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How To Choose A Medical Group Practice: Coping With The Trade-Offs
Whether it is the first group practice or a subsequent decision to move your practice, there are a number of decisions to make. Usually these decisions must be made at a time when you are under considerable stress. Heavy demands by the final year of training, preparation for exams, and responding to the enticements of the many recruiting efforts aimed at you heighten the drain on your time and energy.
The same is true if you are changing your practice. Working hard to keep up with the demands of a practice that has become problematic, while coping with personal and professional strain of moving your family and starting over may seem impossible. However, investing the time to organize your thoughts early in the process will make your life easier.
Analyze the four major factors:
- What do you want in a medical group practice?
- Location, location, location - Where do you want to be?
- $$$ - How much do you want to get paid for it?
- What will you be willing to compromise?
Seldom does a situation have it all. Before committing a time and energy to the interview process, you may wish to make a list of questions concerning each factor. Answering these questions will aid in prioritizing what to look for, as well as what will be your "trade-offs."
Everyone wants the perfect medical practice; thirty minutes to the mountains and skiing, twenty minutes to the ocean with pristine beaches, fabulous income, and of course within two hours each of your in-laws and your parents (close enough to get home on holidays, but far enough that they don’t’ stop by for coffee). Rarely is there a perfect blend of locations, income, and practice.
THE PRACTICE ITSELF
The Group Practice is most often the most important of the three categories because it involves professional training as well as levels of skill, philosophy of practice and your general personality. You should commit to writing your response to each category. You should have a clear answer for each of these questions including now important it is and why.
- Do you prefer solo or some level of group practice?
- What is your practice philosophy; what you will and won’t do for your patients?
- What aspects of practice do you enjoy most and which do you like the least?
- How long and how fast are you willing to work?
- How much routine can you handle?
- How much control will you relinquish?
- What are the demographics and receptivity of the patient population?
- Answer the above question for the medical community.
- Is there a real need for you and your specialty?
Be totally honest with your answers. Ask your spouse or trusted colleague to give feedback on your answers.
LOCATION
Unlike practice or income, locations is basically inalterable, once you have made your choice. Rate each of the following on a scale of one to ten. Ten means it is so important that you can’t compromise, and one means it really doesn’t matter, so long as other factors are satisfactory - then answer why. Again, commit your answers to writing.
- Proximity to family or long time friends
- Climate
- Terrain
- Town size
- Immediate access to recreational facilities (make a list and rate them as above—be honest)
- Cultural activities/facilities
- Special needs such as special schools or religious pursuits
- General type of people in the area
- Familiarity/comfort level with an area
INCOME
Financial considerations include not just direct income, but the formula for how you earn the income, the purchasing power of that income in one location as compared to another, and the value of fringe benefits.
Other factors to consider may be the cost of group membership, salary vs. guarantee, special expenses or costs assigned to you, and special contractual arrangements such as restrictive covenants.
Doing this homework before you begin the process of searching for a practice will help you bring some rationality to it. However, the most difficult part is the fourth category, juggling the complex trade-offs to get the practice that best fits your needs.