Private Practice
Most fellows are familiar with private practice, but with their lives dominated by years and years of academic training, they might not be exactly familiar with how it differs from other practice settings.
What Does Private Practice Mean?
Simply put, private practice physicians are not employees. They are independent in their professional practice.
There are several practice models for physicians in private practice, and carefully
considering each for appropriate fit will create higher chances of early-career success.
Solo Practice
A physician practices independently without partners or employment affiliations and maintains complete autonomy over all aspects of the practice as a sole proprietor. This is fairly rare in neonatology, and can be a challenging prospect for someone right out of fellowship.
PROS
individual freedom, being your own boss, control and decision-making authority in how to run the practice, creating your own schedule, autonomy in patient care, closer relationships with patient families and staff
CONS
longer hours, more business risk, higher costs, complete responsibility over the practice, unpredictable rate of income growth, less opportunity for collegial interactions, difficulty getting time off
PRACTICE CHALLENGES
- working with minimal administrative or clinical staff
- handling all aspects of the practice including paperwork, regulations, and financial management
- working long weeks with less time off
- more sensitivity to economic or market factors
- managing full call coverage or arranging back up coverage
- taking on the administrative burden of developing agreements with insurers
- lost income due to illness or vacation
- limited patient base
- Do you want to own and manage your own practice?
- Are you interested in practicing in a rural area?
- Do you have good organizational skills?
- Are you comfortable with financial reporting and management?
- Are you willing to accept a higher level of business risk?
- Do you want full decision-making authority?
- Are you comfortable with handling various administrative tasks?
- Do you have an entrepreneurial drive?
- Are you proficient in laws, regulations, and insurance?
- Are you comfortable with 24/7 call coverage?
Group Practice
In a group practice, two or more physicians practice in one physical space, utilize the same personnel, share expenses, and divide income in a manner agreed upon by the group.
PROS
Less individual risk, built-in call coverage, shared overhead costs, more opportunity for collegial interaction, practice management functions are often handled by a business manager
CONS
Less individual freedom, limits on the ability to rapidly grow income, need for consensus on business decisions, may have to accept a junior status and buy in to group prior to obtaining partner status
PRACTICE CHALLENGES
compatibility of personalities and professional outlooks across the group
individual incomes of physicians in smaller groups may be lower than those of solo practitioners
maintaining equity in clinical scheduling
deciding how the group is governed
determining the path to leadership roles within the group
deciding how to “divide the pie”
Other Models
There are several practice models and business structures available for physicians in private practice.
ASSOCIATION
Physicians can form an association to share expenses and practice location but each maintains a solo practice.
PARTNERSHIP
Physicians can form a partnership as co-owners of a business. Each partner has equal rights and shares the risks and management responsibilities with gains and losses typically shared equally.
CORPORATION
Physicians can form a professional medical corporation that exists separately from owners and provides a legal mechanism to protect against personal liability from business claims.
INDEPENDENT PRACTICE ASSOCIATION (IPA)
Physicians practice independently without partners or employment affiliations but join an IPA to access the advantages of a large physician network.
