they used their corporate influence to offer their employees a discount on interior house paint.
That’s not a slight against this particular hospital. In fact, these benefits are relatively robust compared to their competitors. But it was my introduction to a fact that rings true across many industries: companies would rather burn money recruiting employees than spend it to retain them.
That wide gulf between money spent to entice a new employee and to retain an existing one has been on my mind a lot lately. If you haven’t heard, it’s likely that our entire economy is in the throes of a Great Resignation. A combination of worsening work conditions, government assistance, and pandemic-related epiphanies have caused a large segment of the population to rethink their jobs and, often, head for the door.
And health care is likely no exception. Our ranks consist of highly trained, in-demand professionals who have borne the brunt of grueling conditions over the past two years. We marched into the breach of COVID-19 with inadequate protection and 18 months later find ourselves somehow fighting the same desperate battles. A reckoning seems inevitable.
After all, resignation is often the only leverage employees hold over their employers. But recent research suggests that the employment environment and work-life balance play a big role in employee retention. What if employers leaned into these principles and spent some money to make your life a little better? Would you stay?
Before you quit, consider negotiating for a few unorthodox benefits:
Free Child Care
If you work in a hospital or other shift work environment, it’s likely your life doesn’t sync with the typical 9-to-5 crowd. Ensuring your children have supervision and transportation throughout the day is not just expensive, it’s also a logistical nightmare. But hospitals and other large health care employers are ideally positioned to offer free, communal child care for their employees. That might mean opening child care facilities on campus, using corporate buying power to obtain credits for commercial day care, or even obtaining a roster of vetted babysitters. A relatively small investment by employers would relieve parents of stress and a large financial expense.
Mandatory Mental Health Days
Clinicians have always suffered from higher rates of mental health disorders and substance use compared with the general population, but surveys suggest clinician mental health has further eroded during the COVID-19 pandemic. Employers need to address this reality.
As this issue moves to the forefront of popular conversation, the stigma around mental health has begun to dissipate. But in a culture that glamorizes overwork, we must be saved from ourselves. Employers should give their workers an allowance of days off specifically for the protection of mental health, whether that means making an appointment with a therapist or enjoying a day at the beach. And the use of these days should be mandatory, automatically added to the calendar so that their utilization is normalized.
In addition, ask employers to add a tax-advantaged spending account (like a health savings account) for employees to use on mental health services, since many therapists are paid in cash.
Fiduciary Financial Advisers
We would never dare to say it out loud, but most health care workers don’t want to work until the day we die. Heck, many health care workers don’t even want to work full-time into their 60s (or whenever they hope to retire). But we don’t often use money to our advantage or consider earning passive income throughout our careers.
Health care workers have enough disposable income to wisely invest a portion, but we often don’t know how. After all, we spent our lives learning medicine, not finance. To make matters worse, many so-called financial advisers are incentivized to sell you products rather than protect your best interests.
A fiduciary financial adviser is legally obligated to always act in your best interest. Instead of earning a commission on the products they sell you, they often receive a flat fee to give you honest advice — a fee your employer could pay. With the right advice, your investments might do the work of that overtime shift you just picked up.
Professional Development — Outside of Health Care
Education funds and tuition reimbursement already exist, but employers often restrict their use to specific health care-related programs. It makes sense in theory: train workers for roles they are likely to fill within your organization. But employees increasingly see benefits as something to improve their lives, not just their productivity.
Ask your employer to sponsor your study or training in a field outside of your health care profession, if that is what interests you. The return on investment for your employer is twofold. First, this generous benefit is likely to attract and retain new talent. Second, a diversity of ideas and disciplines is likely to spur innovation within the organization, creating a healthier, more successful workplace. And if the occasional employee finds their calling outside of the organization, that’s OK; health care should be a career, not a captor.
If I could go back in time and meet the younger version of myself as he boarded that plane to his first job, I wouldn’t slap the ticket from his hand and whisk him off to some other employer. After all, he is about to learn many valuable lessons—medical and otherwise — that only come from experience. But I would tell him to invest in himself not just as a professional, but also as a person. And I would advise him to work with organizations that are willing to make a similar investment, one that lasts far beyond the job interview.
What would make you stay for a job? Share your fantasy benefits in the comments.
Harrison Reed, MMSc, PA-C is an Assistant Professor at the George Washington University School of Medicine and Health Science Physician Assistant Program and practices critical care medicine at the George Washington University Hospital in Washington, D.C. He serves on the editorial board of the Journal of the American Academy of PAs (JAAPA) and his writing can be found at TheContraLateral. Harrison is a 2021–2022 Doximity Op-Med Fellow.
Illustration by April Brust