Most physicians choose medicine to care for others. The essential premise balances this selfless, optimistic objective that the physician is healthy and happy with enough knowledge, experience, and abundance to heal their patients.
Unfortunately, our health care system thwarts us at every turn, with continual devaluation and reduction in reimbursements, paralyzing insurance and government regulations, and demoralizing lack of control.
Ballooning student debt and declining reimbursements, and the perception of greater stability in large heath care systems have led to the current trend for more physicians to choose employment.
More and more physicians feel isolated, helpless, and defeated, which continues to fuel the increasing crisis of physician burnout in America.
Despite these trends, physicians have other options that can benefit them emotionally, physically, and financially.
Private practice offers many stark contrasts from employment within a health care system, hospital, or academic center. Private practice offers benefits that reduce challenges leading to burnout.
Here are ten ways private practice can defend you from becoming a drowning depleted physician.
Choice, flexibility, and customization. Many burnout physicians feel stuck and frustrated because they have no control over the decisions that affect their work daily. In private practice, you have more autonomy in decision-making. In private practice, the primary and greatest difference between being employed and being an owner, or your own boss, is greater choice, flexibility, and customization. Physician-owned and managed practices are more flexible, change more easily, and can be more efficient.
Schedule. Many physicians are exhausted and overworked due to the health care worker shortage and large corporate missions to maximize the productivity of their employees. Private practice affords more flexibility and customization of your schedule, including the length of patient visits and the number of patients seen. Private practice allows fewer days of work and a schedule that matches your life as long as it remains profitable for the practice.
Scope of practice. In a corporate position, you may not have a say in what medical problems you see and don’t, your choice of where you operate, medical equipment, supplies, and vendors because most large institutions gain efficiencies with sole-source contracts. In private practice, you have more voice in your scope of practice, the patients you choose to see, and the procedures you perform. You and your colleagues can choose insurance contracts that align with your priorities.
Team. In private practice, you have more of a voice in your staff’s choice, training, and management and the physician colleagues you work with. You have a say in hiring, promoting, and firing because the physicians are part of the management team. In academic and health care systems, these decisions are made by administrators and managers rather than physicians.
Value and decision-making. Physicians who are burned out often feel depersonalized and disengaged. In an employed position, most decisions are made in the interest of the entire organization and may not represent the interests of the individual physicians.
In private practice, you are not only valued by your organization and team; you are essential and vital—your opinion matters. You determine the brand and reputation rather than serving as an employee who is subordinate to the value of your institution.
Growth and change. In an employed position, the institution determines plans for growth on a broader and larger scale. In private practice, you can grow your dream. You decide where you want to expand and the vision of your future.
Relationships and branding. In most employed positions, you see patients based on the institution’s brand and which insurance companies and employers are serviced.
In private practice, you can build your own reputation in the community. You must develop relationships with referral sources and within the medical community to sustain your referrals and practice.
Involvement in research, publications, and leadership. Most academic positions place requirements to earn research grants and conduct research, write and publish articles and book chapters, teach residents and med students, participate in academic meetings and take leadership positions.
You often must work to seek tenure via academic tracks where you may be promoted or fired in a specified number of years. You often have little say in your colleagues hired, in your staff, where decisions and changes are determined via many levels of leaders.
There are usually no mandates for research, publications, or leadership positions in private practice. You can develop professionally in any way you please.
Passive income. There are rarely opportunities for equity, investments, or additional income streams in corporate employment. Profits from all the income centers generated by physician work return to the institution, not the physician.
In private practice, you have the opportunity and potential for ownership and partnership. You can gain passive income from ancillary income sources beyond your production, such as testing, facilities, surgery center, products for sale, and paraprofessionals.
Taxes. When you are employed, you are paid with after-tax dollars, and your tax burden is higher than when you are a partner paid after expenses based on profit. Owning a business affords more advantages to lowering your tax burden than working as an employee. These differences compound your savings and ability to invest money significantly over your career.
If you choose a private practice that aligns with your values and goals and is the right fit, you are less likely to become stagnant, depleted, and burned out. You are less likely to feel trapped in a place and with people you don’t enjoy and who don’t have the same goals and aspirations as you. If you suffer from or want to avoid burnout, you have a different choice in private practice.
You will not burn out if you love your work and your life. Instead, you will be fired up to enjoy and grow and be better fueled to heal your patients. As it should be.
Brett Levine is an otolaryngologist.
Image credit: Shutterstock.com