"The most exhausting decisions that physicians
make, commonly start with, what kind of
medical practice can you can focus on that
will deliver you the greatest fulfillment,
happiness, and personal satisfaction, as well
as provide you with all of the expectations
you have for your medical practice career."
As I look at the survival problem for the remaining physicians in private medical practice (about 50%), you will always have the upper hand for managing your medical careers and how you practice medicine by starting out, or staying in independent medical practice. You may think better by listing the pros and cons of each, and it may offer you some ideas to work on.
Private Practice:
| Pro 1. You are your own boss, in total control of your career, level of success, level of income. 2. You have the choice of determining the money/income you need and want to match your personal/family financial obligations and lifestyle. 3. Your career expectations are unlimited. Since you control your medical practice productivity, you have the opportunity to modify any necessary elements of your practice to meet your expectations. 4. When you are motivated to accomplish your goals for your medical career that you desire, you can do it... but requires much more work than you expected. 5. You have the opportunity to practice medicine anywhere you desire, with few exceptions. 6. Learning the medical statutes, laws, and practice-inhibiting factors are important for you to start practice is a state that offers you the greatest advantages for your success and for your complete satisfaction in medical practice. 7. Because you are a medical professional and are in full control of your career/practice, you have the advantage anytime of moving your practice, cutting out practice elements you don't want to do anymore, gaining new skills and knowledge to expand your practice income and enjoyment, and choosing partners, associates, and employees. 8. You are in control of your retirement plan, funding your children's college education, and determining the lifestyle you want. | Con 1. The level of control of your medical practice, career, income, and success is dependent on the extent and use of your business knowledge and skills outside of your medical skills and practice. 2. Your choice is strongly modified by the passion, efforts, and self-discipline you maintain career-long to to meet your expectations. No one there to prod you other than yourself. 3. How much you are able to modify your practice to meet your expectations is dependent on your level of income that allows you to make those alterations you need to reach your expectations. 4. The clear trend among the great majority of private practicing physicians is to alter their goals to much lower goals, because they don't earn enough income to reach them. Doctor's being business ignorant have no idea how to avoid this problem. 5. If you don't begin your practice in the area where your best potential exists for your success, you will be forced to live in a lower middle class existence for lack of income to do any better. 6. Many states curb your practice activities more than others. Malpractice risks and protection, abortion laws, licensure problems, and levels of practice are elements that vary widely from state to state. 7. Practice goes well when you are continuing to practice, but the income stops when you are disabled from any cause, become legally convicted, have significant health problems, etc. Some will help you but no one will run your practice for you. 8. About a third of medical doctors retire from practice without any retirement plan. Another third have a retirement plan that will not support their retirement needs and wants. My estimation is that almost half of physicians can't fully fund the college education of their kids. Education scholarships, grants, education loans are often hard to obtain because of your professional status. Students either must attend a less expensive college or not attend the college they desire... or forget college. |
Employed Practice
| Pro 1. You have relatively stable employment and benefits. The business side of medical practice is taken care of for you. 2. Usually salaries are reasonable or somewhat better than private doctors in the same specialty as of November 2014. 3. What you practice and how your practice in your employment is limited to the common usual standard practice of your specialty. All of the easy extra things you would do for patients in private practice are unnecessary. But you do have to measure up to seeing the same number of patients as the other doctors. 4. Your medical education is paid for, so it's a good idea to obtain all the extra training you are interested in practicing while you have it all paid for (You might quit later and could use it later in private practice). 5. Hospital and HMO physician employees have access to immediate consultations in other specialties who are in the same building or nearby. 6. All patient appointments are made for you... which are prescheduled solid for up to 3 months ahead. 7. Time away from the job is easily covered by the other doctors, but conferences, workshops, and vacations have to be scheduled far ahead. 8. Comradery is most commonly with the mid-level healthcare providers rather than your peers. 9. Most physician employees are very good physicians and well trained. | Con 1. Job stability is fragile. You can be fired any day, or your contract will not be renewed for many reasons. 2. As Obamacare continues and the economy does not improve, salaries are expected to drop, the most highly paid people will be let go to compensate for dropping income of employer. 3. You are expected to practice in a way that offers the most profit for the employers. Infertility work, psychiatry, and a few other medical practice elements are poor producers of good income and are not usually covered by health insurance... so are often forbidden or restricted to clinic schedules. 4. There is little incentive to gain new skills, do your best medical care, gain greater knowledge, because doing so does not usually result in increased salary or benefits. 5. These employers are strict about terf battles. OBG physicians who are fully trained and excel in OBG sonography, for example, may be forbidden to do sonography themselves, even when no charge is made for the procedure, and done to make quick diagnosis in their patients... because radiologists would be denied the income from that procedure which they claim as their terf only. 6. Special procedures, fit in appointments, and quick return appointments are almost impossible for you or the patient to make. 7. Seniority determines who gets first choice of time off for anything. 8. Social life is more often outside the employer's and employee peer relationships contrary to that of private practice. 9. There are also a higher percentage of borderline competent doctors found in employed physicians than in private practice. The reason is that they can survive only when connected with other doctors close to them to help them along. |
There are many other pro's and con's as you might imagine. These mentioned above are a summation of the issues I confronted in my 6 years in the military service, 3 years with an HMO, and 5 years of hospital employment. There are an earful of other issues that make or break physicians practicing in any type of circumstances.
You will likely make most of your decisions about medical practice based on your emotions, personality traits, connections, and interests--rather than business facts, unfortunately.
----Professional Probe----
Articles©2013-2022/CGG INVESTMENTS LLC. All rights reserved. #126, 3-16-22
