From academia to ownership: The potential career paths of new physicians

Derek Steinbacher, MD, Chief of Craniofacial and Oral Surgery at Yale New Haven (Conn.) Health, joined Becker's to discuss private practice versus employment in the current market. 

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. Derek Steinbacker: An academic and/or institutional setting makes a lot of sense starting out, so long as it is a place that allows you to do the kinds of cases/see the kinds of patients you want to see; and – as a surgeon – enables you to operate frequently and at appropriate volume.  Those reps and exposure is critical early in one’s career. The opportunity to teach on a daily basis also really reinforces your personal perspective. Not all institutional settings can provide this but if you can find it -- this can be the best foray into one’s practice. 

After a period of time, however, you may find yourself looking for new challenges and more autonomy – especially if your reputation starts to outstrip the limitations that exist within institutional settings.   

At that point – especially for direct-to-consumer, sought-after elective care – there is nothing better than setting up one’s own boutique center. This allows complete autonomy and control of the entire patient journey and experience, from initial consultation to healing.  It takes a lot of work, planning and resources to set-up such a practice or center – but if you can do it – this is definitely a sweet spot for patients and for clinicians. To be an owner-operator is ideal – but granted is not as feasible for every specialty.

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