This column is part of a series of firsthand physician accounts that detail how AMA Health System Member Programs are moving medicine to support patient health and the medical profession.
Where will I start my career?
I know how heavily that question weighs on residents because I had to answer it for myself a few years ago. It’s a question I revisited recently on an episode of “The Break Room” podcast and has been on my mind since.
After all, so much has led up to this pivotal decision where we can choose to work for a hospital or health system, join a private practice or, for the entrepreneurial type, start your own business.
I remember feeling torn. Having completed my residency at a hospital, that environment was familiar to me. At the same time, I was drawn to the autonomy and deep relationships with patients I’d observed at private practices. I knew at the time—and hindsight has confirmed—that joining a practice was the perfect choice for me and one that more residents should consider.
Freedom in and out of the practice
The autonomy makes it the ideal setting for physicians embarking on their career. First, it offers flexibility. After residency, many are starting families, celebrating their hard work, or studying for board exams. Private practice allows you to adjust your schedule so you can dial in the work-life balance that’s right for you and make time for your priorities outside of the practice.
More than that, you can find and define your style of medicine. Free from red tape and rigid protocols, you can explore and refine the way you work to find what’s best for you and your patients. And since you see the same patients over years, you can build long-term relationships. Those relationships not only allow for more personalized, collaborative care but also for you to see the impact of your care on their lives and adapt accordingly.
And while many residents may worry that a smaller setting could lead to silos or limit their career growth, I’ve found the opposite to be true. Having a tight-knit team and a diverse community of doctors to give me feedback and insights into all components of running practice propelled my career.
The AMA Transitioning to Practice series has guidance and resources on deciding where to practice, negotiating an employment contract, managing work-life balance, and other essential tips about starting in practice.
A community of peers and experts
Continuing my last point, feedback is the greatest gift for early career physicians. Up to this point, we’ve been surrounded by mentors who are passionate about cultivating the next generation of physicians. I think one major reason so many residents opt for traditional employment over private practices is a fear that they’ll lose the community and camaraderie that’s so cherished during our medical education.
I’m happy to report that wasn’t at all the case for me. Not only did I have the feedback from the practice owner—who was one of my supervising physicians during residency—but also a broader group of experienced doctors through Privia Health. I was part of a multispecialty network of physicians eager to share their wisdom and time over a quick curbside.
I also had a dedicated practice consultant to meet with regularly and review metrics into my care and operational efficiency. Those data-driven conversations helped me see areas for improvement and make adjustments while familiarizing me with the business of medicine.
Gaining a holistic understanding of health care
Medical school teaches us all there is to know about caring for patients but nearly nothing about the economic or operational aspects of care delivery. In fact, I believe avoiding this often tedious, time-consuming administrative work is another reason why so many residents shy away from private practice. We want to work at the top of our license by providing excellent care, but care doesn’t exist in a vacuum. The paperwork, processes, and regulations outside the exam room very much influence what happens inside it.
As an employed physician, I was exposed to these parts of the business without the financial risk that comes with ownership or the expectation that I know everything on day one. It also helped tremendously that Privia’s teams handled much of the work around billing, revenue cycle management and technology.
That gave me more bandwidth to learn how patient panels grow, how payors shape care and how staffing decisions affect efficiency and morale. In a way, this mirrored my progression from junior to senior resident, accruing responsibilities over time but with guidance and instruction.
This enabled me to understand the anatomy of a high-performing practice, which not only improved how I care for patients but also equipped me with the knowledge and confidence to start my own practice.
And, after a few years, that’s exactly what I did. I learned the skills I need to run a business, which values would shape my practice, and—perhaps most importantly—that I didn’t have to do this all on my own.
The misconception that private practice forces you to fend for yourself is, I believe, the top reason residents are increasingly drawn to traditional employment. I’m here to tell you that isn’t the case. Private-practice employment out of residency isn’t just an option, it was the perfect choice and steppingstone for me. And I’m sure it is for many others who are standing at the same crossroads I was toward the end of my residency.
It takes astute clinical judgment as well as a commitment to collaboration and solving challenging problems to succeed in independent settings that are often fluid, and the AMA offers the resources and support physicians need to both start and sustain success in private practice.
Find out more about the AMA Private Practice Physicians Section, which seeks to preserve the freedom, independence and integrity of private practice.
Dr. Hammoud is the owner of Elite Gynecology Center, which is a private practice in Northern Virginia that is part of Privia Health. She is a board-certified ob-gyn with a special interest in minimally invasive surgery and hormonal replacement therapy in perimenopause and menopause.
