PERSPECTIVE

Choosing the Right Physician Practice Model

Understanding today’s medical practice models can help in your transition to attending. And finding the right model that aligns with your values is crucial to ensuring that you a fulfilling career in medicine.

But how do you pick the right fit for you?

Published April 05, 2024

Five physician practice models

Below, we delve into the different options available for hospital-based physicians — and how to evaluate them — so you can align your work environment with your goals. For physicians who plan to work in an acute care setting, there are five main practice models to consider.

1. Hospital and health system employment

Many acute care physicians work as W-2 employees of health systems or independent hospitals. This model offers a guaranteed salary, predictable schedules, and benefits provided by the employer. Physician employees can usually focus on practicing medicine while their hospitals tackle administrative tasks.

However, being employed by a hospital can limit independent decision-making, which may lead to conflicts of interest. Generally, there are fewer opportunities to get involved in leadership or care innovation, which can stifle initiative and engagement and lead to a “just here for the paycheck” mentality.

2. Corporate employment

Physicians can also work as employees of corporate management groups and agencies that staff key service lines at different hospitals and clinics. Many of these staffing providers offer the same perks as health system employment, like predictable scheduling and defined benefits.

But in corporate environments, physicians are beholden to shareholders and investors which can put profits before patient needs. Many corporate practices are led by non-physicians who don’t understand the unique demands and ethical obligations facing front-line physicians. In addition, corporate directors may supervise many physicians across multiple practice locations, making it difficult for them to offer time, resources, and support.

3. Private practice

The most well-known avenue physicians can take is opening up their own private practice as a 1099 filer. Working solo or with one or two other physicians provides an almost limitless sense of autonomy and ownership since they are only beholden to themselves and their personal professional goals.

Unfortunately, solo practices mean that the burden of administrative work associated with running a physician practice is placed solely on the physician themself with no outside assistance. This can equate to long hours or less time being able to see patients.

4. Independent contracting

Some physicians choose to work as independent contractors or locums, accepting short-term assignments with hospitals or management companies and are often paid at a premium rate. The independent contractor model provides flexibility and the opportunity to explore various locations and practice models.

5. Physician groups and partnerships

Other physicians opt to take on an ownership stake in an independent physician group. As a part of this practice model, partners have a stronger voice in practice decisions either directly or through elections. Physician partners also have a high degree of autonomy and shared responsibility that incentivizes engagement and innovation, as well as potential financial advantages like profit sharing.

But this model may not be for everyone. Smaller groups may require additional administrative responsibilities. Additionally, some physicians may prefer to focus on clinical care and are less interested in leadership or community impact.

Added benefits of a national physician partnership

Physician ownership, especially in a larger, democratic partnership like Vituity, offers several advantages that can contribute to long-term job satisfaction and success. Some of these benefits include:

Aligned values. As a partner, you have a voice in practice matters and the freedom to make decisions in the best interests of your patients. Ownership encourages engagement, innovation, and a sense of shared responsibility for success.
Long-term stability. 100% physician-owned practices without long-term debt or outside investors are more stable. Without creditors, they can weather financial challenges more effectively. Ownership provides security and protects against sudden contract transitions or bankruptcies that can disrupt your career.
Retirement savings potential. Ownership offers significant tax and retirement saving advantages over salaried employment models. Deductions for expenses like continuing education, health plan premiums, and home office costs are possible within partnerships. These tax advantages, combined with higher contribution limits for retirement plans, allow you to retire earlier and with greater financial security.

Join Our 100% Physician-Owned Partnership

Our physician partners practice medicine without influence or pressure from external investors, private equity or long-term debt.

Finding your practice model

As you examine different physician practice models, evaluating how each one aligns with your values and the support available for your growth and professional development is essential.

For one, it's important to gauge the level of autonomy that you'll have within the practice model you choose and how decision-making works. Determine how much control you want over your practice and whether you are comfortable with top-down directives. If you want to be engaged in decision-making and have a say in practice matters, independent groups and partnerships may be a better fit.
You'll also want to think about work-life balance. Consider your desired work schedule and lifestyle. Employment models may offer predictable schedules, while self-employment allows for greater flexibility and the opportunity to travel or work in multiple locations.
Additionally, your own financial goals can come into play. Assess your long-term financial goals and evaluate the potential for retirement savings within different practice models. Ownership models often provide greater tax advantages and the potential for wealth creation beyond a traditional 401(k).

Transitioning to being an attending is a big step, and you should take the time to evaluate your options. As you navigate the job market, consider the support available within these practice models. Finding an organization that aligns with your values and provides the resources you need can fast-track your career, provide excellent healthcare for your community, and help you achieve your professional and financial goals.

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