Surviving — and Thriving — in a Changing Practice Landscape

More physicians are currently employed by hospitals or medical practices than ever before, while fewer are in private practice. Since 2000, physicians as a group have shifted from private practice to being employed, according to a 2016 Medscape report. And the rate of employed physicians has grown by more than 30% from 2000 through 2016.

One reason for this shift is that health care reform and declining reimbursements in many specialties have created greater stress and uncertainty for physicians in private practice. Another reason is that many physicians today want to focus on treating patients — rather than jumping through the many hoops that running a medical practice involves. Here are some tips for surviving — and thriving — in the current complex medical world.

Hospital and practice employment strategies

Physicians who work for a hospital or medical practice usually get paid, so they have more financial security. In addition, they obviously don’t have to worry about human resources, billing, collections, rent, overhead and day-to-day operations.

Here are some tips for achieving success in employment:

• Be aware of the tradeoffs and be prepared for them — in other words, know what you’re getting into.
• Conduct due diligence on the hospital or medical group you’re considering and make sure your goals are aligned with the institution’s mission.
• Connect with physicians already employed at the hospital and discuss their work environment.
• Decide if the tradeoff of less control for fewer business and operational responsibilities will work for you.

If any of these issues raise flags, you might want to explore involvement in any of the hospital’s business-related committees (such as compensation) or management-related positions.

Private practice strategies

Physicians in private practice don’t have to abide by policies, procedures and pay set by someone else. They can use the electronic health record systems and practice models they’ve determined are best for them.

If private practice seems a better fit for you, consider these strategies to help ensure success:

• Learn more about good business practices, so you can leverage profits and minimize overhead.
• Explore merging with another practice, partnering or forming an independent physician association (IPA).
• Look into becoming a micropractice (sometimes just a physician with no administrative or clinical support), which could enable you to keep overhead costs down as low as 35%, compared to the more typical 60% at small primary-care practices.
• Investigate developing a concierge practice to cut back on the patient load by having patients pay an additional fee for more individualized services.
• Look for high-impact areas of savings and emphasize best practices in billing and collections.

Reap the rewards

Being a physician is a rewarding career, but all too often the business, regulatory or administrative aspects of it lead to high stress and career burnout. Some physicians thrive in private practice, while others prefer employment. Make an educated decision to ensure you’ll be the best doctor you can be.