Career and Life Planning Guidebook for Medical Residents

Practice type – The type of practice you work in will influence how much compensation you might expect to earn. Typical practice types include: Single specialty Multi-specialty Hospital/health system Rural health clinic Federally Qualified Health Center Academic medical center Locum tenens Different practice types allow for varying status as employed, independent, or partner physicians. Grouppractices, especiallyhospitalgrouppractices, whether single specialty or multi-specialty, are usually better able to accept and manage financial risk than solo practices. This may be advantageous to weather the ups and downs of the healthcare industry and changing administrations. Group practices have other benefits such as more physicians to spread the workload and share the burden of overhead. Ready to hang a shingle and go it alone? A solo practice offers very little scheduling flexibility and fewer resources for managing the administrative tasks associated with running a practice. Hospital-based practices can generate a more predictable income, a regular patient base, and a solid referral network. This can come at the cost of independence and of following policies that you don’t have a hand in creating. Rural health clinics are most often, medically underserved areas and are subject to specific reimbursement as they are funded in part by a government program.Theyaredesigned to increase access to primary care services for patients in rural communities. They are considered the essential source of outpatient care, emergency care, and basic lab services in a rural area. Federally Qualified Health Centers, also government programs, are also known as community health centers. These centers offer more comprehensive services including diagnostic and lab, pharmaceutical, behavioral, oral, primary and specialty care, after- hours care, case management, transportation, and interpretative services. These centers address the care of a population base in rural and urban areas defined as medically underserved areas or Health Professional Shortage Areas (HPSA). Ultimately, physician compensation opportunities in these practice settings will be impacted by a shortage of physician access (theoretically increasing compensation) and financial limitations of the centers (theoretically decreasing compensation). The mission of an academic medical center (AMC) creates a completely different practice environment. Academic physicians tend to be paid less than non-academic counterparts depending on faculty position within the AMC and their relative scope of responsibility within clinical and research departments. AMCs have not traditionally focused on clinical effort across the faculty, however that is changing as economic pressures increase. AMCs tend to separately define and value protected time for administrative, research, and teaching services apart from clinical services. Practice ownership – According to a 2019 report by Avalere Health and the Physicians Advocacy Institute, hospitals and health systems employed 25% of the physicians in the United States in 2012. That figure is up to 44% in 2018 (2). Medical practices continue to be acquired at a significant pace. This consolidation is reshaping the healthcare industry. Physician Compensation 221 WWW.PHYSICIANCAREERPLANNING.COM