Robert Bailey, MD, had been in private practice for almost 15 years when he was recruited to lead a urology division in the employed physicians group owned by Phoenix Children’s Hospital in Arizona in 2011. Although he might not have entertained the idea a decade earlier, Bailey decided that joining a larger system made sense from both a clinical and financial perspective.
Like Bailey, many physicians see employment with a medical group or hospital as a way to escape the administrative burdens of running a private practice. Surveys show a steady migration away from independent practice as physicians grapple with new delivery models and more complicated billing and coding requirements—on top of the everyday concerns of running a small business (see sidebar, “An Exodus From Private Practice.”)
While moving to a hospital or health system eliminates those burdens, physicians should count on making a few trade-offs, according to their peers and hiring executives. In exchange for more financial security and freedom from paperwork, physicians must accept less control over the way they practice medicine. The key is going in with open eyes, having made a conscious decision to give up some things in exchange for others that are more important to overall job satisfaction.
“Physicians who were partners in a practice and used to making their own decisions face the biggest challenges when they become employees,” says Tommy Bohannon, vice president of sales operations at Merritt Hawkins, a Dallas, Texas-based national healthcare search and consulting firm. “They may no longer have a say in who to hire, what hours the clinic is open, or what hours they work—that’s the biggest adjustment for many.”
Even when physicians are cognizant of those trade-offs, they might underestimate the difficulty of switching from an entrepreneurial to a corporate culture, says Gail Gazelle, MD, a physician career coach and an assistant professor of medicine at Harvard Medical School in Boston, Massachusetts.
“One of my clients thought he had his dream job but he hadn’t thought it through,” says Gazelle. “When he found out how stifling the corporate culture was at his new job, with very little room for creativity or input on how many patients he would see, he was in a state of shock.”