August 3, 2021

Private Practice vs. Hospital Employment

Are you a medical professional deciding between private practice and hospital employment? If so, consider the differences between the two settings so you can make the most informed decision regarding your professional future. It's important to evaluate the pros, cons, and differences between the two so you can make a choice the aligns the best with your skills and personality. Check out more here about private practice and hospital settings. 

Private Practice Offers Autonomy

Working in private practice affords you professional autonomy that is only possible in the absence of the organizational bureaucracy of a larger hospital. In terms of technology, you could choose the computer software that best fits your needs. This way, you can save yourself time creating the clinical data you will need for future patient visits, performing charge capture, and providing your staff with other billing information. 

All managerial decisions will be at your discretion, from regulating the hiring of new employees to the terms and content of daily work assigned to them. Scheduling and pay scale can be your tools for rewarding staff based on performance. You would also have control of the management and logistic-based financial decisions.

You could establish culture by defining your purpose and values while maintaining control over all medical decision-making. Your medical decisions might be more satisfying in the absence of organizational constraints that go against your beliefs. You could also spend as much time as you prefer with each patient and be a stronger patient advocate. 

Gain Experience, Create Your Policies and Set Your Own Pace

As an independent entity, you could market your practice your way while gaining experience with new technologies and the advantages of social media. You would also develop in the art of contract negotiation and revenue cycle management. Learning to track the revenue from a patient's initial appointment through all the steps of the revenue cycle up to patient collections would be a plus to a physician in almost any setting.

You would also create your policies and regulations, like establishing a fair way to handle cancellations and missed appointments. You could also delegate appointments and scheduling to your staff while setting the parameters to create a balance that is right for you. Perhaps you would allow for increased patient flow on certain days of the week. If you would like to make the atmosphere more relaxed, you could have comfortable furniture or soft music in your waiting room. 

The more specialized you become, the more money you are likely to make. Perhaps you want to start a practice that is focused on a niche; this would likely increase your earning potential.  

Considerations of Private Practice

In private practice, you start at the top. There are technically no promotions, so that the only way you can grow is to make your practice grow. If you start a practice with other physicians, it is possible to trade certain responsibilities with them, but this could also encourage competition among you. 

While the potential to make money could be greater, there is also no base salary in private practice unless you join a practice run by other physicians and offer you a base salary. You need to be treating patients and covering your overhead before paying yourself. 

Hospital Employment

With hospital employment, the administrative staff is already in place to focus on treating patients. There are separate departments within a hospital that handle human resources, billing, and collecting, along with paying the rent and overhead. While the hospital handles all day-to-day operations, your only focus will be helping patients as long as you follow hospital procedures. It might also be easier to get time off in a hospital position since you can rely on more co-workers to see your patients while you are away.

Hospitals can guarantee you a base salary. In this setting, you are part of a team where parts of a patient's care can be delegated to the relevant provider. A Registered Nurse might perform delegation. At the same time, only the doctor can diagnose the patient's condition while building a therapeutic alliance to improve patient outcomes and increase satisfaction for the patient. 

Career Growth

Working in a hospital allows for both lateral movement and upward growth. You might start in a certain department and eventually become the head of that department or perhaps a medical director. As you grow within a hospital and your salary increases, you could continue to enjoy a cap on rotation. 

Cons of Hospital Employment

In a hospital setting, you will lose some of your freedom to hospital constraints. For example, time constraints could keep you from offering the level of care you wish to give. Some constraints could lead to staff shortages, poor organizational culture, and in some cases, inadequate training. 

Hospitals often find it necessary to implement regulations on their physicians. Surgeons may have to disclose who will participate in surgeries before obtaining written consent from patients. Later, they have to document each time they enter or leave an operating room. In other situations, any physician in the hospital could be scrutinized for delegating duties to unlicensed practitioners. 

There could also be changes in software technology that are meant to help but instead burden a physician. Some software systems could shift much of the burden of coding, documentation, and administration on the physician, which could take valuable time for patients. 

Choosing the Right Fit

When choosing which is right for you, "Private Practice" or "Hospital Employment," consider your personality and work style. Are you single, or do you have a family? Do you mind being on call, and how important is guaranteed vacation time?  

If you are tech-savvy and would like to own your own business, a Private Practice could allow you to grow in these areas. If you enjoy being a team member and you just want to help patients while leaving most of the administration and technology up to others, then Hospital Employment might be right for you. 

There is no right or wrong answer here. It all depends on what setting you find professionally rewarding when considering the independence of employment. A licensed physician can start in one setting and then transition to another, while some physicians become employed in practices that are entirely owned by other physicians.

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