Specialists prefer to work in the public sector over the private sector, with factors such as the chance to take clinical risks more likely to influence their choice of workplace than income, an Australian study suggests.
Researchers surveyed 3422 non-GP specialists from the Medicine in Australia: Balancing Employment and Life (MABEL) survey, using a discrete choice experiment to assess their preferences for job characteristics and public or private sector work.
A previous study using the same MABEL dataset showed that 48% of medical specialists combined public and private sector work, 19% worked the private sector only and 33% worked in the public sector only
In this study, respondents were given scenarios of jobs with differences in earnings, hours worked, on-call arrangements, percentage of time in private practice, teaching and research opportunities, time spent in administration and location. They were asked which they would prefer, including the option of staying in their current job.
While specialists chose the status quo of their current job 81% of the time, the authors said the overall findings were as expected:
“Specialists prefer higher earnings, fewer hours, less on-call, more teaching and research opportunities, less administration and working in metropolitan areas,” they wrote in Human Resources for Health.
However, on average, specialists preferred working in the public sector, with preferences for time spent in the public outweighing the private sector.
That was despite the factor that financial value of the public sector work was “very small” – at 0.14% of their annual earnings to work an additional hour per week.
Lower wage earners were found to prefer the public sector while those with higher wages preferred the private sector, although the associations were small, according to findings
The respondents were also asked about their attitudes to financial risk, career and professional risk (e.g. publicly challenging your professional colleagues), and clinical risk (e.g recommending a new or controversial treatment).
Doctors averse to clinical and career risk were found to have a strong preference for the private sector, which the author suggested was likely due to the job characteristics.
“Although career trajectories are more well-defined in the public sector, there is more tournament-type competition between specialists to work in trajectory teaching hospitals to undertake high quality research and teaching,” they wrote.
They suggested that doctors who preferred taking clinical risks may choose the public sector because it involved more complex and challenging cases.