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Young Ophthalmologists Study

Young Ophthalmologists Study. August 8, 2008. By:. #7658. Background Information. Background The American Academy of Ophthalmology is interested in identifying the reasons why young ophthalmologists leave their first job. Purpose

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Young Ophthalmologists Study

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  1. Young Ophthalmologists Study August 8, 2008 By: #7658

  2. Background Information Background • The American Academy of Ophthalmology is interested in identifying the reasons why young ophthalmologists leave their first job. Purpose • By understanding why young ophthalmologists change jobs, the AAO can offer resources for both young ophthalmologists and hiring practices to minimize the amount of time and money lost due to turnover.

  3. Background Information ~ (continued) Research Method • This study was conducted via the Internet. • An invitation was sent by e-mail to young AAO members asking them to participate. • Bruno and Ridgway provided survey links to the AAO. The AAO sent the survey invitations and reminders. Sample • E-mail invitations were sent to 1,959 AAO members in practice less than 5 years. • 192 members completed the survey. • Completion rate was 10%.

  4. Background Information ~ (continued) Timing • First invitations were sent on June 20, 2008. • One reminder e-mail was sent. • The study closed on July 18, 2008. Terminology • Throughout this report, doctors who remain in their first full-time position are referred to as “job retainers” and those who have held two or more positions are referred to as “job switchers.”

  5. Sample Demographics Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.1/5/8 = Please select which statement below best describes your (personal primary practice focus, years in practice, and gender). (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  6. Sample Demographics~ (continued) Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.2/6/7 = Please select which statement below best describes your (age, number of years in current position, fellowship completed). (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  7. Sample Demographics~ (continued) Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.9 = Which subspecialty below is your primary subspecialty? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  8. Key Findings

  9. Job Retention and Satisfaction Levels for Young Ophthalmologists • As a group, young ophthalmologists are reasonably satisfied with their first full-time position. • Nearly four out of five (78%) ophthalmologists in their first five years of practice remain with their first full-time position. About one in five (22%) have held more than one position. • A majority of young ophthalmologists are satisfied with their first full-time position, with six in ten (62%) saying they are/were extremely or very satisfied. As might be expected, job switchers were much less satisfied with their first position, with only 12% saying they were extremely/very satisfied. Key Findings

  10. Important Practice Characteristics When Seeking First Position • Practice aspects rated most important to young ophthalmologists when seeking their first full time position include: • Opportunities for advancement or partnership • Location of practice • Type of practice (private, academic, healthcare) • Ultimate income potential • Impression of future colleagues • Reputation of practice • Opportunity to practice their subspecialty • Most doctors were relatively satisfied with their first practice’s type and location, its reputation and opportunities to practice their subspecialty. Key Findings – (continued)

  11. Key Issues in Job Retention/Satisfaction for Young Ophthalmologists • This study identifies four key issues in job retention/satisfaction among young ophthalmologists: • #1 Opportunities for Advancement or Partnership/Income Potential • While important to Young Ophthalmologists, switchers expressed a lack of satisfaction with their true opportunity to advance, and/or earn appropriate income in their first position: • Both opportunities for advancement/partnership, and the related issue of ultimate income potential were rated important when seeking a first full-time position. • Job switchers were much less satisfied with these aspects of their first job experience compared to job retainers, and were less satisfied with their starting income level. Key Findings – (continued)

  12. #1 Opportunities for Advancement or Partnership/Income Potential • (continued) • The possibility of partnership was offered to significantly more job retainers than switchers. Further, nearly half of switchers offered the possibility of partnership say they were not made fully aware of the conditions. • Poor pay and a lack of business were frequently given as reasons for switching jobs. • Another frequently mentioned reason for switching jobs was inequitable work sharing, which a number of switchers explained as seeing fewer patients because of their status in the practice, or being expected to find their own patients/build their own practice. • Growth/partnership issues were mentioned by both retainers and switchers when asked about advice they would give to a new ophthalmologist. Key Findings – (continued)

  13. #2 Location of Practice • Practice location was also deemed important by Young Ophthalmologists, and was a reason for job switching: • The importance of practice location was rated second highest among factors considered when seeking a first full-time position. • One of eight doctors mention the importance of practice location when giving advice for a new doctor. • Switchers report dissatisfaction with location (by doctor or family) as a reason for leaving first job. • Nearly half of switchers report their first position’s location as a large metropolitan area. Significantly more job retainers practice in a mid-size city. • Significantly more job retainers mention location as a reason for wanting to stay in their first job for specified time. Key Findings – (continued)

  14. #3 Relationships with Other Doctors/Staff • The issue of relationships seemed to play out in several ways: • A doctor’s impression of his/her future colleagues was rated highly among issues considered when seeking a first full-time position. • Job switchers were much less satisfied than retainers with their impression of future colleagues. • Three in ten job switchers identify relationships with other doctors as a reason for leaving their first job. Relationships with non-MD staff also contributed to job switching. • Volunteered advice for new doctors included comments which may indicate trust issues – including advice related to practice culture/ethics/trust and the need to get job details upfront/in writing/reviewed by attorney. Key Findings – (continued)

  15. #4 Work/Life Balance Issues • While time off and being “on call” were considered very important by less than half of doctors when looking for their first full-time job, work/life balance issues do seem to have a role in job retention among young ophthalmologists: • Job switchers were much less satisfied than retainers for the amount of time off they received, and for frequency of being on call. • Job switchers report being on call more frequently than job retainers, both during the week, and on weekends. • While most doctors – both switchers and retainers – indicate they had enough time off at their first full-time position, job retainers were allowed more days off in their first year, had more days for CME, and indicated actually taking more days off during their first year than doctors who had switched jobs. • One in six job switchers report work/life balance as a reason for leaving their first position. Key Findings – (continued)

  16. Young Ophthalmologists and the AAOE • Most young ophthalmologists (95%) are aware of the AAOE, though less than one in ten say they fully understand its role. • One in ten young ophthalmologists report membership in the AAOE. More than one in five are unsure if they are members. Key Findings – (continued)

  17. Detailed Findings

  18. Number of Positions Held Since Residency/Fellowship Training • Nearly four out of five (78%) young ophthalmologists remain in their first full-time position after completing their training. A few (4%) have held three or more positions. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.3 = Are you currently in your first full-time position after residency/fellowship training? Q.4 = You indicated that you held multiple position since residency/fellowship training. How many positions have you held? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  19. Overall Satisfaction With First Full-Time Position • A majority of young ophthalmologists are happy with their first full-time position, with six in ten (62%) saying they are/were extremely or very satisfied there. Overall, job switchers were much less satisfied with their first position. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.13 = Overall, how satisfied were you with your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  20. Importance of and Satisfaction With Factors Related to First Full-Time Position • Practice aspects rated most important to young ophthalmologists when seeking their first full-time position include: • Opportunities for advancement or partnership • Location of practice or institution • Type of practice (private, academic, healthcare) • Ultimate income potential (e.g., as a partner) • Impression of future colleagues based on interview • Reputation of practice or institution • Opportunity to practice their subspecialty

  21. Importance of and Satisfaction With Factors Related to First Full-Time Position – (continued) • Among these important aspects, most doctors were relatively satisfied with the type and location of their first practice, its reputation, and of their opportunities to practice their subspecialty there. • Job switchers were much less satisfied with its opportunities for advancement or partnership, their impression of future colleagues, ultimate income potential, and the reputation of the practice. • Though these issues are of lesser importance, job switchers were also much less satisfied with the breadth of training available, the amount of time off, their frequency of being on call, and the starting income level in their first practice.

  22. Factors Related to First Full-Time Position-Quadrant Analysis(Total Ophthalmologists = 192)

  23. Factors Related to First Full-Time Position-Quadrant Analysis (First Job Retainers = 150)

  24. Factors Related to Full-Time Position - Quadrant Analysis(Job Switchers = 42)

  25. Reasons for Leaving First Full-Time Position • Poor pay, poor relationships with other doctors, inequitable work sharing, and a lack of business are the specific reasons indicated most frequently for leaving a first position. Base = Job Switchers (42). Q.16 = You indicated that you left your first full-time position. Please indicate which factors below were the reason or reasons that you left.

  26. Reasons for Leaving First Full-Time Position(continued) Base = Job Switchers (42). Q.16 = You indicated that you left your first full-time position. Please indicate which factors below were the reason or reasons that you left

  27. Partnership or Shareholder Offering and Full Awareness of Conditions to Achieve Partnership in First Full-Time Position • The possibility of a partnership was offered to significantly more job retainers than switchers. Further, nearly half of switchers offered partnership say they were not made fully aware of the conditions of partnership. Base = In Private Practice in First Full-time Position and Not Solo Practice (138), Job Retainers (106), Job Switchers (32). Q.17 = Was partnership (shareholder) offered as a possibility in your first full time position? Q.18 = Were you made fully aware of the conditions required to achieve partnership (shareholder) when you were hired into your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  28. Whether Practice Would Pay to Attend Conferences and, if so, Amount of Reimbursement in First Full-Time Position • About three-quarters of Young Ophthalmologists report that their first employer reimbursed them for attending conferences, such as the AAO annual meeting. Most were reimbursed 100%. Base = Total Ophthalmologists Not in Solo Practice (184), Job Retainers (142), Job Switchers (42). Q.19 = Did your practice/institution in your first full-time position pay to attend conferences, such as the American Academy of Ophthalmology Annual Meeting? Q.20 =How much were you reimbursed? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  29. Whether Respondent Had Enough Personal Time Off in First Full-Time Position • Four out of five ophthalmologists indicate they had enough personal time off at their first full-time position. There is no significant difference among job switchers and job retainers. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.21 = Did you feel you had enough personal time off in your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  30. Number of Days Allowed to Take Off in First Year of Full-Time Position • On average, doctors were allowed about 20 days off in their first year of employment. Job switchers averaged slightly fewer days. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.22 = How many days contractually (personal, vacation, sick, holiday) per year could you have taken off in the first year of your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  31. Number of Days Allowed For Continuing Medical Education in First Year of Full-Time Position • Doctors whose contracts allowed a specific number of days off for CME in their first year report an average of 7.6 CME days. Job retainers report significantly more CME days (8) than job switchers (6). Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.23 =How many days contractually could you have taken off for continuing medical education in the first year of your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  32. Number of Days Actually Taken Off During First Year of Full-Time Position • Job retainers indicate taking more days off (16.9) during their first year than their colleagues who had switched jobs (14.3). Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.24 = How many days did you actually take off that first year? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  33. Whether Given a Written List of Work Performance Expectations When Starting First Full-Time Position • Three out of four young ophthalmologists do not recall being given a list of performance expectations when starting their first position. Statistically, there was no difference between job switchers and job retainers. Base = Total Ophthalmologists Not in Solo Practice (184), Job Retainers (142), Job Switchers (42). Q.25 = Were you given a written list of work performance expectations when you started your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  34. Frequency With Which Work Performance Formally Evaluated in First Full-Time Position • About two-thirds of doctors not in solo practice indicate they received no regular formal performance reviews in their first position. Job retainers were more likely to receive informal performance feed-back, while job switchers more frequently report that their performance was not evaluated in any way. Base = Total Ophthalmologists Not in Solo Practice (184), Job Retainers (142), Job Switchers (42). Q.26 = How often was your work performance formally evaluated in your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  35. Frequency of Being on Call During Monday to Friday Work Week in First Full-Time Position • In their first job, young ophthalmologists report being on call one of every 6 days during a regular workweek. Job switchers indicate being on call more frequently (every 5 days) in their first position. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.27 = In your first full-time position, how often were you on call during the Monday to Friday work week? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  36. Frequency of Having Weekend Call in First Full-Time Position • Overall, job switchers report having weekend call more frequently (on average, every 4.6 weekends) compared to job retainers (who average every 6.2 weekends). Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.28 = In your first full-time position, how often did you have weekend call? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  37. Whether Physician Workload Was Shared Equally in First Full-Time Position • Two-thirds of job retainers feel that the workload was shared equally, while more than half of job switchers believe it was not shared equitably. Job switchers were more likely to say they saw fewer patients, especially surgical patients and new patients, or that they were expected to find their own patients. Base = Total Ophthalmologists Not in Solo Practice (184), Job Retainers (142), Job Switchers (42). Q.30a/b =In your first full-time position, did you feel that the physician workload was shared equally? Why do you say that? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  38. Number of Patients Seen per Day on Average in First Full-Time Position • On average, young ophthalmologists see about 25 patients per day. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.29 = In your first full-time position, how many patients on average were you seeing in a day? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  39. Whether Respondent Knew Ahead of Time Length of Time Would Stay at First Full-Time Position • Significantly more job retainers say they wanted to stay in their first position for a specified time. They more frequently mention an intention to stay in the practice or its location for life/indefinitely, and the partnership/career potential there. Base = Total Ophthalmologists (192), Job Retainers (50), Job Switchers (42). Q.31a/b =Did you know ahead of time that you wanted to stay in your first full-time position for a specified time? Why do you say that? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  40. Overall Satisfaction With Mix of Patient Cases in First Full-Time Position • More than two-thirds of young ophthalmologists indicate being extremely or very satisfied with the mix of patient cases in their first job. Job switchers were less satisfied with its patient case mix. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.32 = How satisfied were you with your mix of patient cases in your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  41. Where Information Was Obtained When Looking for First Full-Time Position • When looking for their first full-time position, young ophthalmologists most frequently sought information from physicians known through their residency program, AAO, and friends. Job retainers more frequently consulted physicians known through their residency, friends, and online resources. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.33 = When you were looking for your first full-time position, where did you get information? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  42. Practice Setting in First Full-Time Position • Three out of four young ophthalmologists report that their first full-time position was with a private practice or partnership. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.10b = In what type of setting was your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  43. Type of Area for First Full-Time Position • Nearly half of job switchers report that their first position was in a large metropolitan area. Significantly more job retainers practice in a mid-size city. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.11 = In what type of setting was your first full-time position? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  44. Number of Ophthalmologists in First Full-Time Position • A majority of young ophthalmologists (61%) began their careers in a practice with 1-5 ophthalmologists. Job switchers worked in various sized practices. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.12 = How many ophthalmologists did your first full-time practice/institution employ, including yourself? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  45. Overall Satisfaction With Existing Salary • About two-thirds of job switchers say they are very or extremely satisfied with their existing salary. Base = Job Switchers (42). Q.34b = Overall, how satisfied are you with your existing salary? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level. Note: Very satisfied actually 45% due to rounding.

  46. Average Number of Patients Seen per Day • Job switchers report that they are now seeing, on average, about three more patients per day compared to their first position. First Position Current Position Mean = 23 Mean = 26 Base = Job Switchers (42). Q.29 = In your first full-time position, how many patients on average were you seeing in a day? Q.35 = How many patients on average are you currently seeing per day? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level. Note: 20 or less actually 21% due to rounding.

  47. Satisfaction With Academy Efforts to Meet Needs • More than half of young ophthalmologists (53%) say they are extremely or very satisfied with the Academy’s efforts to meet their unique needs. Only 6% indicate that they are dissatisfied. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.36 = Now, just a few final questions. How satisfied are you with Academy efforts to meet your unique needs as a Young Ophthalmologist? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  48. Awareness of American Academy of Ophthalmic Executives • While most young ophthalmologists (95%) are aware of the AAOE, less than one in ten say they fully understand its role. Over seven of ten indicate partial or full understanding of its role. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.37 = Are you aware of the American Academy of Ophthalmic Executives (AAOE) and do you understand its role? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  49. Whether Respondent is a Member of the American Academy of Ophthalmic Executives • One in ten young ophthalmologists report membership in the AAOE. More than one in five are unsure if they are members. Base = Total Ophthalmologists (192), Job Retainers (150), Job Switchers (42). Q.38 = Are you a member of the American Academy of Ophthalmic Executives (AAOE)? (A/B) =Significantly greater than indicated column at the 90% confidence level. (a/b) =Significantly greater than indicated column at the 80% confidence level.

  50. Volunteered Advice for New Ophthalmologist Starting First Job • Much of the advice offered for new ophthalmologists centered on job seeking issues, such as the culture/ethics/associates in a potential practice, practice location, contractual details and review, and growth/partnership issues. Job switchers more frequently mention networking with other ophthalmologists, and understanding expectations. • Other advice included the values of flexibility/open-mindedness, working hard, setting limits, being realistic and patient, and continuing to learn.

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