private practice with buy in vs hospital system

[MgoblueNY]

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I am a neurology fellow starting the application process for a job next July. I am very unsure about what direction to go into. Either working for a healthcare system versus private practice and wanted to get some thoughts as it pertains to neurology.

I always saw myself as a private practitioner in the community however with healthcare and all its changes I am not sure if that is the smartest decision. Additionally some private practices have a "buy in." I have heard conflicting opinions about whether a buy in is even reasonable.

Working for a system provides stability and a decent salary but almost no room for growth and you will report to an administrator which bothers me. The private practice is a lot of responsibility in terms of running a business and uncertainty but with that comes independence and hopefully higher income.

The way I see it in private practice in my area of the US (northeast) you make less in your first few years but the goal is to become partner and your income and autonomy increases significantly.

Does it make sense to be the junior in a partnership today when the benefits may not be there tomorrow? Is a partnership "buy in" also something that makes sense? I would be joining a group of neurologists in private practice (options are in the range of 5-10 physicians in a group). Are larger groups more likely to survive?

I guess my biggest concern is will I join a private practice today put in the time and money and ultimately the practice will be forced to be taken over by a healthcare conglomerate and the benefits I worked for wont be there and I will be a employee and probably should have just joined a health system from the beginning.

I appreciate the advice.

 

[bustbones26]

I am a neurology fellow starting the application process for a job next July. I am very unsure about what direction to go into. Either working for a healthcare system versus private practice and wanted to get some thoughts as it pertains to neurology.

I always saw myself as a private practitioner in the community however with healthcare and all its changes I am not sure if that is the smartest decision. Additionally some private practices have a "buy in." I have heard conflicting opinions about whether a buy in is even reasonable.

Working for a system provides stability and a decent salary but almost no room for growth and you will report to an administrator which bothers me. The private practice is a lot of responsibility in terms of running a business and uncertainty but with that comes independence and hopefully higher income.

The way I see it in private practice in my area of the US (northeast) you make less in your first few years but the goal is to become partner and your income and autonomy increases significantly.

Does it make sense to be the junior in a partnership today when the benefits may not be there tomorrow? Is a partnership "buy in" also something that makes sense? I would be joining a group of neurologists in private practice (options are in the range of 5-10 physicians in a group). Are larger groups more likely to survive?

I guess my biggest concern is will I join a private practice today put in the time and money and ultimately the practice will be forced to be taken over by a healthcare conglomerate and the benefits I worked for wont be there and I will be a employee and probably should have just joined a health system from the beginning.

I appreciate the advice.

I've done private practice and worked for the system so I may be able to give you more information. If you do not mind, PM me and we'll talk.