Private practice v. Hospital employment

[cbrons]

I read an interesting article (just 2 pages) about the considerations one should make before jumping at the first opportunity to get out of private practice and into the comfort, regularity, and general relief of direct hospital employment. Our medical school recently hosted a small get together with a family medicine physician from the rural Midwest who extolled the wonders of hospital employment. I also noticed in my hometown (rural Midwest), the largest private practice recently "sold themselves" to the local hospital. Leaves me to wonder if my long-time goal of ever establishing my own business and being my own boss is going to be a feasible option in a few years when I finish my training.

After reading this article, I was curious what some of the practicing physicians think about this issue.

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[EdibleEgg]

Employment is false security. I'm sure it's easier, but it comes at a price. Private practice may be less common, but it's not going away any time soon.

 

[rachmoninov3]

Like many class of 2011ers, I long thought that I wouldn't want to burden my family further with the extra time and energy it takes to run a private practice, however that view is quickly changing.
First, after speaking with some older physicians who built their own practices and have later been bought by a hospital corporation, they tell me that when it's just you and the patient no matter if insurance or selfpay, you have a responsibility to that patient. As an employee physician, your responsibility is to your boss rather than your patient.
Secondly, with experience as a union CNA, I can tell you that hospital corporations, even if nonprofit, are for profit entities. They often do something to the tune of increasing salary then decreasing staffing. Nursing ratios were often: 8:1 m/s, 6:1 intermediate care/tele, and 3:1 ICU They soon find that they lose nurses, and no surprise this last place was losing MDs and relying heavilly on locums as well. In fact, the word around the university IM residency was that this hospital was a great place to moonlight, but don't you dare sign a contract there. In short, soon physician employees will be no different than nurse employees. Well there are a few differences: no union and you don't have to pay overtime!
Finally your article is very eye opening, and will be something to think about over the next 3 years before I'm in a place to sign a contract!

 

[Sneezing]

'Big box medicine' is one thing vying for the destruction of medicine. Its sad how dyanmics are changing in favor of employeed positions. I for one will not.

 

[PharmaTope]

Like many class of 2011ers, I long thought that I wouldn't want to burden my family further with the extra time and energy it takes to run a private practice, however that view is quickly changing.
First, after speaking with some older physicians who built their own practices and have later been bought by a hospital corporation, they tell me that when it's just you and the patient no matter if insurance or selfpay, you have a responsibility to that patient. As an employee physician, your responsibility is to your boss rather than your patient.
Secondly, with experience as a union CNA, I can tell you that hospital corporations, even if nonprofit, are for profit entities. They often do something to the tune of increasing salary then decreasing staffing. Nursing ratios were often: 8:1 m/s, 6:1 intermediate care/tele, and 3:1 ICU They soon find that they lose nurses, and no surprise this last place was losing MDs and relying heavilly on locums as well. In fact, the word around the university IM residency was that this hospital was a great place to moonlight, but don't you dare sign a contract there. In short, soon physician employees will be no different than nurse employees. Well there are a few differences: no union and you don't have to pay overtime!
Finally your article is very eye opening, and will be something to think about over the next 3 years before I'm in a place to sign a contract!

ya that is VERY SCARY. people keep selling practices off to hospitals. the hospital then has big power and able to recruit more patients with new technology etc. what ends up happening is the ability to have your own practice is gone.