This is probably a really silly question, but what is "private practice" in EM? I have been seeing this written places, like residents who say they chose to go into private practice, but then how can they be EM docs? Don't EM doctors only work in the ER at hospitals?
"private practice" EM??
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I believe they mean "non-academic".
As an EM doc, you can be a part of a group (employee or partner), part of a contract-management group (like EmCare - big, nationwide corporate group), an independent contractor (either with the hospital directly, or, again, with a group - getting the benefits, but having to pay for them all yourself), or a hospital employee (salaried, just like everyone else).
There are some subtleties - for example, at Duke, all of the attending physicians in all specialties work for the "PDC" - the "Private Diagnostic Clinic", which is a wholly-owned non-profit corporation of the Duke Medical Center. Still, the physicians are academic - all hold academic appointments, and have various academic duties, in conjunction with clinical duties.
As a "private practice" doc, you work your shifts. You may have an academic assignment, but the medical center doesn't sign your checks. Your main job is not teaching (although you may do some), but moving the meat.
Another term for "private practice" is "community EM doc".
As an EM doc, you can be a part of a group (employee or partner), part of a contract-management group (like EmCare - big, nationwide corporate group), an independent contractor (either with the hospital directly, or, again, with a group - getting the benefits, but having to pay for them all yourself), or a hospital employee (salaried, just like everyone else).
There are some subtleties - for example, at Duke, all of the attending physicians in all specialties work for the "PDC" - the "Private Diagnostic Clinic", which is a wholly-owned non-profit corporation of the Duke Medical Center. Still, the physicians are academic - all hold academic appointments, and have various academic duties, in conjunction with clinical duties.
As a "private practice" doc, you work your shifts. You may have an academic assignment, but the medical center doesn't sign your checks. Your main job is not teaching (although you may do some), but moving the meat.
Another term for "private practice" is "community EM doc".
What does it mean that they can be a part of a group? Does this mean they work at a hospital, but are employed by a group?
D
deleted65604
Maybe people refer to "private practice ER", but I'm not sure I've ever heard that before.
The actual job doesn't change much from "community ER" compared to "academic ER", at least from the perspective of pulling shifts in the ER.
I practice in a community ER, meaning that one of our primary goals isn't to train ER residents (although many residents rotate through community ERs). I have no pressure or incentive to publish papers or conduct research.
In academic ER, you become an assistant professor, and full professor, etc. and get a pay raise if you achieve those designations.
To achieve these designations, you teach lectures, and try on your shifts to teach residents as you are seeing patients, but there is also pressure and incentive to do research and contribute to the Department and Hospital in ways other than just pulling shifts. Some people work at academic institutions and are "clinical staff", meaning they have no other responsibilities other than moving meat on shift. Where I trained, about a 1/3 of the staff were clinical guys, but they still taught you on shift, you still presented to them, and they still taught occasional lectures.
Admittedly, I don't understand everything involved, but I think the line is kind of blurry when you look closely at a some jobs and try to classify them as "community medicine" and "academic medicine".
If anyone can help me better explain what it entails to become a full professor, and what is unique about working in an academic center, feel free to share.
My ER group is a C- corporation, with the only members being the ER docs. There is a buy in period were you buy shares (taken pre-tax). As such, we have the contract to staff the ER and bill for services given by the ER docs. If the hospital doesn't like our ER group, they can cancel the contract and hire a different group of doctors to staff the ER, who could come from a different corporation of doctors in a neighbouring city, or they could hire a ginormous national corporation like EMCare.
There are large businesses that specialize in staffing ERs. When you work for them, you generally get a wage, and probably don't have many administrative duties. The company takes care of billing and recruiting. My small 5 person corporation has to hire office staff, and take care of billing, and the finances of running an ER.
One major difference is that if my corporation takes in more earnings than were payed out to the ER docs, then we can divide up the excess every 6 months and give ourselves a bonus. My ER is rather small, and as a result, we probably experience more ebb and flow of patient volume, our hourly wage is lower than guys who work in large centers. I think this is done to give a cushion to the director to be able to take into account potential short-falls in collections. I got a $25,000 bonus for christmas unexpectedly because our patient volume was up. In a large corporation, that excess would have gone to profit of the overall company, rather than the ER docs themselves.
Technically, I am not a hospital employee. I have to obtain hospital priviliges, and the hospital can take away my privileges. Therefore in essence, they could force my employer to fire me. However, my paycheck comes from the C-corp that employs me. If our group flounders for some reason, and isn't pulling in enough money, the hospital has no obligation to help us out financially. We sink or swim independent of them.
Some ER doctors are hired directly by the hospital and the hospital pays them a wage and takes the profits or losses of the ER.
The actual job doesn't change much from "community ER" compared to "academic ER", at least from the perspective of pulling shifts in the ER.
I practice in a community ER, meaning that one of our primary goals isn't to train ER residents (although many residents rotate through community ERs). I have no pressure or incentive to publish papers or conduct research.
In academic ER, you become an assistant professor, and full professor, etc. and get a pay raise if you achieve those designations.
To achieve these designations, you teach lectures, and try on your shifts to teach residents as you are seeing patients, but there is also pressure and incentive to do research and contribute to the Department and Hospital in ways other than just pulling shifts. Some people work at academic institutions and are "clinical staff", meaning they have no other responsibilities other than moving meat on shift. Where I trained, about a 1/3 of the staff were clinical guys, but they still taught you on shift, you still presented to them, and they still taught occasional lectures.
Admittedly, I don't understand everything involved, but I think the line is kind of blurry when you look closely at a some jobs and try to classify them as "community medicine" and "academic medicine".
If anyone can help me better explain what it entails to become a full professor, and what is unique about working in an academic center, feel free to share.
My ER group is a C- corporation, with the only members being the ER docs. There is a buy in period were you buy shares (taken pre-tax). As such, we have the contract to staff the ER and bill for services given by the ER docs. If the hospital doesn't like our ER group, they can cancel the contract and hire a different group of doctors to staff the ER, who could come from a different corporation of doctors in a neighbouring city, or they could hire a ginormous national corporation like EMCare.
There are large businesses that specialize in staffing ERs. When you work for them, you generally get a wage, and probably don't have many administrative duties. The company takes care of billing and recruiting. My small 5 person corporation has to hire office staff, and take care of billing, and the finances of running an ER.
One major difference is that if my corporation takes in more earnings than were payed out to the ER docs, then we can divide up the excess every 6 months and give ourselves a bonus. My ER is rather small, and as a result, we probably experience more ebb and flow of patient volume, our hourly wage is lower than guys who work in large centers. I think this is done to give a cushion to the director to be able to take into account potential short-falls in collections. I got a $25,000 bonus for christmas unexpectedly because our patient volume was up. In a large corporation, that excess would have gone to profit of the overall company, rather than the ER docs themselves.
Technically, I am not a hospital employee. I have to obtain hospital priviliges, and the hospital can take away my privileges. Therefore in essence, they could force my employer to fire me. However, my paycheck comes from the C-corp that employs me. If our group flounders for some reason, and isn't pulling in enough money, the hospital has no obligation to help us out financially. We sink or swim independent of them.
Some ER doctors are hired directly by the hospital and the hospital pays them a wage and takes the profits or losses of the ER.
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jarabacoa -- i think you hit the nail on the head...
i think when people refer to private practice they mean that they are employed by a private group that is contracted to provide services to a hospital...
i think most people are under the impression that ED physicians are all hospital employees or university employees, which is not the case.
so to answer the OP's question, we all work in ED's or possibly stand alone urgent care clinics, but we are not all hospital employees, and thus some people refer to being in "private practice..."
i think when people refer to private practice they mean that they are employed by a private group that is contracted to provide services to a hospital...
i think most people are under the impression that ED physicians are all hospital employees or university employees, which is not the case.
so to answer the OP's question, we all work in ED's or possibly stand alone urgent care clinics, but we are not all hospital employees, and thus some people refer to being in "private practice..."
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Yes, I would take "private practice" in EM to mean "community doc."
(Although some of us community docs are actually employed by the ol' Ivory tower. My group is an extension of a residency-training site group, and although we only work at our little community hospital, the paycheck comes from the university. I also get the fancy-schmancy title, but don't have any teaching or research responsibilities, which I would argue defines the community-vs-academic debate.)
(Although some of us community docs are actually employed by the ol' Ivory tower. My group is an extension of a residency-training site group, and although we only work at our little community hospital, the paycheck comes from the university. I also get the fancy-schmancy title, but don't have any teaching or research responsibilities, which I would argue defines the community-vs-academic debate.)
