Thriving in Private Practice

Practical steps to reduce burnout and improve joy in private practice

Jul 14, 2022

Feeling overwhelmed in your physician private practice?

AMA Recovery Plan for America’s Physicians

After fighting for physicians during the pandemic, the AMA is taking on the next extraordinary challenge: Renewing the nation’s commitment to physicians. 

Managing the staffing, finances and regulatory compliance obligations amid the ongoing strains of the COVID-19 pandemic can contribute to physician burnout. And doctors in private practice have additional responsibilities that can put them at higher risk than other doctors, according to Christine Sinsky, MD, vice president of professional satisfaction at the AMA. But on the other hand, they also have more control over factors of their own environment, which can offer some protection from burnout.

Dr. Sinsky discussed the growing problem of burnout is a recent episode of the “AMA Thriving in Private Practice” podcast—which is available on Apple Podcasts and countless other podcast apps.

Most physicians face very similar challenges, she said.

“How to manage the volume of work? How to find and retain support staff, and how to train that support staff? How to stay current with the exponential growth of medical knowledge?”

Dr. Sinsky added that “physicians, particularly in smaller private practices, have the additional responsibilities of actually running the business, of dealing with the insurance companies and the regulations and all of those kinds of responsibilities.”

Reducing physician burnout is a critical component of the AMA Recovery Plan for America’s Physicians.

Far too many American physicians experience burnout. That's why the AMA develops resources that prioritize well-being and highlight workflow changes so physicians can focus on what matters—patient care.

There are three categories of pressure that can generate burnout: organizational culture, practice efficiency, and organizational support for individual self-care.

“Those drivers will have different flavors in a private practice setting versus in an employed setting. For example, in small practices, each physician has a greater influence over the culture of the practice,” she noted.

“That's an advantage that private practices have—they can help to create the culture among their fellow physicians and among their staff that aligns with their own values, whether that be the value of growing the practice or serving a particular patient population, or being financially stable. In a small, physician-owned practice you can have greater influence on culture,” Dr. Sinsky said.

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.

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Physicians in private practice also have more control over workflow and information flow and so can “set up really strong models of team-based care,” Dr. Sinsky said. “Private practice physicians may feel an extra financial burden and feel like they're taking a greater financial risk in terms of building up advanced models of team-based care and having a stronger team, but being accountable for practice costs gives physicians freedom to make choices, and these physicians will ultimately reap the financial rewards of this more efficient model.”

For example, “I wanted to hire an extra nurse to be part of our practice. I was really glad that I did, because the increased productivity that resulted more than made up for the additional cost of that nurse. Even if it had been neutral, or even a little cost-negative, however, the improvement in the quality of my life and the improvement in the quality of care I felt we gave to our patients would have been worth it,” she said. “Small practices have the additional financial stress of being responsible for the bottom line, but also have the additional agency to make those decisions for themselves.”

Access key steps, best practices and resources with the “AMA STEPS Forward® Private Practice Playbook” (PDF).

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Change some key workflows to save time, cut doctor burnout

“You have to invest time to save time. If you invest two hours on a given day to determine how to save 10 minutes every day for the rest of the year, and year after year—that's going to pay off big dividends,” Dr. Sinsky said.

Attitude is also a factor.

“Burnout is infectious, and it is inverse to professional fulfillment. Finding joy in work that we do, that also is infectious. When physicians are able to connect with the meaning and purpose of their work and bring the staff into that connection with the meaning and purpose, we all benefit. In the end then, of course,. our patients benefit from that,” she said.

Find out more about the AMA Private Practice Physicians Section, which seeks to preserve the freedom, independence and integrity of private practice.

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