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.
OWNING A MEDICAL PRACTICE
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.
ESTABLISHING A PRACTICE
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
La State Med Soc NEW PHYSICIAN’S GUIDE 15
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