Staying Independent vs. Seeking Employment

Choosing to Stay Independent vs. Seeking Employment with a Hospital or Group

Although pediatricians enjoy caring for patients, there is no disputing the fact that a medical practice is a business that must be run efficiently and profitably. Many have traded their independence for steady paychecks from hospitals. The move has wide implications not only for doctors but also for patients’ pocketbooks.
Often, patients don’t realize their physician has become a hospital employee until they get their bill.

When pediatricians are choosing hospital employment, they usually believe that running a medical practice is too difficult to manage. What might be some other considerations hospital employment?

  • Running a pediatric practice is becoming more complicated and many pediatricians are not comfortable with pending healthcare reform.
  • Sometimes pediatricians will join a hospital or health system organization as a means to stabilize salaries, get predictable hours and get relief from administrative work
  • Without the right EHR, the electronic health record (EHR) requirements can drive pediatricians to leave private practice.
  • And, pediatricians starting out may find it too difficult to build a patient base

On the flip-side, being employed has its own limitations:

  • A pediatrician will give up his or her autonomy, needing to accept the chosen EHR, all the policies and procedures and all the pricing
  • The ability to remain proactive and institute change will be greatly diminished

So what are some of the advantages of staying or going independent?

  • One of the biggest advantages is the autonomy pediatricians have over their businesses; there is no hospital policy to follow and change can happen on a dime
  • Flexibility for additional service offerings exist to grow practice revenue and patient base
  • The ability for an appropriate work/life balance exist
  • As a business owner a quality-and-cost-focused pediatrician will be in the best position to negotiate contracts with insurance companies more so than negotiating compensation with employers
  • The ability to learn about all aspects of running a business exists

In an ideal setting, a pediatrician “on the fence” might want to first think about adopting workflow practices that allow for quality time with patients while getting their time back and getting paid.