Choosing a physician practice area is a big step for any physician, and a particular area of concern for medical residents and fellows. As the healthcare industry continues to evolve beyond the traditional options of solo or group practice and hospital employment, so do the practice options for working physicians.
"Residents are notoriously overworked and reluctant to take time out to plan their future," notes Brian W. Cook, MD, FACEP, writing for the Emergency Medicine Residents' Association. "I can't stress enough though how critical this planning is to your long-term happiness and satisfaction! The time you spend will be repaid many fold."
So how can doctors in training who lack real-world practice setting experience tell what model will be best for them? Locum tenens work can be a great way to get a feel for what type of practice setting best satisfies your personal preferences and professional goals.
"Travel, interviewing, decision making and relocating are all time consuming," as Dr. Cook points out. Luckily, locum tenens work gives new physicians the chance to try all of these aspects of choosing a practice setting, without the burden of making a long-term commitment.
"Most time consuming is the aggravation and stress of making a bad choice and having to start the entire process again," Dr. Cook adds. Again, this is another advantage of locums work, which is customized to eliminate bad choices and let physicians approach practice settings on a trial basis.
Types of Practice Settings
To help determine just what type of practice setting may be right for you, let's take a look at the pros and cons of all the chief types, as defined by the American Medical Association (AMA).
- Solo practice. "While this option offers the most freedom, it also can be the most difficult, as administrative burdens, high startup and overhead costs and unpredictable work hours all fall on your shoulders."
- Group practice. "These settings may offer more predictable work hours and income, but on the other hand ... you may have less of a voice in income distribution, office management and other practice issues."
- Hospitalist practice. "Physicians who want to focus on the medical care of hospitalized patients may find they enjoy the shift-based schedule. However, the shift work can be long, and can result in ... working more nights and weekends [and] limited patient continuity of care."
- Academic medical practice. "This setting offers opportunity for research and being at the cutting edge of knowledge and skills ... [but] the complex leadership and bureaucratic structures ... can be discouraging." Resident duty-hour limits can also be a source of frustration.
- Employment. "Joining a managed care organization, hospital-based specialty, corporate health department, public service or other employed agreement often means income guarantees and set hours ... [but] employed physicians may have little, if any, ownership interest or control over the practice."
"Some hospitals may purchase and manage existing solo or group practices, or may directly hire physicians to work in their inpatient facility or ambulatory clinics," further explains Philip Masters, MD, FACP of the American College of Physicians (ACP).
"Health care corporations may own and run clinics with employed physicians. And some physician-run groups are structured on an employment model, where a group practice is structured more like a corporation that employs clinicians instead of pursuing a more traditional partnership model."
How Locum Work Can Help Physicians Choose a Practice Setting
"Decide first if geography is a prominent concern," advises Dr. Cook. "If you are set on living in a particular area, limit your search there. Don't waste your time or anyone else's interviewing in a locale where you don't want to live." Locum tenens advantage: With locums work, you can find a short-term job in the location of your choice, which can be parlayed into a longer-term role.
"Find out how physicians whose training is similar to yours and who are practicing in similar locations are compensated," Dr. Cook writes. "You can usually negotiate compensation in a comparable range if you take the time to investigate." Locum tenens advantage: Locum tenens work lets you build experience (and, often, your compensation rate) in short-term assignments.
Dr. Cook adds: "You need to compare high, medium, and low volume settings as they match your personal abilities and preferred methods of practicing. The higher volume setting provides more excitement and variety of cases. The low volume setting provides more time for patients and for educating them and their families. [T]ake the time to observe one or more entire shifts in that setting before committing yourself to that environment." Locum tenens advantage: The variety of locum work means you can try all of these types of practice settings on a trial basis before you decide what works best for you.
If you’re a physician or advanced practitioner interested in locum tenens opportunities, you can search available locum tenens jobs here.
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