Question: If you were just starting your career as a physician, would you choose employment or private practice? What factors would you consider in your decision?
Editor’s note: This response was edited lightly for brevity and clarity.
Dr. Walter Steigleman:I think employment is likely a better bet for the foreseeable future given current market forces. Large groups and hospital systems have some pricing leverage with insurance companies these days. The smaller practice is just not able to compete, same for personnel issues. In the past few years, all of us have struggled to recruit and retain enough ancillary staff. When these staffing shortages are diluted in a larger practice or medical system, it’s less than ideal but the job can still get done. I have friends/acquaintances in small practice settings where they’ve now been forced to wear many hats including even working up their own patients. Many significant stressors for the small practice these days. Some select folks are thriving in small practices which could be said of any field — be it law, athletics, entertainment, etc. However, I think the majority of folks in small practices are struggling these days and likely will be in the foreseeable future. Changes in reimbursement models and the purported mass exodus of aging physicians in the near future could make private practice of all sizes more financially feasible.
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