3 Reasons to be in Private Practice

A difficult reality in American healthcare today is the steady decline of the private practice doctors office. According to the Physicians Foundation 2018 Physician Survey only 31.4% of physicians today identify as independent practice owners or partners. This is down from 48.5% reported in 2012.

The reasons for this downward trend are many. For one, federal policymakers have played a big role in providing financial incentives for healthcare consolidation and increasing regulation which threatens to overwhelm private practices. Physicians entering the workforce with a high amount of student loan debt is another contributor. Increasing numbers of young physicians, burdened with debt, are choosing a guaranteed check from the hospital over taking on the additional risk of private practice.

An Optimistic Future for Private Practice

Despite the current downward outlook for the present state of America’s independent doctors, there are still many excellent reasons to be optimistic for a resurgent future. It’s certainly not clear that the trend towards hospital employed physicians is improving the state of healthcare. Costs continue to rise out of proportion with the quality of care.

Frustrations over the state of our healthcare system are being felt by both patients and physicians. Many disagree with the move away from privatization.

Hospital employment of physicians is not the cure all. Just like any free market of business, a physician who has more autonomy will be more productive.

Physician Survey Respondent

Enthusiastic young doctors, especially those with an entrepreneurial spirit, have many reasons to be excited about choosing to pursue an independent career. Higher earning potential, increased freedom and autonomy, and greater focus on patient care are just a few of the many benefits of private practice.

Here are three specific reasons to be in private practice:

1. Higher Earning Potential

The average medical student carries nearly $200,000 of debt upon graduation. Keep in mind, this is just an average. I find many with whom we work have much higher debt. For this reason alone, taking a guaranteed payment as a hospital employee is a very attractive option for someone anxious to relieve their debt burden.

Choosing to be employed over practice ownership means forfeiting the potential for more earnings in the long run. Physicians who practice independently build their wealth and equity in their business over time. It doesn’t happen immediately. It’s not an easy proposition. And, it doesn’t happen without intentional planning.

The bottom line is that an independent physician is motivated by doing what is best for the patient and the economics of the market. They are free to find ways to increase revenue in their service offering, implementing efficiencies, retaining ancillary revenue, and cutting out high administrative costs that are passed downward in a hospital setting, which results in higher pay over a longer period of time.

2. Increased Freedom and Autonomy

The second reason to be in private practice is increased freedom and autonomy.

Loss of clinical autonomy is a major complaint of hospital employed physicians. One physician’s comment from the Physicians Foundation 2018 Physician Survey said:

I am no longer a professional, I am an employee and treated with less respect and consideration than previously.

Physician Survey Respondent

As the owner of a private practice, you have much greater freedom and autonomy than someone who is employed by a hospital. Of course, your business success is dependent on how well you perform, but you always have the flexibility to choose your own hours and the amount of patients you see.

It’s your business, which means you set the rules. You set the office policies. And, you have the opportunity to establish the culture of the office and even how to decorate the hallways. As an independent practitioner, you are the leader that guides your team with the values and culture that you believe is best.

In healthcare today, we can’t compete on price – much of it is fixed.  We can’t really compete on technology because it is easily duplicated. The one thing that we can use is culture, it is our competitive edge.

Quint Studer – Hardwiring Excellence

3. Greater Focus on Patient Care

Physicians are in the business of caring for their patients. Every physician I’ve ever met wants the best outcome for their patients more than anything else. As with all people in healthcare, they wish to feel a part of part of something worthwhile.

Practicing independently allows physicians more freedom to interact with their patients in a way that fosters more engaged conversation and collaboration. Independent physicians are more equipped to develop meaningful relationships with their patients.

This is in contrast to a hospital setting, where most interactions are reduced to rote formulas and prescribe treatments devised by administrators.

Without real human connection, patient health outcomes worsen. A 2014 study by the Commonwealth Fund found that, compared to hospital-owned practices, small private practices have “significantly lower” rates of patients going to the hospital with preventable health problems.

Physicians with a heart for focused patient care will have no difficulty choosing a career in private practice over hospital employment.

A Surprising Phone Call

Last week I received a phone call from a woman searching for a private practice physician. She called because she had learned that I work with independent physicians. Here was an informed patient or “customer” who was looking for the value found in being treated by an Independent Physician.

I was disappointed that I couldn’t find an independent physician that was conveniently located in her town. I provided a client name that I knew would serve her needs well, but she would have to travel 45 minutes to get to their office. She thanked me for the information and said that she would call my client.

After hanging up the phone, I realized that that the value of having an independent physician treat you is making an impact upon the patient – ultimately the one who is paying the bill.

Private practice may no longer be in the majority today, but that doesn’t mean it’s the wrong choice. In fact, many physicians believe and are passionate about it still being the best model for patient care. Evident of my phone call with this patient seeking advice, there are patients out there who have the same belief.