Private Practice Doctors Share the Pros and Cons of Self-Employment


11.19.2019

You’ve probably thought about what it will be like to start your career in medicine for years—maybe even decades. Perhaps you picture yourself having a consultation with a first-time patient or performing minor procedures. One thing you may not have considered, though, is the type of practice you’ll eventually choose once you’re done with medical school and residency.

There are numerous models physicians can choose from, including private solo practice, locum tenens, and hospital employment. Many providers used to opt for private practice, but that’s changing. In fact, recent data indicates only 14.8 percent of physicians run a solo operation today. And less than half of physicians are owners in either an individual or group practice.

Just because ownership is dwindling doesn’t mean it’s outdated or unsatisfying. We reached out to some private practice doctors to hear about both the perks and the drawbacks of self-employment. By the end of this article, you may have a better sense of whether private practice would be a good fit for you.

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Advantages to being a private practice doctor

While some physicians start out in a hospital setting, Dr. Lauren Kuwik, internist and pediatrician, knew private practice was right for her by the end of residency. “I rotated through a wonderful practice where things were organized, and I saw a great example of a respectful and caring doctor-patient relationship with a good quality of life,” she explains. “And I was hooked.”

There are a number of reasons physicians like Dr. Kuwik enjoy private practice. Take a look at some of the perks.

You get to be your own boss

Practicing medicine is inherently collaborative, but many physicians don’t think about this when starting out in their careers. This can be a huge mistake for those who decide to seek employment at a hospital or other large organization.

“In an employed situation, the physician has very limited control over who he or she works with and how,” explains Dr. Benjamin Ticho, pediatric ophthalmologist at Ticho Eye Associates. “This can lead to inefficiency, frustration, and personality conflicts.”

This is why Dr. Ticho thinks it’s incredibly important to consider the relationships you can develop with staff should you choose to go into private practice. You have the opportunity to hire individuals who have a similar working style. That can result in a great environment.

“Some of my life’s most rewarding relationships have been the professional day-to-day interactions with staff members,” Dr. Ticho offers.

"Some of my life’s most rewarding relationships have been the professional day-to-day interactions with staff members."

It can be lucrative

There’s no doubt that private practice doctors are required to wear many hats. Being a sole or partial owner means you need to have some business know-how. If you have a knack for this sort of thing, private practice could be a more lucrative choice than employment.

“Private practice equals more autonomy and more pay without an administrator breathing down your neck,” Dr. Kuwik suggests.

Just know that this isn’t a guarantee. You certainly could earn a higher salary in private practice, but there are a number of things to keep in mind. In private practice, you also take on more risk and will likely need to negotiate payment contracts. And it’s essential that physicians who operate their own practice understand resource needs.

Also consider that furthering your business education could increase your odds of success. Some physicians find it helpful to obtain an MBA to make sure they understand everything that goes into developing and running a sustainable health care business.

You may be able to provide better patient care

For many physicians, the potential to provide truly exceptional patient care is one of the biggest advantages of running a private practice. You can help ensure this is the case by hiring the right team. Dr. Ticho mentions that he thinks a common mission of providing excellent care is one of the key elements for running a successful business.

And patients notice the difference. Dr. Kuwik hears positive feedback quite often.

“They like how small everything is and how personal the care is,” she says. “They appreciate knowing that when they call, my staff or partners know who they are.”

"They like how small everything is and how personal the care is."

Drawbacks of being a private practice doctor

As you’ve heard, there are some clear advantages to private practice. But it’s not for everyone. There are a few potential disadvantages you should consider.

You may be more limited in your time off

The amount of free time you’ll have as a working physician will really depend on the nature of your practice. Physicians who work in small groups or partnerships often have a bit more wiggle room than solo practitioners. If you choose to run a practice on your own, though, you might not have as much freedom.

“Solo practice means you are always on call, unless you enter a call-sharing group with other physicians,” Dr. Kuwik says. She also adds you’ll need to find someone to cover for you during extended leaves. And it can be expensive to hire a locum tenens physician while you’re away.

"Solo practice means you are always on call, unless you enter a call-sharing group with other physicians."

You may experience some incredibly busy days in private practice as well. It’s certainly something you should take into consideration if you have, or want to have, a family.

“The private practice physician often spends more time with staff at work than with family at home,” Dr. Ticho explains.

Private practice isn’t always practical

Believe it or not, your specialty can play a big part in determining which practice model is best for you. Primary care lends itself well to private practice. But that isn’t the case for all fields.

“Some specialties like pediatric infectious disease, for example, really depend on a hospital,” Dr. Kuwik explains. This is also true for some surgical specialties.

"Some specialties like pediatric infectious disease, for example, really depend on a hospital."

That said, Dr. Kuwik also points out that some physicians contract with hospitals rather than seeking employment through them.

It can be a lot

While some physicians love working in all aspects of a business, others find it to be a burden. Owning a private practice means you’ll be involved in hiring, financial decisions, facilities management, marketing, and more. If that sounds more stressful than satisfying, private practice probably isn’t for you.

Final considerations

You obviously have a lot to think through when determining whether private practice is right for you. It can be a little overwhelming. Start by simply having conversations with physicians. Dr. Kuwik says residency is a good time to do this.

“Pay attention to where people go for jobs,” she suggests. “Talk with them. Find out what their schedule is like, how much they get paid, what their benefits are, and if they’re happy.”

It also helps to know whether you have a knack for business in the first place.

Shape the career you want

While some private practice doctors love their careers, it’s clear that self-employment isn’t for everyone. If you’re considering going this route, take some time to consider your priorities. You may find the pros outweigh the cons once you do.

Regardless of which type of practice model you think you might want to pursue, you first need to complete your education and training. Securing a residency is a pretty important part of that process. While obtaining strong letters of recommendation and performing well on licensing exams can help, you also need to put your best foot forward during the interview.

Find out how you can stand out as an applicant by reading our article “Experts Share Residency Interview Preparation Tips for Medical Students.”

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