In an era when new doctors need business skills (1) and the role of the physician is ever-changing, it is not surprising that content that focuses on ‘medical business’ topics is some of the most engaging and thought-provoking for Doximity members. Some topics that our physician members find particularly captivating at various clinical career stages make intuitive sense: for example, content on managing student loan debt performs very well with early-career physicians, personal finance in mid-career, and content that touches on retirement resonates with those in the later stages of their careers. The Editorial team at Doximity looked further into the data on what users across different career stages are reading and observed some interesting trends.

For this analysis, we defined an early-career physician as <5 years out of training, a mid-career physician as 5 to 15 years out, and a late-career physician as >15 years out of training. Based on our analysis of the most engaging content from Doximity’s medical business newsletters in 2019, three trends emerged as to the evolution of topical interests as our physician users progress through their careers. As physicians get later on in their careers they show:

1. Decreased interest in compensation, non-clinical career opportunities, and clinician wellness
2. Increased interest in health care prices (though not necessarily health care policy)
3. Increased interest concerning malpractice

The Link Between Compensation, Non-Clinical Career Opportunities and Clinician Wellness

Doximity's annual physician compensation report (2) served as a resource this year for physicians looking to navigate the US health care system’s current employment landscape. While you could rightfully presume that compensation remains an important topic throughout one’s career, readership data shows that there is a steady decline in how compelling physicians find clinical compensation-related content as they enter later career stages. This might reflect a better understanding of, or greater comfort level with, one’s own compensation level after having spent some time out in practice. It might also correlate with the growing number of physicians that are seeking compensation from sources other than their clinical employment.  

Early and mid-career physicians are being crippled by student loan debt and the burdensome requirements to maintain medical licensure. With a physician compensation bubble potentially emerging, it is understandable that these groups are more likely to pursue "side hustles" like consulting and medical advising. These and other non-clinical career opportunities have increasingly gained readership among early and mid-career physicians. 

Nearly half (3) of all physicians report experiencing burnout, which is so widespread that the World Health Organization now recognizes (4) it as an “occupational phenomenon.” Many physicians write about fighting burnout by acquiring financial independence. In one of Doximity’s most popular Op-Meds this year, "The Hospital Won’t Love You Back," a physician contributor details the bitterness that can come with cumulative disappointment throughout a medical career and how financial independence can allow for some emotional distance from that negativity. Readership interest in clinician wellness is strong across all user groups but shows decline in later career stages.

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Here’s the most discussed article about salary/compensation: 

The Physician Compensation Bubble Is Looming

Interest in Health Care Prices, but Not Necessarily Policy

Rising health care prices hurt everyone and physicians are showing increasing concern and interest in content covering topics such as health insurance issues and exorbitant health care bills/prices. Readership interest in content on the specific topic of health care prices appears to increase in physician groups later on in their careers. Interestingly, our data does not show such a correlation with progressively increasing interest in content directly related to health care policy per se. Why does interest/engagement in health care prices increase, but interest in policy stagnate later in a physician’s career? Content covering health care costs is often case-based and may make for a more compelling read than content on health care policy writ large, which can often be a more nebulous topic to cover. One of the most engaging articles of 2019 on health care prices was about the massive patient bills coming out of Zuckerberg Hospital in San Francisco.

Physicians appear to be more opinionated about policy than action-oriented, even when it directly impacts their career(s). The author of this well-engaged article poignantly shares, “Merely 1,324 physicians, out of 800,000 in the US, have contributed to the legal fight against the onerous MOC process, despite the fact that it is reviled by the majority of doctors...Why are so few of our fellow physicians standing up when given the chance?” 

In 2014, Harvard Business Review (5) outlined what is needed to engage physicians in revolutionizing health care, citing tenets such as garnering shared purpose, appealing to self-interest, and embracing tradition. Are later-stage physicians just more comfortable in their ways and/or their institutions’ ways, making them less likely to engage in policy change? 

What motivates you to read about health care prices? What motivates you to read about health care policy? Are there specific topics you would like Doximity to cover more? (Feel free to leave suggestions in the Comments section.)

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Here’s the most discussed article about health care prices:

Zuckerberg Hospital ER Doesn’t Take Private Insurance, Sticking San Francisco Patients with Huge Bills

Malpractice Scares

The fear of being sued is a significant one for many physicians throughout their career. Stories like the Minnesota Supreme Court case on physician-patient relationships and malpractice garnered much discussion on Doximity. As a physician progresses through their career, readership interest in malpractice-related content appears to grow steadily. This might be influenced by early-career physicians being trained to expect malpractice issues as a normal part of the profession and culture. Alternatively, one might wonder if it could be a reflection of early-career physicians being less sensitive to or informed about potential ramifications? According to the American Medical Association, nearly half of physicians 55 and older report having been sued, compared with just 8% of physicians younger than 40 (6).

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Here’s the most discussed article about malpractice:

MN Supreme Court Rules Physician-Patient Relationship Is Not Necessary to Sue Docs for Malpractice

Common Themes Still Unify Physicians Across Career Stages

One common theme emerges for all physicians no matter the career stage: you’re not alone. 

You’re not alone when you’re working through how to balance work and personal life or deciding whether to continue being a physician or find a non-clinical route in your career. Maybe you are like this one physician who has been able to find her own work-life balance.

You’re not alone when you’re trying to understand health care prices and policies because you’re looking to improve patient care or even your own future well-being in medicine. Could your story be similar to this physician who woke up to being a liability?

You’re not alone when you’re up against malpractice or other legal issues. This physician was able to find a community of physicians in similar situations. Have you found a community to help you through trying times?

Whatever the trend, no matter the struggle, and no matter the stage you are in your career, you are in good company at Doximity. Write and share your views on Doximity's Op-Med. What other topics would you like to see covered in our future medical business newsletters? Thank you for your membership.

References

1. Pearl, R. M., Fogel, A. L., et al. (2018, April 11). New Physicians Will Need Business School Skills. Retrieved from https://catalyst.nejm.org/new-physicians-need-business-school-skills/.
2. Doximity 2019 Physician Compensation Report. (2019, April 2). Retrieved from https://www.doximity.com/doc_news/v2/entries/18323150.
3. Berg, S. (2019, January 24). Physician burnout: Which medical specialties feel the most stress. Retrieved from https://www.ama-assn.org/practice-management/physician-health/physician-burnout-which-medical-specialties-feel-most-stress.
4. The World Health Organization. (2019, May 28). Burn-out an "occupational phenomenon": International Classification of Diseases. Retrieved from https://www.who.int/mental_health/evidence/burn-out/en/.
5. Lee, T. H., & Cosgrove, T. (2014, December 3). Engaging Doctors in the Health Care Revolution. Retrieved from https://hbr.org/2014/06/engaging-doctors-in-the-health-care-revolution.
6. O'Reilly, K. B. (2018, January 26). 1 in 3 physicians has been sued; by age 55, 1 in 2 hit with suit. Retrieved from https://www.ama-assn.org/practice-management/sustainability/1-3-physicians-has-been-sued-age-55-1-2-hit-suit.

Article written and researched by Felix M. Chinea, MD, Erin Mercer, MA, and Angelica Recierdo, MS.

Illustration by April Brust