Making the practice switch: One doctor became an employee, the other started his own office

Both physicians share their experiences about their paths to a better life and offer tips to others considering a change.

By Karen Caffarini, AMNews staff. July 21, 2008.

Physicians often say: They love their work, just not their practice environment.

The exodus is largely from solo or small practice to large-practice or employed situations, according to surveys such as one released late last year by the Center for Studying Health System Change. Doctors cite long hours spent pushing through towers of paperwork and working for smaller and smaller reimbursements, with less quality time left for patients and even the physicians' own families.

But it's not all one-way. Physicians tired of what they see as the politics and stifling lack of clinical freedom in a large-group or as an employee are breaking away into solo practice or a small group. They argue that the ability to set your own schedule and work under your own terms can allow for more quality time with patients -- and the physicians' own families.

Here are personal stories from two physicians who changed their practice environments.

Internist Timothy Gatewood, MD, left a small private practice in Kokomo, Ind., to become an employed physician for Howard Regional Health, the local hospital system. Robert Jones, MD, a Raleigh, N.C., orthopedist, left an employed position at a large group to open a new practice with two other partners.

Physicians who see themselves in these stories can take some instruction from these experiences, experts say. However, it is crucial for physicians to consider their own motives for changing their practice settings, whether their personality would best fit in an employed or small-practice setting, and whether they -- and their families -- are ready for what can be an arduous adjustment.