I was wondering how do you find a full-time job that expects fulltime hours to be cool with cutting back those hours as you build your private practice. And when you are working full-time when do you see your private patients and how can you guarantee that you will definitely be available?
Some hospitals are willing to pay for part time work while offering full-time benefits. My current job with the state is, and that's a reason why I work with them despite the mediocre pay. (Among other factors such as great experience). I can cut my hours with the state job so long as I tell them about 2 months ahead of time. They never gave me an exact time period, but I know enough of the hospital operations to know 2 months would be considered kosher in terms of me still maintaining good relations with the administration.
As a physician, where I work, you can still get benefits but the less hours you work, the more the benefits come out of your pocket based on tiers. That said, I pay peanuts IMHO for my full time benefits considering that I'm not full time.
Another thing about my state job is they don't care what time I show up or leave so long as it's on weekdays, I don't show up after 10am and don't leave before 8pm. That leaves a lot of flexibility for my private practice. I could for example leave 8pm one night, then the next day leave 2:30 so I can get to my office.
In my situation, if I were to cut my state hours and expand my office hours, there would be a period of time of a few weeks where I'd probably have to work 5-10 more hours than usual or less as a result of the changes but to me that's fine. I love what I do. If I work more, great, more money. If not, that's just more time off to spend with friends and family.
Mind you that not every hospital in the area will be fine with this. Mine is. In fact if I decided to do PP all the way I'm still thinking of staying with the same hospital because I'd still get benefits as if I'm a full-time employee (pension, healthcare etc). If I did PP 100% I'd have to pay for my own healthcare and that of my wife, no pension, etc. The minimum the hospital will let me work while still getting full-time benefits is 20 hours a week. Fine by me. My plan was to get a few doctors in with me in the PP if I started my own and I know a few that'll do it. That'll more than cover the costs of me not being there all the time, I'd get the best of both worlds.
If you can't find a hospital that'll let you do this type of thing, you might be able to find locum tenens. That'll at least fill up the free time you have while your practice is building.
(Of course if I work for the University, all this is moot. They don't let you work for anyone but them, a reason why all of this is frustrating---too many options and I like all of them).
Also wondering if it's possible to get private malpractice and have a PA work under your liscence after pgy-1?
I wrote this in another thread. It's pretty much illegal (unless the laws have changed) to work while as a resident other than moonlighting, and you have to follow very specific rules with moonlighting. Some of which are 1) you have to be covered by the hospital, 2) you have to have a license to practice, 3) you have to be at least PGY 3 or 4 depending on your state laws.
Even if you could do PP as a resident, trust me, you don't want to do this, and if I were a PD and a resident wanted to do it, I'd strongly discourage them, even consider cutting them from the program. Starting a PP could cost tens of thousands of dollars, could yield no profits for months, and there's a big learning curve. If you have an office manager, you're going to have to pay him/her and their benefits if any. You'll likely not find a manager you feel you can trust on the first try. Only after going through a few and seeing their terrible work will you land the right one. You wouldn't know what to do on a lot of things and this would cut into residency work. You're going to get calls throughout the day from patients and if it were during residency hours, attendings will not be happy. If you made any mistakes, shark lawyers would likely consider targetting your program since you are their employee and still under their training. "So Mr. Program Director, you let your resident practice privately even though he did not yet graduate from the program?"
Also please do not take any offense by my comment, but if you were thinking of doing PP after PGY-1, you're being too bold. You're reminding me of a medstudent that demanded to do a C-section first day of his Ob-Gyn rotation without considering that he pretty much didn't know what he was doing. If you did PP in PGY 2, I garauntee you'll find yourself in a "WTF did I get myself into" situation, aside from the fact that you'd likely not be practicing within the bounds of the law. I wouldn't recommend private practice until one is comfortable with outpatient clinical practice, they feel they can be in charge of employees, and they want the responsibility of having to nurture the thing for at least several years.
Good Luck ! Do what floats yer boat !
