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Most young physicians are aiming for job promotions

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There are ample opportunities for physician promotions for those employed by hospitals and healthcare systems, those in a private practice with hospital affiliation, and those with nonclinical jobs working in industry. This article covers the reasons why some doctors aim for promotion throughout their careers, as well why some choose not to. As a bonus, several examples of doctors who’ve had multiple promotions within their organizations aims to inspire you as you develop your own career goals.

How many doctors are vying for promotion?

Medscape’s Young Physician Compensation Report 2020 states that 59% of physicians under the age of 40 are aiming for promotion. It would be accurate, then, to say that “the majority” of young physicians are aiming for promotion. Nonetheless, it’s certainly not a vast majority.

I am struck by how split young physicians are in this regard.

On one hand, climbing the corporate ladder has been widely considered to be the ultimate career goal for a long time. I do feel that this notion is starting to change; however, today’s young physicians (most of whom are millennials) were led by society to believe that the ladder needs to be climbed.

On the other hand, a promotion for a physician typically means less time seeing patients and more time engaged in administrative responsibilities. I recently saw a post in an online forum that read “Most doctors don’t become doctors to sit in an office all day long.” So, it also makes sense that many physicians don’t aim for promotion.

Interest in promotion declines with physician age

Also of note in the Medscape report is that percentage of young physicians aiming for promotion is nearly twice that of older physicians. Of physicians ages 40 to 69, only 32% are aiming for promotion. The report states that this is “not surprising,” though I’m left wishing there was more insight.

Have the physicians in the older group already gotten promotions and feel liked their careers have peaked?

Or, have they grown disenchanted by the idea of climbing the corporate ladder over time, ultimately deciding that promotion isn’t worth it to them?

The goal of promotion depends on work setting

In addition to age, I strongly suspect that organization type is associated with desire to get promoted as a physician. The goal of promotion as it relates to employer type is another detail that I would have liked to see in the Medscape survey.

Within academia, for example, vying for promotion is the prominent mindset. It’s somewhat of an expectation that you’ll work your way up the academic ranks from Assistant Professor to Associate Professor to full Professor. Physicians who aren’t interested in this are presumably less likely to accept a position in academia.

There may be a lower percentage of physicians aiming for promotion in non-academic settings – for example, those employed by private hospitals and those with nonclinical jobs in industry.

Trajectories of physician promotions

Here are several examples of physician promotion trajectories that I spotted on (you guessed it.. my favorite networking site!) Linkedin. Take a gander and then keep reading for the reasons that you, too, may want to consider aiming for career advancement through promotion.

This emergency medicine doc started at his hospital as a staff physician. Over a period of less than 7 years, he got promoted to Medical Director of the emergency department, Chief Medical Information Officer, and finally Chief Medical Officer.

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An anesthesiologist began with New York-Presbyterian Hospital as their Deputy Quality Patient Safety Officer and was promoted to Medical Director of Operating Rooms 3 years later. The rest of his path has touched nearly every corner of the C-suite as Chief Innovation Officer, Chief Medical Operating Officer, and Chief Transformation Officer.

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A neurosurgeon practicing within the Henry Ford Health system got promoted to Medical Director, then Senior Vice President and Chief Academic Officer, and then all the way to CEO. Within that time period, he also became the chair of the Department of Neurosurgery and Co-Director of the system’s Neuroscience Institute. What a career!

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I’ve got a couple of examples of physician promotions in non-clinical careers, as well:

This physician joined anthem as a National Medical Director, a role that he held for nearly 6 years before receiving a relatively rapid series of promotions to CMO of the Government Business Division and three different Senior Vice President roles.

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This physician was the Market Medical Director with managed care provider Evoluent Health for only a year before being promoted to Regional Chief Medical Officer. From there, he was subsequently promoted to Medical Executive and then to CMO of the company’s Medicaid line of business.

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Working your way up within an organization doesn’t necessarily take the better part of a decade, though.

This doctor started at Ro, a digital health company, as the Associate Clinical Director. Within the next two years, she was promoted to Clinical Director, Vice President of Medical Affairs and Research, and then Senior Vice President of the same division.

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Reasons you should aim for a promotion…

Aside from the societal expectation of “working your way up” in your career, there are a number of reasons that doctors tend to aim for promotion.

Higher pay

This is the big one. Promotions inevitably are accompanied by salary increases. Some physicians may be able to trade out clinical productivity incentives with yearly bonuses. When you reach the C-suite, golden parachutes and other agreements that increase the overall value of your compensation package come into play.

According to Mercer’s 2019/2020 US Compensation Planning Survey, the average salary increase offered with a promotion in the labor market at large was 9.3%. It was 11.1% for executive level positions. Not only are these numbers significantly higher than the ~2% cost of living increase that you might get if you’re not promoted, they have also been increasing over time:  Average promotional raises were increased by 1.5% from Mercer’s previous year’s survey.

Better work-life balance

A better work-life balance certainly isn’t a consequence of every promotion. Higher-level jobs tend to have long hours. Some require travel and putting in work on the evenings and weekends. In contrast, they often have decreased on-call requirements, less after-hours charting, and more predictable hours for physicians. Physician promotions can mean improved work-life balance for some doctors, despite the higher level of responsibility.

More relevant experience for non-clinical jobs

Many non-clinical jobs for physicians (such as those in the pharmaceutical or health insurance industries) require some amount of relevant experience. Doctors who don’t have direct industry experience often need to gain relevant experience while in a clinical position. The best way to do this is by doing the type of work that typically comes with physician promotions:  administrative work, leading committees or teams, writing policies, interfacing with clients and vendors, addressing personnel issues, and so forth.

Physicians interested in eventually transitioning to a non-clinical job may want to aim for promotion to help get their foot in the door for their desired position.

Ability to accomplish more

You might be able to accomplish more, help more people, or do more for an issue you’re passionate about by taking a promotion. Like work-life balance, whether this is the case depends on the exact position you’re in and promotion you’re offered.

In many cases, being promoted as a physician means that you can lead process changes and make decisions that affect an entire division, company, or patient population. You may not be treating as many patients as you’re used to after you get promoted. But you’ll be impacting the care that patients receive on a larger scale.

…and reasons that climbing the corporate ladder may not be worth it

As I mentioned at the beginning of these article, there is no consensus among young physicians as to whether to aim for promotion. In fact, 41% report that they are not vying for promotion. Why not? Here are some of the main reasons.

There are other ways to increase your income

Higher pay is a major driver for pursuing promotion. But there are other ways to increase your compensation – especially as a physicians. Identify a consulting niche, start a business on the side, or do some moonlighting. You can also dedicate free time to learn about investing or to set up sources of passive income. Doctors with private practices can add new services or adjust certain processes to increase their bottom line.

Changing employers can offer better options for career advancement

Getting promoted within your company is, of course, only one of multiple possible ways to advance your career and increase your salary. Accepting a new position with a different organization is even more common.

Changing to a new position at a new company can be a lateral career move, in which you have a role that is similar to your previous job. A lateral move often means at least somewhat of a shift if your job responsibilities, though, so you might learn new skills or create value in a different ways.

Changing employers can also be a diagonal career move, meaning that the new job represents movement upwards in terms of leadership or seniority.

Less time practicing medicine

Promotions inevitably result in less time actually seeing patients. Some physicians welcome this change. For others, it’s a convincing reason to not pursue promotion at all. Forming relationships with patients is the most rewarding part of the job for 29% of young physicians.

Promotions can happen for the wrong reasons

In the best case scenario, a promotion is offered to an employee because he does great work and has the potential do even greater work after receiving a promotion. In a less than ideal scenario, promotions can be offered due to high rates of employee turnover, takeovers and mergers, and other situations in which the company is left scrambling to fill its leadership positions.

In summary, young physicians are split as to whether they are aiming for promotion because there are advantages and disadvantages to both types of career paths. There is not right or wrong that applies to everyone. Pursuing promotion is a great way for some doctors to reach their career goals. For others – especially those who are content with seeing and treating patients – it may be unnecessary.

There’s no need to make a final decision in advance

Interestingly, Medscape’s young physician compensation survey asked about respondent’s goals for promotion as a Yes/No question. It assumed that all early-career physicians have already set goals related to their career paths. While I’m a big proponent of forming professional goals, I know that it can be difficult to set clear goals when there are so many unknowns about your career and where other aspects of your life will take you.

So, while I encourage setting goals related to your medical career, it’s totally fine to not make up your mind right out of the gate as to whether you want to get promoted as a physician. Here are a few steps you can take in the meantime to help you eventually make this determination:

Speak with more senior physicians. Do this at each job you have and at each conference you attend. Find out what they’ve liked and disliked about getting promoted or why they decided not to take promotions.

Decide what factors make your job fulfilling. Think about what parts of a promotion would balance out decreased patient time and increased administrative responsibility for you. This might be a certain salary, schedule, work-from-home days, or leading a certain type of team.

Reassess your career periodically. Take some time each year to sit down and assess where your career and happiness levels lie, and what you need to do to shift things in the right direction – whether this is working toward a promotion or not.


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