After residency, you'll choose from several types of medical practice. Do you want to pursue private practice or group practice? What about hospital employment or being a fill-in physician? Before launching down a career path, review the four types of medical practice below to identify which one might best fit your long-term goals.
1. Private practice
What it is: In this type of medical practice, you're the only doctor, practicing independently of any hospital or health system. While you must adhere to professional and state licensing laws, you aren't subject to other external policies. According to the American Medical Association, 47.1% of physicians were private practice owners in 2016.
The benefits: On your own, you set your schedule, choose when to take a vacation and make all staffing decisions. As the one in charge, you select your treatment protocols, and you can avoid any personality or professional conflicts with colleagues.
Keep in mind: The buck stops with you. You are responsible for all office expenses, are always on call, and manage all your employees and any office issues. Taking time off can be difficult because it's hard to find coverage for your patients. Additionally, you could wait several years to turn a profit, limiting your income and your ability to invest in cutting-edge technologies.
2. Group practice
What it is: This type of medical practice includes two or more physicians, from the same or different specialties, who provide medical care in the same facility. It can feel like a hybrid of private practice and hospital employment — you enjoy many freedoms, but you also have greater stability. The Physicians Foundation's 2018 survey reported that physician-owned medical groups employed roughly 12% of doctors.
The benefits: Working together, you share responsibilities, including call coverage and office expenses. By working with other providers, you can easily learn new skills and techniques, and you can quickly ask co-workers for a second opinion when needed. You work shorter hours, have built-in on-call coverage and have more access to working capital, making it easier to invest in the latest technologies.
Keep in mind: With shared responsibilities come divided resources. The front staff and nurses work with everyone, and you have little power to manage or train them in how to treat patients. You have less control over your own schedule and you might find yourself competing with colleagues over patients, limiting your ability to rapidly grow your income.
3. Hospital employment
What it is: In this type of medical practice, you treat patients, but you're also a hospital employee without the added business responsibilities of running your own shop. You're employed just like the nursing and front office staff. As of 2016, according to Becker's Hospital Review, 42% of all physicians were hospital employees, a jump from 25% in 2012. During the same time, the number of hospital-employed practices rose by 36,000 — a 100% increase.
The benefits: As a hospital employee, you focus solely on treating patients, passing along responsibility for billing, coding, hiring, firing and any other administrative responsibilities. Hospital incomes are guaranteed and steady, benefits packages are included and you typically have several opportunities for career development.
Keep in mind: You'll be like every other employee — you won't have autonomy over how and when you see patients, and you must abide by your institution's rules and regulations. Additionally, the hospital can change your salary based on your performance as well as quality and patient satisfaction measures. You're also expected to adopt and master new technologies, including electronic medical record systems.
4. Locum tenens
What it is: Doctors who pursue this type of medical practice serve as temporary — or fill-in — physicians. Typically, assignments range from several days to several months. According to Physicians Practice, locum tenens providers account for more than 5% of the physician workforce, and they practice in more than 90% of healthcare facilities, treating approximately 7.5 million Americans annually.
The benefits: You have the freedom to set your own schedule, and you can work as much as you like in the geographic areas you prefer. Being a temporary employee can also keep you above the fray of interoffice politics. You're typically paid commensurate with your training, and overtime and call coverage can yield even higher income. Additionally, unlike hospital-employed doctors, you purchase only the insurance and benefits coverage you need, forgoing others, such as life insurance or long-term coverage, that you might not want.
Keep in mind: Your schedule is flexible, but you lack job security. Even if you sign a contract, your employer may retain the right to cancel the job on short notice. Consequently, be sure to read any contract carefully before you sign. You'll also invest significant time and research into identifying the benefits plan that works best for you. Finally, as a temporary employee, you may be more likely to feel excluded or ostracized from both office decision-making and socializing.
Ultimately, choosing the right type of medical practice for you can be a significant factor in your job satisfaction. Weigh the benefits and drawbacks carefully in order to make the choice that best fits your lifestyle and career goals.
