Private Practice vs Hospital Employed

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    As I exit residency and look for positions I find myself wondering which is best: Private or hospital owned. My impression and experience has been that privately owned practices do require more work, but income is significantly higher and you maintain your freedom as a practitioner. Hospital owned has many incentives, however friends who ran to hospitals years ago are now running back because they are being squeezed by reduced RVUs, higher time requirements and restrictions on practice habits. What I am finding is very confusing. All the websites say ACA changes are geared such that private practices will soon find themselves selling to the hospitals. Some proponents state that hospital procedures will reimburse better versus in office procedures and that new ACA requirements are making it exceedingly difficult for private practices to survive. I am curious what your experiences are and what your input would be for a new physician leaving residency and wanting to make the most of my career.


    I’m not in an office-based specialty, but my impression is that the trend has been away from private practice, and that is mainly because of financial reasons. Hospitals and large groups can get better contracts for the services they provide. There are still people with successful private practices, but it seems that everything has to be in your favor: location with good payor mix, not too much competition, low cost of living, absence of student-loan burden, high-paying specialty, excellent business skills, willingness to work long hours, etc. Then there is the whole question of whether to hire mid-levels so that your practice can see more patients, which is definitely a trend but some people are not comfortable with that.

    Good luck with whatever you decide!


    Private practice is far more better than working with a hospital. You can start a private practice till the time rules change. You will get quite a good experience out of it.


    There is a reason that I do locums. I don’t want a private practice and I don’t want to be under the thumb of some corporate entity telling me to see more patients, etc. I doubt I will ever work for an entity again. Of course the lifestyle is not for everyone but it may be an option for you initially until you decide what you really want.


    private is always best but many are now hospital based which is unfortunate

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