Your Employer Should be an Open Book

The last few years have been a tumultuous time for the emergency medicine (EM) specialty, especially as it pertains to our workforce. Per Medscape, emergency physicians have the highest burnout rate—65 percent—among all surveyed specialties.1 Attrition rates within the profession are high and rising, especially for female physicians and those working in rural settings.2–5

If many emergency physicians are unsatisfied with their jobs, what prevents more emergency physicians from finding a better workplace? ACEP is identifying and addressing the factors harming the EM job marketplace through advocacy work while also developing new resources.

At the most fundamental level, emergency physicians cannot change jobs if they are legally prevented from doing so by non-compete agreements. In March 2023, ACEP sent a letter to the Federal Trade Commission strongly supporting the FTC’s proposal to ban non-compete agreements from employment contracts.6 Per ACEP President Christopher S. Kang, MD, FACEP, “ACEP supports the Commission’s proposal to categorically ban non-compete clauses, and we urge it to finalize the regulation as proposed to help address the current anti-competitive conditions faced by many emergency physicians that limit their right to freely practice medicine in their communities.”7

Other core elements of a well-functioning job market are supply, safety, transparency, and simplicity. The EM job market could be improved in all four of those dimensions. The EM job market’s lack of transparency is especially striking. Even figuring out which medical practice staffs a particular emergency department is challenging. As job boards post only about one-fifth of emergency department jobs at any given time, the emergency-physician application process often still relies heavily on word of mouth. In an era when we can do almost anything online, the EM marketplace still functions much like it did in the last century.

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The EM job market’s opacity and inefficiency have led to the growth of expensive intermediaries. EM practices spend up to $50,000 per hire in recruitment costs, while locum tenens companies charge up to 30 percent commissions.

ACEP is actively addressing the safety, transparency, and simplicity of the EM job market. ACEP has recently partnered with Ivy Clinicians to create ACEP Open Book, the core of which is a survey of employers about their practices and characteristics. The survey results will be easily searchable through ACEP’s Career Center.

For those looking to find more information about specific emergency departments, Open Book will grant all ACEP members free access to Ivy Clinicians’ platform. Ivy has connected every emergency department with its employer group, as well as site-level demographics, quality, and efficiency. Searching for potential employers through Open Book will be as simple as searching for houses on Zillow.