Career and Life Planning Guidebook for Medical Residents

The reality is that employed physicians and those in private practice face different challenges and risks largely related to reimbursement. A private practice model puts the pressure on physician owners to manage ever-changing rules and requirements and to assume risk associated with commercial and governmental payers. A hospital-employed model shifts most of the risk to the hospital for administrative and regulatory burdens; however, employed physicians can begin to feel like a cog in a wheel merely churning out widgets. Areyou looking for the freedom to own andmanage your own practice? Do youwant closer relationships with your patients and the ability to establish your own culture? Physician-owned practice may offer less value in the initial set of contract years, but may offer more value in the long term. Independently ownedandoperatedpractices canbemoreefficient and nimbler in making decisions. Higher business risk comes with higher reward. Also, you may have opportunities to invest in other areas such as a medical office building, ambulatory surgery center, and other ancillary services that are not available through hospital-owned practices. Recently there have been other market disruptors in the arena of physician employment, such as large investor-backed entities such as DaVita and Optum. These groups may offer ownership interest or equity in their practices that may not be available with not-for-profit hospitals and health systems. Regardless of the practice type, make sure you fully evaluate the practice leadership. Look for practices that are physician led and professionally managed. As the healthcare delivery system is continuing to be reorganized, shared accountability among physicians, hospitals, and payers is critical. Physician-led groups are an integral part of a model of integrated care. A successful practicewill engage its physician leaders in areas of clinical quality, system development, and public policy. SECTION II: T MINUS TWO YEARS CAREER AND LIFE PLANNING GUIDEBOOK FOR MEDICAL RESIDENTS 222