A first-hand account of the pros and cons of hospital employment

Virginia pediatrician Rebecca R. Fox, M.D., knows firsthand the pros and cons of working as a hospital-employed physician.

As the healthcare industry once again sees a cycle in which hospitals acquire physician practices, “make sure you know the positives and negatives associated with being independent or part of a large organization,” Fox writes in Diagnostic Imaging. But if you are unhappy with your choice, “remember, you can always change how you practice medicine,” she adds.

In her 23 years as a pediatrician, Fox has ridden the wave and seen the practice of medicine from both sides. She started her career in 1993 when she joined a private practice owned by a single physician. But the doctor sold his practice to a local hospital three years later. The hospital continued to buy up profitable practices but after less than four years they were running in the red. The administration decided not to renew the contracts of its doctors so they were free to resume private practice. Fox did.

The negatives of being a hospital employee are that doctors are no longer in charge of their own practice and become a “cog in the wheel,” she says.

But there are also positives. For instance, she notes that hospital-employed doctors don’t need to take out loans to cover practice expenses until they become profitable and are likely to have a good benefit package. Doctors can also concentrate on their patients rather than management responsibilities, she says.