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You’re in your final year of residency and looking ahead as you navigate the various practice options and job offers available to you. Read on to get a broad understanding of the workforce, hiring, and salary trends in California and better prepare yourself to make an informed decision about your first job as a family physician.

 

Where will you work and who will be hiring you?

California is facing a tremendous influx of individuals, both through Medi-Cal and Covered California, who will be seeking access to primary care. At the same time, a growing, aging population is reaching Medicare age and utilizing care. As such, there are opportunities for employment in almost every clinical setting for family physicians, whether in a hospital, health care organization, group practice, clinic, or hospice. In fact, California is second only to Texas in the number of healthcare job postings[1] and family physicians rank as the most recruited type of physician[2].

That being said, you will be heavily recruited by large integrated health systems, such as Kaiser Permanente and Sutter Health. These practice settings offer the above-average salaried positions, loan assistance, and work flexibility that young family physicians often seek for their first job. You will also be pursued by medium to large medical groups, where you may have the opportunity to become more involved in health care leadership through the development of accountable care organizations (ACOs) and implementation of Patient Centered Medical Home (PCMH) models.

A great need for family physicians exists in Southern California, in the greater Los Angeles, San Diego, and Inland Empire areas, where enrollment in insurance has spiked but physician supply has not kept up. For those interested in a Federally Qualified Health Center (FQHC) or FQHC look-alike setting, the Inland Empire and Central Valley are hotspots for salaried family physician positions.

How about direct primary care?

While fewer and fewer physicians are pursuing solo practice, direct primary care is an emerging option for those who want the autonomy of a solo practice without the administrative stress of dealing with insurance. In a direct primary care practice, patients pay a monthly, quarterly, or yearly fee for a range of primary care services and maintain catastrophic or supplemental insurance for extra care. While the initial challenge remains recruiting a patient panel, direct primary care can allow more time for patient care and opportunities to integrate tele-medicine and innovative care which may not otherwise be compensated.

 

What will you make?

Family physician compensation in California sits right in the middle of the national spectrum of pay, averaging $179,000. As the value of the family physician in controlling overall healthcare costs is more recognized, pay is slowly, but steadily, increasing. You can expect to make within $10,000 of this average based on your practice setting, and should take this range into consideration during your salary negotiations.