New physicians are entering a healthcare landscape shaped by financial pressure, changing employment models and shifting expectations.
From the appeal of employed positions to growing interest in shift-based work, five trends in particular have emerged in how early-career physicians choose where, and how, they practice.
Employed physician models
Physicians are increasingly gravitating toward employed models, drawn in part by the stability they can offer. In 2024, 47% of physicians were employed by or affiliated with hospitals, according to a Government Accountability Office report.
“It’s a very interesting trend to see the wave of physicians that are going into the employed model or academic model,” Emeka Nwodim, MD, orthopedic surgeon with a sub-specialty in spine surgery at Bethesda, Md.-based The Centers for Advanced Orthopaedics, told Becker’s.
“It’s definitely understandable with the extraneous expectations, demands and economic and financial constraints that we’re facing in healthcare.”
Private practice’s renewed appeal
Joshua Siegel, MD, director of orthopedic sports medicine at Exeter, N.H.-based Access Sports Medicine and Orthopaedics, sees physician employment as a pendulum that has swung hard in both directions, and he believes it may be starting to move back toward the independence of private practice.
“When I first started, there was a huge preponderance of physicians getting out of fellowships, at least in orthopedics, and not wanting to join a hospital, rather going into an independent group so they could provide this large swath of services that might be prohibited or limited at an institution,” he told Becker’s.
Over time, however, he watched the market shift. The business side of medicine became more complex, the challenges of staying independent grew and the earnings gap between employed and independent physicians narrowed.
Those experiences spread through professional networks, residencies, fellowships and training programs. Consequently, Dr. Siegel said, younger physicians are increasingly viewing employment as a first stop rather than a final destination — especially if they believe they will earn more after getting a few years of experience under their belt.
Data suggests physician-led practices may still hold strong appeal. According to a Bain & Co. survey of practicing physicians, average satisfaction in physician-led organizations ranges from about 70% to 90%, compared with 50% to 75% in health system-led practices. Seventy-eight percent of physicians in physician-led practices also said their organizations had effective processes and workflows, compared with 59% in health system-led practices.
Commitment to health equity and preventive care
Justin Frederick, MD, chief medical officer of graduate medical education at Renton, Wash.-based Providence, said young physicians want their work to feel meaningful and mission-driven and have a commitment to health equity and preventive care.
“Young residents have a strong desire to do meaningful, fulfilling work,” he told Becker’s. “Residents want to feel their work makes a difference.”
“I’m optimistic about this generation’s commitment to health equity and meaningful work. They’re energetic and enthusiastic, even amid funding gaps,” he told Becker’s. “They also see the importance of preventive healthcare. I hope over the next decade we move upstream and become more proactive rather than reactive.”
Work-life balance
Newer physicians are also bringing different expectations around work-life balance and burnout. A 2017 American Medical Association survey of millennial physicians found that 92% said maintaining work-life balance was important, but only 65% said they felt they had achieved it at that point in their careers.
Barry Sagraves, partner at Chicago-based ArchGate Partners, told Becker’s that the shift in expectations may make the long path to becoming a physician less appealing.
“This is related to the widespread social disaffection with higher ed in general, with increasing numbers not believing the benefits are worth the enormous cost of both undergraduate and graduate training,” he said.
At the same time, some leaders say incoming physicians are redefining the conversation.
“I’m also seeing increased interest in better work-life integration — not balance, but integration,” Dr. Frederick said.
Multiple reports point to physicians’ desire for greater flexibility. Forty-six percent of physicians said more flexible schedules were among the workplace changes that would help most with burnout, and more than half said they would accept lower pay in exchange for better work-life balance, according to Medscape surveys published earlier this year. The findings suggest that health systems that offer flexibility may have an advantage in recruitment and retention.
Shift work
Dr. Frederick said he is also seeing greater interest in shift-based roles that can reduce administrative burden.
“We’re seeing more interest in hospitalist positions, where physicians can do shift work and avoid the inbox burden common in ambulatory care,” he said.
Other leaders are seeing similar patterns, even as more procedures move to the outpatient setting.
At Phoenix Children’s, leaders noted a growing trend in the subspecialty space. Traditionally, many subspecialists — including endocrinologists, gastroenterologists and neurologists — have primarily worked in outpatient settings, where they see patients in clinic for follow-up and chronic care, but Phoenix Children’s is now seeing more subspecialists who want to spend most of their time caring for inpatients.
“We’ve discovered a population that really prefers to be on inpatient service caring for a subspecialty population more than they like the clinic, and vice versa,” Jared Muenzer, MD, chief physician executive at Phoenix Children’s, told Becker’s.
