How Did You Choose Between Working in Private Practice vs. for a Hospital?

Deciding where you work requires careful consideration, and you may find that your needs and preferences shift throughout your career.

While hospitals may offer more robust infrastructure and benefits, you may be saddled with administrative tasks and overwhelming bureaucracy. Working in private practice may allow for more flexibility and work-life balance, but also carries financial risk. If you manage your own practice, you'll have to manage the staff and grow the business.

So who is more satisfied at work: physicians in private practice or physicians who work in hospital settings? There's not a clear-cut answer, so join the discussion and let us know what you think.

Employed Physicians: Stability and Support

According to Medscape's Employed Physicians Report, many hospital physicians reported enjoying the stability and support without the additional pressures of running a business. Reported advantages include a stable salary, employer-covered malpractice insurance, and a reported generous work-life balance.

Still, some physicians pointed out the disadvantages:

• Loss of control over business decisions
• Changing business practices without the patient in mind
• Non-physicians making health-related decisions for the sake of the business.

For some physicians, the increased push toward making money at the expense of patient care puts a damper on the advantages of working for a hospital or clinic.

Private Practice: Autonomy and Flexibility

On the other hand, private practice offers a different set of advantages. Fifty percent of doctors in private practice are very satisfied/satisfied with the autonomy of owning the practice. They have control over their schedules and the autonomy to set their own policies. However, maintaining a private practice comes with challenges, such as managing business operations, handling administrative tasks, and navigating financial uncertainties. Despite this, self-employed physicians out-earn their hospital-employed physicians, on average.

Trends in Practice

Between 2012 and 2022, physicians in ownership positions at private practices decreased from 60% to 47%, while positions in hospitals increased from about 6% to about 10%. Economic pressures, such as Medicare payment cuts and rising practice costs, have driven more doctors toward hospital employment.

Finding Work-Life Balance

Work-life balance is a significant factor for physicians when choosing between private practice and hospital employment. Fifty-four percent of physicians would work for less pay in order to have a better work-life balance.

Physician compensation across all practice settings (single specialty group, multi-specialty group, solo practice, etc.) saw annual growth rates exceeding 5% in 2023.

Join the Discussion

• Are you satisfied with your clinical setting? If not, what’s holding you back from practicing in the way you want to?
• What qualities make up a good private practice? For those who are just starting out, what should physicians be aware of when joining a new practice?
• What are red flags and green flags when choosing a hospital to work at?

Share your thoughts in the comments.