A large number of physicians are addicted to unhappiness. Practicing medicine is no longer fun, and they are frustrated working in an environment where they do not feel valued and appreciated. Forty percent of all physicians are looking to change their employment venue over the next two years, according to a recent survey by the AMA.

Physicians’ unhappiness is understandable.

Reimbursement by Medicare and other payors is declining, while the costs of operating a practice are increasing. Physician practices are not profitable, with hospital-owned practices losing more than $200,000 a year.

The response to these losses by administrators is to put more pressure on physicians to see more patients while the support staff for practices is being reduced.

Physicians feel they are now production workers with little control over their professional lives.

As I have written, practices perform better financially and provide better patient care when physicians feel valued and respected.

Health systems’ sustainable competitive advantage is to create an environment where physicians feel valued and appreciated. This positive culture will drive the recruitment and retention of physicians—the most critical resource of any health system.

Hospitals whose physicians view their organization as having a positive culture share common characteristics.

Competitive compensation

Physicians need competitive compensation to feel valued. Physician compensation needs to be above the median and ideally closer to the seventieth percentile. Physicians measure respect in terms of dollars.

Flexible schedule

Physicians place a high value on organizations that allow them to balance personal and professional commitments. Young parents want to start office hours after they drop their children at school. They also value an organization that ends office hours early so they can attend their children’s soccer games.

A physician caring for an elderly parent also values an organization that adjusts the physician’s schedule to take their mother to a doctor’s appointment.

Practice operations

Giving physicians a voice in how the practice operates is key to physician satisfaction.

Physicians want to interview prospective practice managers and have input into the hiring decision. Physicians also want to help decide the practice’s office hours and how many patients are seen in a day.

Physician governance

Physicians want to work in organizations governed by physicians. Physicians want key decisions to be made by physician leaders who understand physicians’ needs. Physicians also want leadership to reflect the group’s makeup in terms of age and primary care/specialist composition. Younger physicians are resentful of organizations where physician leadership is exclusively composed of older physicians.

Opportunities for clinical and administrative leadership

Physicians want the opportunity to advance clinically and administratively. For example, a primary care physician might want the opportunity to lead an initiative to improve diabetic care and reduce unnecessary visits to the emergency room and inpatient admissions.

Physicians also want to be coached on how they can improve their leadership skills and be given management growth opportunities.

Health systems with a culture where physicians feel valued and appreciated have a sustainable competitive advantage. This competitive advantage will drive market and financial success.

Jeffry A. Peters is a health care executive.