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As physicians finish up their training and begin looking for their first job, or as practicing physicians decide to make a career change, the employment possibilities can seem not only endless and intimidating, but also confusing. In the rapidly changing world of physician entities and employment arrangements, it seems there is no shortage of unique practices that are more and more owned by or affiliated with a hospital system. While an increasing number of private (and I use that term in this blog to merely mean non-hospital owned) groups are purchased by large hospital systems, some groups that started from the ground up have managed to proudly remain standing on their own. For physicians who join such private groups, the pros and cons are many, and often balance themselves out in many ways. Where groups owned by large hospital systems do not benefit from holding onto 100% of the revenue they churn up, they often have streamlined operations, with strong compliance and billing support, a robust EMR, and strong payor and referral relationships, leaving less day-to-day worries for the physicians and administrators.
On the other hand, the smaller private groups that have remained standing on their own tend to be leaner and have a much more focused view on running their practice with a business-minded approach. While they may not benefit from the operations support that a hospital-owned practice may enjoy, they are likely to be more efficient in specific areas, allowing them to take full benefit from their revenue and reinvest that revenue where available and appropriate. In these types of practices, physicians are often given the opportunity to "buy in" to the various different entities that may be affiliated with the private group, such as ambulatory surgery centers ("ASCs"), research entities, etc. When a physician is able to buy into such entities they obviously then reap the reward of the revenue coming into those entities from various different sources- a benefit often not enjoyed by physicians employed by hospital-owned groups. Additionally, physician employees and partners of private groups almost always have more leeway when it comes to the ability to adjust their practice and day-to-day operating procedures in a way that best suits their style and needs; whereas, physicians employed by large hospital systems typically have a harder time getting meaningful changes to take place in a timely fashion.
If you're beginning your physician job search and are interested in exploring private practice opportunities, be sure to flesh out the various issues that have the potential to impact your well-being down the road. While younger physicians are likely to begin as an employee of a private group, eventual partnership is very common and somewhat expected, and before you invest your first couple years as an employee, you will want to make sure you know exactly what you're walking into.
For more information about different employment and partnership structures, and how your physician job search can be tailored to meet your specific needs, call Leigh Ann at 317-989-4833 or email at loneill@lauthoneill.com.
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