Finding your niche
Presenter Aaron Broadwell, MD, a rheumatologist in a private specialty practice of five physicians and five advanced practice providers in Shreveport, La., discussed the prospects for a career in private practice at the Fellows Conference. Private practice is not dead as a career choice, he observed, “despite what I continue to hear.” Data show that 70% of rheumatologists currently are in employed positions, but he sees signs of a movement back toward private practice.
Other basic career paths outlined by Dr. Broadwell include:
- Academic medicine, which offers opportunities to teach future physicians (although it’s also possible for rheumatologists practicing outside of academia to teach as well).
- Hospital employment, which has a higher starting salary but also a greater emphasis on RVUs (relative value units) and productivity, with less job security than it used to enjoy.
- Military/Veterans Administration positions, which may have antiquated office systems and salary caps.
- Other paths, including corporate medical director positions with pharmaceutical companies and insurance companies.
Newer options include concierge and direct specialty care models where physician-operated practices partner with their patients to provide specialty care services under a flat or periodic membership fee, and joining one of the large, multistate, rheumatology care management groups like United Rheumatology, LLC, and American Arthritis and Rheumatology Associates.
Private practice medical groups are both single specialty and multispecialty, both large and small – as well as solo rheumatology practices, Dr. Broadwell said. “People launch solo private practices all the time. It is good for some doctors. It has the highest risk and the highest potential reward.”
Becoming profitable in solo practice may take a year or two, while the doctor remains responsible 24/7, including the need to arrange for vacation and sick leave coverage. Solo practitioners need to be up to date on billing, coding, revenue cycles, bundled payments and the like, and eventually need to hire and supervise a team the doctor can trust.
What can young rheumatologists do to learn more of the nuances of these approaches? Dr. Broadwell recommended joining their state rheumatology society as well as the American College of Rheumatology. “The National Organization of Rheumatology Management is a phenomenal source of information, not just for your office manager but also for you,” he said. He also recommended linking up with colleagues through social media outlets such as the Rheumatology Private Practice Group on Facebook.
No relevant financial relationships were reported by the conference speakers.
A version of this article originally appeared on Medscape.com.