Private vs Hospital/Academic Medical Practice
Article written by Emil Z
When the time comes to finish your last year of residency, many young doctors ask themselves a very frequent question: “do I go solo for private practice or stay within hospital/academic settings?” Of course, this question sounds too obvious for some freshly minted doctors who made up their minds from the get-go, however, there are certain things to be aware of!
When a young doctor decides to go for private practice, there are a couple of things he or she must have in mind.
First, do I know anything about management and business in general? As you know medicine is the most personal business you can ever enter and having a proper business plan will set your private practice for success.
Second, the most important question is, do I or do we (assuming you have partners) have enough capital to open a medical office and sustain ourselves without a profit for 1.5 years? This question is very important, as you need to cover your basis and overheads for 1.5-2 years exactly, keeping in mind that you are entering a competition for patients in the neighborhood, and new guys on the block need to prove themselves first!
Three, it’s your geographical location. Maybe this is too obvious to mention, but your location plays a huge role in the success of your medical practice. Depending on your specialty, you need to make sure your office is reachable by major public transportation and fully accessible from the neighboring boroughs.
Four, it’s your insurance acceptance. Do your quantitative and qualitative research on the area you serve. Ask around what insurance most patients might have in the neighborhood; look for insurance dealers who sign up patients - they might give you a good inside of what to expect. This step is very critical, as your insurance compensation is how you will be able to survive on a long run and of course make a profit from the service you are offering. If you set up your office in rural or underserved settings, keep in mind that most of your patients will most likely have Medicaid and Medicare coverage, so you would need to come up with creative ways to generate revenue.
Five, it’s all about customer service! Yes, you might have fellowship-trained expertise and you are well-known in the industry already, however, if your bedside manners are bad and your front desk is not trained on courtesy and professionalism, then my friend - you will see some interesting ratings online. Eventually, it will catch up with you and you might even have to close your doors - forever.
But, if you are up for a more academic and hospital route, there are numerous opportunities that will help you succeed. Not only you will never have to worry about mentioned above points (except for bedside manners, please be nice, always! :), but you will get to enjoy the collaboration between your colleagues’ expertise and even get involved in teaching if the hospital is a teaching one. However, you would need to abide by the politics and rules the hospital administration sets, even if you strongly disagree with them! It all depends on your personal goals as a practicing physician!
I would like to point out that it doesn’t mean that you can’t do both, you certainly can. But once again make sure you know the fine print of the contract and know how to negotiate your time spent at each facility. There are many doctors who work for private practice and have time when they are on call for emergency cases in nearby hospitals. That way they know what to expect, and even if you sign up to work as a private practice physician in a rural or underserved area, this could be a nice incentive to keep you financially afloat.
There are of course two sides to each bargain. Many private practice physicians pride themselves that they have better autonomy and authority to treat patients and even provide some of the services pro bono if they want to. But it still comes down to profitability and success, as you will have people who work for you and they all need to get paid. Additionally, your malpractice insurance must be in place and you should be comfortable practicing medicine not too defensively, otherwise, you will become a cold-blooded robot constantly concerned about lawsuits. The sweetest part of private practice is of course your hours. This is where most of the physicians are sold. I completely understand that even among non-surgical doctors divorce rate is lurking and the post-residency lifestyle is something of a huge concern! So it’s no surprise, that you would want to choose private practice over hospital.
If you look at the hospital settings on the other hand, there are politics that you will not always agree with. Like that surgery, you would love to perform, but the hospital doesn’t approve the insurance coverage or needed time off to attend your kids’ basketball game. Your every move should be according to the policy written by the hospital administration etc. However, as you know hospital is where most patients are, so your expertise in medicine will only grow stronger and deeper, and the rank of your credentials will be higher with years spent practicing your craft.
Either position you decide to go with, it’s imperative to know that physicians must be knowledgeable at negotiating contracts, managing business operations, and even finance. Even successful hospitals in the nation such as the Mayo clinic, asks its board of physician-directors to lead the hospital boldly not only medically but also with the business sound.
At Scientissimum not only we improve underserved healthcare, but we also provide tools for physicians to become leaders in navigating successful practice privately and academically. We implement the latest expertise in healthcare marketing and business development for your brand to strive and get a positive message to the present and future patients. If you need help with marketing or business development, get in touch with us now and see how Scientissimum Medical Group can improve your hospital or private practice today!