COMPARING MEDICAL PRACTICE SETTINGS Physicians have numerous practice options, each offering a different degree of clinical autonomy and financial risk. Choosing a practice setting ultimately will be based on your professional and personal preferences. As a physician, your first decision should be whether you want to practice clinical medicine as your full-time duty or include non-clinical duties. You can be the owner of a solo practice, an equity owner in a group practice or an employee of a group practice, hospital, academic institution or health care system—which could be a private and public organization. If splitting your time with non-clinical duties, you should consider hospital systems or group practices that allow you to hold an administrative role or perform research. Keep in mind that opportunities will vary depending on medical specialty, geography, patient populations, and the health care market dynamic between providers and payers.
FULL ACTIVE LICENSURE
i *MORE INFORMATION ON FCVS APPLICATION:
Once a physician in training completes his or her training and they plan to practice medicine in the state of Louisiana, a full active license must be applied for.
Applicants who complete the FCVS verification process establish a permanent, lifetime portfolio of primary- source verified credentials - allowing easy and cost- effective access to medical credentials whenever they are needed. This service is especially valuable to those physicians graduating from medical school outside the United States or Canada, where verification can be time-consuming, costly and difficult. It is also extremely useful for those applicants applying to several state boards simultaneously, or those whose postgraduate training programs have closed.
Checklist for an initial full active license:
• Complete the required LSBME online application
• Complete and mail: • LSBME Oath
• LSBME Third Party Authorization document • Statement of legal name • Federation Credentials Verification Service (FCVS) Application* • Background check
OWNING A MEDICAL PRACTICE
The LSMBE may design or administer its own examination, or it may use examinations from any national examining agency, either public or private as long as such examinations are, in its view, sufficient for such purpose.
Owning a medical practice offers physicians the highest levels of autonomy and financial risk. If you choose to own a solo or a group medical practice, you will have to decide whether to establish a new practice, buy an existing practice, or buy into an existing practice as a partner.
Follow these tips to help ease the process of applying for medical licensure:
ESTABLISHING A PRACTICE
• Request a Copy of Current Medical License Requirements. When contacting a licensing board for the 1st time, request a copy of its current licensing requirements and the average time it takes to process applications. This helps prevent unreasonable expectations in processing time and gives a better idea of when to close a practice, plan a move or arrange a start date with a new employer to minimize financial loss. • Send Your CV. Physicians should provide the licensing board with a resume or curriculum vitae (CV) when they first make contact. This will allow a licensing board to evaluate potential problem areas early in the process. • Disclose All Information. Don’t try to hide potentially derogatory information from a licensing board. It is much better to come forward with the information, assist the board in obtaining records and other necessary data, and provide information about mitigating circumstances that would prevent license denial. • Follow up to Expedite the Process. Personally contacting and following up with the medical schools, training programs and appropriate hospitals will motivate these institutions to verify credentials more expeditiously. Following up with the licensing boards in other states where licenses are held also may assist in shortening the time for licensure. The Federation Credentials Verification Service (FCVS) provides a centralized process for state medical boards to obtain a verified record of a physician’s core medical credentials. Call FCVS at 888-275-3287 for more information. • Plan toWait at Least 60 Days. Physicians should plan for at least a 60-day period from the time they submit a completed application for a license and the actual date licensure is granted. Physicians who are graduates of a medical school outside the United States should anticipate a slightly longer period. It takes time for the state medical licensing boards and their staff to fairly evaluate each application for licensure.
Establishing a new practice starts by understanding the needs within the community. Is there an unmet need for your specialty in the area which could demand long hours, or will you be competing against established groups and needing to recruit patients? Your practice is your small business and you should understand the market for your services as you build your business model. Generally, establishing a practice will also carry a significant financial and administrative burden. For this reason, it is recommended that you have a year of savings to carry the practice through the first year. You will be responsible for meeting regulatory requirements and practice laws, as well as raising capital, hiring employees and negotiating contracts with insurance payers. This can be a time-consuming endeavor but ultimately provides you equity in your business and the ability to be your own boss.
BUYING A PRACTICE OR BUYING INTO A GROUP
Buying an existing practice that is already profitable or buying into a group practice as a partner still affords a physician a high degree of autonomy but lessens financial risk somewhat. Joining or taking over an established practice often has the added benefit of an established patient base, so your case load will be full when you start. In some cases, you may work for a medical group as an employee and later have the opportunity to become a partner. The financial risk and administrative burdens are shared in a group practice, but so are decisions regarding income distribution, insurance benefits for employees, financial investments, and day-to-day management of the practice. Before you buy an existing practice or join a group as a partner, it is important to consider the culture of the practice and how it fits your professional, personal and business needs and aspirations. If you are negotiating a contract with an established practice, be sure to work with an experienced physicians’ contract lawyer to carefully review income sharing, benefits, and other contract provisions.
PRACTICING MEDICINE AS AN EMPLOYEE
By becoming an employee of an organization such as a group practice, health care system, or government entity, you have an established patient base and increased income stability. Depending on the organization and the physician’s interest, there
14 La State Med Soc NEW PHYSICIAN’S GUIDE
La State Med Soc NEW PHYSICIAN’S GUIDE 15
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