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For Physicians – Understanding Employment Models

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As a physician, you will be overwhelmed with offers of employment. As we all know, there are more practice opportunities than physicians available to fill them. You will hear about many different options, but most choices can be divided into three major employment models; solo practice, partnership and employment with each having their own pros and cons. The most important initial choice to make is whether to go on your own or join a group.

Three difference of Solo vs. group:

  • Money
  • Time
  • Personal Values / Way of Life

Solo Practice

  • physician makes it theirs.


Small business ownership with all of the benefits of being the boss.

  • The physician is the entrepreneur.
  • Independence – the physician is the decision maker – freedom to operate every aspect of the business.
  • Whatever money the physician makes is theirs


  • The headaches of being the boss and running the business aspects of a practice. Doing everything.
  • Success of a new start up is dependent on your ability to run and manage your own business.
  • The opportunity can be backed by a hospital provided income guarantee, or funded through a bank.
  • Income Guarantees: Hospitals often provide assistance in the form of start up money and monthly income. Some are loans to be repaid while others are forgiven over a period of time.
  • Time – long weekend and evening hours.
  • Lack of coverage for emergencies.
  • Lag time for billing
  • Reimbursement rates – not always as high as they are for members of a group


  • Private practice partnerships vary in size and in arrangement.


Business ownership with all of the benefits of being the boss plus benefits of sharing overhead costs with multiple partners.

  • Increased financial security and controlled lifestyle.


  • The headaches of being the boss and running the business aspects of a practice. Less “say” in how things are run prior to becoming a partner.
  • Get the terms of partnership in writing!
  • Time and costs to partnership will vary.
  • Make sure to get to know your new colleagues before you sign a contract to join them.


The prevailing trend today is towards employment, either as a hospital employee or in a multi-specialty practice due to the following:


  • Declining physician incomes Defined salary and comprehensive benefits
  • Changing physician demographics.
  • Looming physician shortages.
  • Increasing acceptance by hospitals and physicians
  • Physician-hospital alignment.
  • Shared Call.
  • No worries about the business end of the practice – Shared management decisions and problems
  • Equal treatment of all employed physicians
  • A ready source of income.


Bureaucracy is inherent in large organizations. Less or little “say” in how things are run.

  • Others will have a say in the way the practice is run. More bureaucratic and policy driven.

The physician needs to make sure the hospital is financially sound and unlikely to go bankrupt or acquired by another entity.

Bottom Line

Understanding the different employment models will help you to make the most educated decision about your career choices. Weigh the pro’s and con’s of all of your options and understand the details of your contract.

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