Is it possible to start a residency in a private practice?

[tacobellforlife]

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As the title says, I was looking at new Dermatology programs and recently saw that a private practice in Michigan, Dermatology and Cosmetic Center PLLC Program, opened a residency program. Asking Google and ChatGPT it states that a private practice can not start a residency program as it needs to be part of ACGME approval.

However, the program is also listed on the ACGME website. Residents also rotate through a near by hospital facility known as Hurly Medical Center, but looking at their ACGME data it does not list Dermatology as one of the residency programs offered; nor is Dermatology offered as a residency program on the main hospital GME website.

I am just curious as to how this works? Is this the beginning of new training occurring in a private practice setting?

 

[ThoracicGuy]

Not that this answers your question, but trusting any answer from ChatGPT is wrong. Those things put out garbage with real answers. Don't trust it.

 

[GoSpursGo]

They probably jumped through the hoops to get ACGME approval. They may not be a GOOD program, but as given the competitive nature of dermatology you would presumably prefer training there over going unmatched

 

[NotAProgDirector]

There's nothing stopping any small outfit -- whether private practice, a rural based clinic, HMO, or whatever -- from starting a residency program. If they are to be the Sponsoring Institution, then they just need to follow both the ACGME Institutional Requirements and the program requirements. The institutional requirements will include a need for a DIO -- but for a sponsor with a single residency program the PD is usually the DIO also. They will need a GMEC (not a big deal), and otherwise need to make sure that they meet all the requirements. If there's a program requirement that the residents/fellows have inpatient experience -- then that site needs to have an affiliation with a hospital for that. In this case, they will need both inpatient derm care, and dermatopathology experience - which looks like has been set up.

The problem that they can run into is funding. Residencies are paid by CMS via the Medicare cost report. But I doubt this small PP submits a Medicare Cost Report, and their IME payments would basically be zero. I expect they are not planning on getting any funding, and are just planning on paying for it out of operational funds. if they can expand their clinic patient numbers because of the residents, likely will easily pay for itself.

 

[gutonc]

There are LOTS of surgery fellowships that operate like this. No reason something like derm (which is 98.7% outpatient) can't do the same. Jump through the hoops, figure out a way to pay them and there you go.

 

[comp1]

Sure, lots of different types of organizations start residencies. It's quite a lot of work for the PD and other attendings (which isn't remunerated by itself) and isn't necessarily net profitable unless you have Medicare funding as described above or some significant grants. There are private companies who run businesses specifically to help organizations meet the ACGME requirements to set up residencies, but it's definitely not easy.

 

[AlbinoHawk DO]

I saw a fellowship where the hospital hired a private group to run it

There always loopholes

 

[LucidSplash]

The surgeons that trained me were an academic private practice, multi-surgical specialty group. Not hospital employed. Level 1 trauma included. The neurosurgeons were a separate group but also private practice, although they didn’t have residents or fellows. Which mean the trauma residents got to put in the ICPs. Private practice can look different than the commonly held ideal.

 

[Apollyon]

I don't see any issue with this, if they have the volume. This would be for "money" specialties, like derm and ortho (like the Steadman clinic - they have fellowships), because they could pay for it, even without government cash infused.

 

[dozitgetchahi]

There are LOTS of surgery fellowships that operate like this. No reason something like derm (which is 98.7% outpatient) can't do the same. Jump through the hoops, figure out a way to pay them and there you go.

There are several (previously) osteopathic derm programs like this that already exist. Iirc most osteopathic derm programs basically were established in random private practices. And some of these programs still exist after the DO/MD merger.

 

[AlbinoHawk DO]

There are several (previously) osteopathic derm programs like this that already exist. Iirc most osteopathic derm programs basically were established in random private practices. And some of these programs still exist after the DO/MD merger.

I think there are MD fellowships in Ophthalmology where this is the case. It's an old-school apprenticeship model

 

[tacobellforlife]

I think there are MD fellowships in Ophthalmology where this is the case. It's an old-school apprenticeship model

I think some of the Ophthamology residencies are still held in private practice centers, no? I guess I should've realized that before making the post. Usually see posts about "X Eye Center" and it turns out to be at a private clinic or so.