Hospital vs. Private practice

xnfs93hy

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I'm sure this topic has been beaten to death and discussed many times over. However, I want to post a thread on here to get some answers without being beaten down for not using search.

I have heard that if you start your own practice and you do WELL, then the sky is the limit on how much you can earn. I'm pretty sure if you start your own practice, where you did your residency has no bearing whatsoever. It is all you.

I cannot see myself running my own practice. I would feel more comfortable with a salary.

I have also heard that if you plan to join a private practice (or a group practice?) that you can make more. But I do not know if this would be for me either because, how much more would I really be able to make?

I have one other question as well.

What about the hospital? I know a cardiologist who does very well for himself and didn't go to a big name med school or residency program and works at the local medical center. I do not know if he has his own office. If you work for the hospital, do you actually WORK IN the hospital?

Honestly, this isn't really a question of "How can I make a million dollars". I'm not concerned about that to be honest because after researching, I doubt I will ever hit that amount in medicine...no one does.

Also, according to nationwide statistics, most doc DO work in a private/group practice setting. Why is that?

If you work for a hospital, isn't your malpractice and all that paid for?
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The reason I ask is because I would rather go to work everyday at a hospital than run my own office or be hired into someone else's office. Even if it meant being paid less.

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My mother is a nurse, and she has talked to me about this topic before. She used this story:

My family doctor was going through hard times before, because he needed to relocate his practice. The meant he needed to rent out a new space, pay to transfer all of his equpitment, buy his own things, and establish everything himself (including paying all of his employees). For a few years he was scrounging for money, but now that he is on his feet, he is doing very well.

My mother advised me to not go private practice. She works with a bunch of specialty doctors who don't pay a dime for anything they need, they simply get it supplied by the hospital. Although their salaries are pretty much fixed and they get paid what the hospital wants to pay them, that salary is set from day 1 of their working and they will never have to worry about it fluctuating down to a level that isn't live-able.
 
As a rule, Hospitals pay less, cause you have to use their facilities to see patients, get their malpractice insurance, and they get to choose both your salary and your hours. You're at their service. You have the holidays they decide you should have. If you're academic faculty, you're expected to do research and bring in grant money, and you might have teaching responsibilities. Basically, you have a boss.

When you have your own practice, everything is up to you. You probably don't have to pay the hospital for privileges every day (minor procedures can be done in your clinic), you choose when you want to take time off, when to get there, when to go home, and what to do with your time. You also get to choose what kind of insurance to take, whether you'll accept medicare/medicaid, etc. On the other hand, the responsibility is also entirely yours, and you often have to end up working harder at least in the beginning to get things started.
 
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Also, according to nationwide statistics, most doc DO work in a private/group practice setting. Why is that?
It's my understanding that many people who shoot for a DO do so because of a family tradition and then join their family practice. Dunno what proportion of DOs fall in that category, though.
 
As a rule, Hospitals pay less, cause you have to use their facilities to see patients, get their malpractice insurance, and they get to choose both your salary and your hours. You're at their service. You have the holidays they decide you should have. If you're academic faculty, you're expected to do research and bring in grant money, and you might have teaching responsibilities. Basically, you have a boss.

When you have your own practice, everything is up to you. You probably don't have to pay the hospital for privileges every day (minor procedures can be done in your clinic), you choose when you want to take time off, when to get there, when to go home, and what to do with your time. You also get to choose what kind of insurance to take, whether you'll accept medicare/medicaid, etc. On the other hand, the responsibility is also entirely yours, and you often have to end up working harder at least in the beginning to get things started.

I'm unsure what the OP means by "work for a hospital" vs "private practice" as there are many models of medical practice. However, assuming that by "work for a hospital" we are talking about full-time academic faculty who draw their salary from the medical school, then that would be me!

Everyone is entitled to practice in the setting they would like, but I can't imagine, and never have, wanting to practice in a solo practice. My schedule, my night call, my hours and my vacations are all part of the negotiation process. I have a huge say in these. No one forces me to work ANY day, well, except for one big holiday in December, cuz, I don't celebrate that holiday....;)

My salary, malpractice and benefits are all covered/negotiated. I have no ideas the exact amount the medical school pays for my malpractice. I don't have to do billing EXCEPT for the legally required paperwork which is not a large time sink.

I have to teach. So? I love teaching. That's a positive.

I do research and bring in grant money. Plenty of academic physicians do not have independent grants or have minimal grants. They are clinical faculty.

I have a boss. Even in a group private practice there is a boss. Sure, in a solo practice, you wouldn't have a boss. Again, this isn't a problem for me and the negatives of an independent solo practice would vastly exceed the positives.

As far as taking insurance, well, I have no problems with caring for ANY patient who I'm asked to see, regardless of their financial status.

To each their own. I prefer academics.
 
I'm unsure what the OP means by "work for a hospital" vs "private practice" as there are many models of medical practice. However, assuming that by "work for a hospital" we are talking about full-time academic faculty who draw their salary from the medical school, then that would be me!

Everyone is entitled to practice in the setting they would like, but I can't imagine, and never have, wanting to practice in a solo practice. My schedule, my night call, my hours and my vacations are all part of the negotiation process. I have a huge say in these. No one forces me to work ANY day, well, except for one big holiday in December, cuz, I don't celebrate that holiday....;)

My salary, malpractice and benefits are all covered/negotiated. I have no ideas the exact amount the medical school pays for my malpractice. I don't have to do billing EXCEPT for the legally required paperwork which is not a large time sink.

I have to teach. So? I love teaching. That's a positive.

I do research and bring in grant money. Plenty of academic physicians do not have independent grants or have minimal grants. They are clinical faculty.

I have a boss. Even in a group private practice there is a boss. Sure, in a solo practice, you wouldn't have a boss. Again, this isn't a problem for me and the negatives of an independent solo practice would vastly exceed the positives.

As far as taking insurance, well, I have no problems with caring for ANY patient who I'm asked to see, regardless of their financial status.

To each their own. I prefer academics.

Oh I'm with you on that, I'd definitely like to go into academia as well. I'm glad to hear it's not as much of a "oh no this evil administrator is cracking the whip" as I thought. Yay!
 
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